Date Presented 04/23/2023

Rural emergency departments lack resources and staff education to support the diverse sensory needs of autistic children. This project utilized a stakeholder collaboration approach to create a multifaceted tool kit to support their unique needs.

Primary Author and Speaker: Sabrina Kabakov

Additional Authors and Speakers: Allison Caudill, Alyssa Smith, Alana Woolley, Karla Ausderau

Contributing Authors: Rose Cutting

PURPOSE: Sensory processing difficulties are a core characteristic of autism spectrum disorder (ASD) limiting access to public spaces and services including emergency departments (ED). Autistic children in rural communities are twice as likely to visit the ED and are willing to travel to urban environments to get appropriate care. Rural EDs lack staff education and environmental modifications that facilitate a positive experience and receiving quality care. The purpose of this project was to use a stakeholder-collaboration approach to create education materials, environmental modifications, and integrate sensory regulation support to accommodate autistic children in ED settings.

DESIGN: This study utilized a community-based participatory research approach to develop and implement a multifaceted ED toolkit.

METHOD: The Person-Environment-Occupation-Participation (PEOP) model was adapted to understand ways to better facilitate care in the ED. A diverse stakeholder team was created consisting of researchers, parents, community partners, healthcare providers, and staff to provide feedback and recommendations throughout the process. To better understand the needs of the community, a literature review, site visit, and interviews were conducted to create a multifaceted toolkit.

RESULTS: An Emergency Department Sensory Support and Accessibility Toolkit was created, which included educational materials, environmental adaptation resources, and sensory-friendly tools.

CONCLUSION: The ED toolkit has been successfully implemented in the collaborating ED departments improving care and access for autistic children and families. The creation of the ED toolkit will increase accessibility to care in rural EDs and support healthcare for autistic children. Occupational therapists play a critical role as stakeholders in the ED to facilitate the creation of a supportive environment for autistic children and families to receive appropriate care in rural areas.


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Probst, J. C., Barker, J. C., Enders, A., & Gardiner, P. (2018). Current State of Child Health in Rural America: How Context Shapes Children’s Health. The Journal of Rural Health, 34, s3–s12.