Preventing A Rescue From Being A Tragedy

New program trains safety workers how to respond to autistic children

By Clare Leschin-Hoar, Globe Correspondent | March 12, 2006
Source: The Boston Globe

Captain James Hagerty of the Franklin Fire Department was expecting to find a teenager on drugs when he responded to a call from a local video store last May. The girl inside, the manager reported, was speaking and acting erratically—talking to the videos, flapping her hands.

‘’Naturally, drugs is what comes to your mind,” said Hagerty. ‘’But something about her mannerism didn’t go with drugs. Her hand motions were rapid, and she was repetitive in her vocabulary. It didn’t quite fit the profile of someone under the influence.”

That’s when it dawned on Hagerty—the girl was exhibiting traits of someone who is autistic. Immediately, he changed his approach, recalling training he had recently received on dealing with children with autism.

The 20-year firefighting veteran took a few steps back, adopting a more soothing tone. He gave the girl time to answer his questions, building a rapport. It turned out she had wandered away from her home, and Hagerty was able to reunite her with her anxious family.

The training that helped Hagerty defuse the situation will soon be more widely available. At a time when more children are being diagnosed with autism, the Autism Spectrum Division of the state Department of Mental Retardation is launching an effort to train emergency workers on how to recognize and deal with it.

The agency is working closely on the project with a variety of groups, including the Autism Alliance of MetroWest, the Norfolk district attorney’s office, and the Central Massachusetts Autism Resource Center.

‘’Families indicated that this was high on their priority list. They have real fear—and stories—about when it doesn’t go right. Families just want to be reassured that their community [emergency workers] are trained,” said Cariann Harsh, senior project manager at the Autism Spectrum Division.

Autism spectrum disorders are a group of developmental disabilities that begin in childhood and extend through life. People affected often have problems with social and communications skills. Many also have unusual ways of paying attention, reacting to sensations, and learning, according to the federal Centers for Disease Control.

The number of children diagnosed with the disorder has been on the rise. The CDC estimates that 1 out of 166 children nationwide are affected. That means that a child with the disorder can be found in nearly every school and neighborhood and that emergency personnel are more likely to encounter an autistic child than ever before.

State officials estimate there are between 10,000 and 12,000 Massachusetts children between the ages of 3 and 18 who have the disorder.

The need for different tactics in dealing with autistic children was highlighted for advocates and for public safety personnel in August 2004, when an autistic child in Millis wandered away from his home and was missing for four days. Searchers had to alter their standard methods to locate the boy, because he had an aversion to loud noises, such as those made by helicopters and dogs.

‘’The Millis incident definitely brought it forward as a wake-up call to first responders. Very much so,” said Captain John McLean of the Sharon Fire Department, who trains firefighters to deal with autistic children.

Westwood fire Lieutenant William Cannata, the state coordinator for the $50,000 training project and the parent of an autistic child, said it is a potentially volatile situation when emergency personnel race to a scene, adrenaline pumping, and are confronted with an autistic child’s unusual behavior.

‘’Absolutely, and this is where the training is really important,” said Cannata ‘’If the first responder can recognize someone with autism before they act—to recognize on approach—then they can act in an appropriate manner. People with autism are often mistaken for people on drugs or under the influence of alcohol.”

For the past three years, Nannette Ohman, executive director of the Framingham-based Autism Alliance, has been training emergency personnel in a number of local communities, including Millis, Medway, Framingham, Natick, Holliston, Hopkinton, and Wellesley. The state has adopted Ohman’s training course for use statewide.

Ohman said one basic thing emergency workers need to know is that people with autism are often averse to loud sounds and bright colors such as those associated with police cars, firetrucks, and ambulances.

Ohman teaches emergency workers to eliminate the use of sirens or helicopters, to approach an autistic child individually, and to remove large hats, such as the helmets firefighters wear, that might frighten the children. Don’t touch around the head and shoulder area, and listen for echolalia—a child’s involuntary repetition of words that is often a sign of autism, Ohman advised.

‘’Wait and give them extra time to respond when speaking to them. Ask questions. The dialogue should be open-ended so they can fill in the blanks, such as ‘Your name is. . ..’ instead of ‘What’s your name?’ ” said Ohman.

McLean said that ‘’sometimes the comprehension just isn’t there, and you have to rephrase. You start out with ‘What’s your name?’ and then ‘Can you tell me your name?’ ‘Can you write your name?’ And we have to allow extra time for them to process our questions and then respond to them.”

Ohman’s work resonated with parent Allison Daigle of Framingham, whose son Justin participated in a training video Ohman has developed for emergency workers.

In the video, Justin illustrates how difficult it can be for an official to gather basic information from an autistic child, such as a phone number or an address.

‘’It’s really tough for Justin, and that was a no-distraction environment. If we sat down and did the same thing today, I’m not sure he could do it. It’s still a struggle for us,” said Daigle. ‘’He doesn’t understand the full ramifications of an emergency situation if he had to go in an ambulance or if there was a fire.”

Cannata said the response from rescue workers has been very positive.

‘’Nationwide, we’re seeing many incidents, and we’re being proactive in getting the training to our first responders, so we all have a heads up before something happens,” said Cannata.

Cannata estimates that 1,100 police, firefighters, and EMTs have been trained in Massachusetts, but he said that’s barely scratching the surface.

Recently, the Massachusetts Firefighting Academy began incorporating the training for every new recruit. Cannata said efforts are underway to spread the training, which typically lasts two to four hours, to other emergency workers across the estate.

‘’We’ve been told by people at the national level that we’re at the forefront, and are leading the way. . . . Massachusetts is one of the most proactive areas in the country on this training,” said Cannata.
© Copyright 2006 Globe Newspaper Company.

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