Today's guest bloggers are Jackie Rosen, CCLS and Laura Cadge, CCLS, CTRS, child life specialists at Children's Hospital of Philadelphia.

Going to the emergency room can be stressful for any family. Not only are families experiencing an unexpected illness or injury, but the ER is an unstructured environment where there can be loud noises, lots of people, and bright lights. While this environment can be stressful for all children, it can be particularly stressful for a child with autism. The following information will help you, as the caregiver, feel more equipped to navigate an ER visit and advocate for your child's individualized needs:

1. Make a list of materials for your child that are essential for maintaining routines, providing sensory experiences, or have helped your child cope through difficult experiences in the past such as various textured items, bubbles, squishy balls, chewy tubes, light spinners and music.  If it's not possible to bring these items when going to an ER, ask staff if they have any resources that would provide a similar experience for your child. Some materials in the hospital are adaptable; for example, a lead vest worn during an x-ray can also provide the same sensory experience as a weighted vest.

2. It's helpful for staff to know which stressful triggers or motivators are most helpful for your child so they can provide the best care. Of the behaviors that your child is exhibiting in the ER, communicating which are due to increased stress or pain versus your child's typical form of self-soothing or stimming will be helpful for staff to know as well.

3. If bright lights are a trigger for your child, ask a staff member if the lights in the room can be dimmed whenever they're not needed for a medical exam or procedure.

4. When staff are in the room, advocating for as few quiet voices at a time is helpful in decreasing stimulation and allowing your child to hear the your voice.  Other sounds that may cause your child to have an adverse reaction are important to communicate as well.

5. Inform staff about how to best communicate or interact with your child such as verbal, communication boards, sign language, purposeful sounds or movements.

6. You are not "in the way" during an exam or a procedure. As your child's caregiver, remaining bedside will likely be beneficial to the child during any new experience or procedure. While at bedside, you can implement any or all coping mechanisms listed previously, including hearing a caregiver's voice, or helping to facilitate the use of items brought from home to minimize stress or anxiety for your child.

Feeling empowered to communicate and collaborate with the medical team will allow them the opportunity to provide the best care possible for your child.  As your child's caregiver, advocating in an ER whenever possible will help to decrease any potential stress for your child and your family as a whole.

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