Urgent care is often the first line of defense for a family with someone on the autism spectrum when unplanned medical treatment is necessary.
Parents understand just how frustrating it can be for their child to receive proper medical attention from a professional who fully understands Autism Spectrum Disorder (ASD).
Hypersensitivity to Touch- A Challenge for Provider and Patient
The experience of a 14-year-old autistic boy who visited an urgent care facility with his parents after being stung by a bee demonstrates how many visits to urgent care centers go for those on the spectrum.
The patient is described as “non-verbal and hypersensitive to touch”. The parents note that they think he is experiencing respiratory distress due to the fact that he is drooling more than normal. The patient still experiences anxiety as he is led from the waiting area into the examination room, however his anxiety levels would most likely be much higher in a loud, busy ER waiting room that typically consists of many more people and longer wait times. He begins to increase his repetitive movements and rocking along with loud scripting. As the parents step in to soothe their son, the staff falls back to assess the situation.
In these situations, the caretaker is an important part of understanding what is going on with the child, as there is no way for the provider to what what ‘normal’ behavior looks like for this child. That is one of the most important things for healthcare providers to understand that is often overlooked when treating people with autism.
Autism is a Spectrum, and Treatment needs to be a Spectrum as Well
The above occurrence is just one way an autistic individual can react to an urgent care or emergency room (ER) setting. However, there are benefits to visiting an urgent care center rather than the ER when treating non-life threatening injuries and illnesses for those with ASD.
It is also common that an autistic child might not demonstrate characteristics of the disorder until things become more serious, to the point where it’s too intense for a typical doctor’s appointment. This can also happen after hours either because the child is struggling to communicate with their caretaker or the caretaker might not notice right away that something is wrong. This is when a parent is faced with the important decision of taking their child to urgent care or the ED/ER.
The Complexities of Autism Require Understanding for Effective Care
Autism is a complex disorder that looks different for each person affected and depending on the day. There is a common saying within the autism community to help explain the specialized nature of the disorder: “If you’ve met one person with autism, you’ve met one person with autism.”
When seeking care, parents must be weary of non-specialist providers simply because their limited knowledge of ASD can negatively impact the quality of care for autistic patients who have acute medical conditions. Unless a medical professional is specifically trained in autism, it can be very difficult for them to understand how to work with the disorder and what to look for.
Every patient with autism will possess a different set of characteristics that require a higher level of care and understanding. The ASD population is only growing and it is becoming essential that healthcare professionals in the urgent care setting understand how to provide effective treatment.
ASD is defined as a “neurodevelopmental condition with difficulties in social interaction, verbal and non-verbal communication, and repetitive behaviors.” According to The Journal of Urgent Care Medicine, ASD consists of five developmental disorders that encompass these characteristics:
- Classic Autism: Shows up before age four, involves poor eye contact, delay in language, social deficits, resistance to change, prone to seizures.
- Asperger Syndrome: Deficits in speech and communication, stereotype behaviors, expansive memories, extreme interest in a particular subject, development of normal language and cognition
- Rett Syndrome (present only for females): Developmental regression after six months of age, microcephaly, loss of motor skills
- Childhood Disintegrative Disorder: Developmental regression after age three years of age, severe functional impairment, loss of social and language skills
- Pervasive Developmental Disorder: Impairment in social interaction, communication, or repetitive stereotype behavior (essentially a less intense form of autism)
Why Urgent Cares are the First Choice for Less Serious Issues
A study conducted in 2015 showed that participants deemed the ED and the way it delivered care as insufficient when it comes to meeting the unique needs of children with ASD.
There are many reasons that urgent care is preferred over the ED for less serious problems or injuries.
The wait time at an urgent care center is usually significantly less when compared to that of an ED. Typically the wait time at urgent care is less than an hour and 80 percent of patients only have to wait for 15 minutes. Compare this to EDs where the average wait time is more than 90 minutes before the patient is taken to a room for initial assessment and over two hours before most patients are discharged.
It’s reported that patients with broken bones have to wait almost one hour before simply receiving pain medication at the ED. The number of people leaving the ER before even being seen has also doubled recently.
Less waiting means less time parents have to manage their child’s anxiety and stress in a public waiting room, which can be very uncomfortable. Parents of children with autism also often feel that ED staff members don’t quite understand them, especially when they try to show them how to interact with their child. This can increase the child’s stress along with the parent’s.
Less People Helps Avoid Sensory Overload
Another benefit to urgent care is that there are far less people in the waiting room than at the ER. The fewer people there are, the less sensory stimulation the child with autism has to endure. Less people also typically means the environment is generally calmer with less noise and general chaos. The unpredictability of the waiting room at the ED is overwhelming for those on the spectrum.
Andrea Greenblatt, research coordinator at the Hospital for Sick Children in Toronto, “a visit to a hospital emergency department can be scary for anyone – but especially for a child who has autism. We know that many people with autism are more sensitive to noises, bright lights and odors. Many are likewise uncomfortable with new environments and unfamiliar people – all pretty standard in an emergency department.”
Less Medical Staff to Interact with
Seeing many unfamiliar faces and hearing strange voices is a quick way to invoke anxiety and panic within someone who is on the spectrum, but by receiving treatment at an urgent care center this can be minimized or avoided. Urgent care also usually has less medical staff in the examination room during treatment, which means the autistic patient is interacting with fewer strangers.
Urgent care centers are also much smaller than EDs not only meaning they can hold less people, but everything is in closer proximity. The walk to the exam room from the waiting area is shorter, involves running into less people, and in general is less chaotic.
Convenience is another great benefit to urgent care. Nowadays patients have the option to walk right into urgent care or check-in online and even check wait times from home or at work. This could potentially remove the need to wait in a waiting area altogether.
One of the greatest reasons parents who have autistic children visit urgent care is due to the low cost. While trips to the ED can cost an average of $1,900 for outpatient visits and $13,198 for admitted patients, urgent care is far less expensive. Urgent care centers also only provide one bill so there is no additional billing from external companies, which can feel frustrating and misleading.
Increase Customer Retention by Becoming Autism Certified
While urgent care is preferred by many parents who have children on the spectrum, there is still room for these facilities to improve their patient care and position themselves as an expert and leader in autism.
Becoming autism certified is an efficient way to ensure urgent care staff is equipped with the knowledge and expertise they need to treat patients on the spectrum with high-quality care.
Elizabeth Mangone and John Shufeldt, from The Journal of Urgent Care Medicine, comment, “Adjustments to the typical urgent care protocol are required to treat an autistic patient. Assessing the source and level of pain is delayed by the need to first determine where the patient falls on the autism spectrum. Awareness of autism signs and behaviors aids physicians and urgent care staff in diagnosing and treating a patient’s acute illness, independent of the developmental disorder.”
Familiarity with Autism is Important for Effective Treatment
It is important for medical professionals to possess awareness of autism signs and behaviors because this allows them to properly diagnose and treat a patient’s acute illness, independent of the developmental disorder. For example, parents often hesitate when deciding to disclose their child’s autism diagnosis because they are worried that the healthcare clinician will focus solely on that rather than the reason the child is seeking medical attention.
The most important thing medical professionals can do in order to treat acute illnesses in patients with autism, is to learn more about the disorder and make necessary accommodations for these patients.
“A lot of adults with autism feel lost,” says Lisa Croen, director of the Autism Research Program at Kaiser Permanente, a managed healthcare provider based in California. “It’d be great if physicians had some more general training and awareness. Just like with any other condition, they really have to take into account that particular person in their office and adjust what they’re doing to meet the needs of that patient.”
An autism certification prepares urgent care staff to care for individuals on the spectrum at far greater capacity than those currently providing care at the ED. The certification also communicates to parents who have autistic children that the urgent care center is credible, trustworthy, and prepared to help their child.
Becoming certified allows urgent care centers to stand out and makes the choice for parents between urgent care or the ED an easy one. When parents know that their urgent care center is knowledgeable and capable of caring for their child, they will return when their child is in need.
Improve care and treatment, increase staff’s knowledge and expertise, and boost patient loyalty and retention.
Learn More About Becoming a Certified Autism Center™