Faculty Bibliography

Objectives: Youth with ASD experience complex psychiatric symptoms and medical comorbidities that often lead them and their families to seek care in the emergency department (ED). Yet EDs, including both general medical and pediatric EDs and psychiatric-specific emergency settings, are often poorly equipped to care for youth with autism. Enhanced interdisciplinary collaboration, use of care pathways to address communication and sensory needs, and more comprehensive evaluation can improve both the patient's experience in the ED and the quality of care received. Methods: Speakers will present the following three models for improving collaborative, interdisciplinary care for youth with ASD in different emergency settings: 1) a regional program to improve care for youth with ASD in a network of general hospital EDs; 2) an autism care pathway in a pediatric ED setting; and 3) an autism care pathway in a psychiatric ED setting. Finally, financial and administrative barriers to enhanced care for youth with autism in the ED will be discussed, along with the ways that these barriers can be addressed on an individual institution level and policy level. Results: Participants will gain exposure to models of enhanced care for youth with autism and strategies to implement such models of care. Conclusions: Given the rising prevalence of ASD, improving care for patients with ASD in our EDs is critical. Child psychiatrists can lead efforts to improve care to make a meaningful impact on the ED experience of youth with autism

Objectives: Most staff in a psychiatric emergency service, even CAPs, have little experience with the emergency evaluation, crisis management, and behavioral treatment of patients with autism. This presentation will teach participants about the evaluation and behavioral management of patients with autism in a child/adolescent psychiatric emergency setting through staff training to improve care for these patients. Methods: This presentation will cover autism-specific evaluation strategies and tools geared to a psychiatric emergency setting for children and adolescents. This evaluation, as well as behavioral interventions and staff trainings, part of a larger Autism Clinical Care Pathway, will be described in depth. Results: Knowledge of specific evaluation concepts and strategies can be extremely useful in a child/adolescent psychiatric emergency setting, both in terms of acquiring a better understanding of patients' immediate treatment needs and strategies for behaviorally managing this population. Multidisciplinary staff training on the basics of autism, behavioral management, and staff collaboration is an important part of promoting improved care for youth with autism in a psychiatric emergency service setting. Conclusions: Given the difficulties managing patients with autism in an emergency setting, specific evaluation procedures and behavioral interventions can be beneficial. Moreover, this information can be conveyed through staff training in a way that is feasible and promotes safety

Children with mental health problems are increasingly being evaluated and treated in pediatric clinical settings. This article focuses on the epidemiology, evaluation, and management of the 2 most common pediatric mental health emergencies, suicidal and homicidal/aggressive patients, as well as the equally challenging population of children with autism or other developmental disabilities.