July 2001

From Women's and Children's Hospital, Adelaide

World-first program to manage autistic children during medical procedures

Between two and five of every 10,000 children are diagnosed with autism. Boys are affected more commonly than girls.

These children have an impaired ability to communicate and relate to adults and other children. Characteristically they have fixed routines in their every day life. Any change in their routine can be very distressing and coming to hospital may cause panic attacks or temper tantrums, which are extremely difficult to manage.

The Women’s and Children’s Hospital, Adealide, South Australia has developed a unique management program to help autistic children, their parents and staff cope with this distressful behaviour when they need an anaesthetic for an operation.

Head of anaesthesia at the hospital, Dr Johan van der Walt said the program acknowledges the wealth of knowledge parents have of this condition and their child’s special needs and enables them to have considerable input in the forward planning of medical procedures for their child.

Our program has been developed over the past four years and has turned hospital attendance from being a major ordeal into a manageable experience.

We have developed systems to identify in advance that an autistic child is scheduled to have a procedure under anaesthetic, and we immediately contact the parents to plan the child’s admission.

We discuss the severity of the autism, the child’s likes, dislikes, phobias, special needs and parent’s useful distraction techniques – this allows us to plan an individualised admission and discharge procedure for the child, Dr van der Walt said.

Features of the program, published this week in the prestigious international journal Paediatric Anaesthesia include:

 Admission to a special quiet room just before theatre is scheduled. All admission details are processed in advance to facilitate this.

 Giving a sedative orally in the child’s favourite drink. This generally avoids having to restrain the child in any way. Parents are often asked to drink an identical but non-medicated drink.

 Avoidance of stress on waking by routinely giving intravenous fluids to the sleeping child rather than waiting to see if these are necessary after waking.

 Avoidance of the stress of possible post operative vomiting by routinely giving anti-vomiting medication to the sleeping child.

 Allowing the child to waken in the parent’s presence and plan for early return to their familiar home environment on the same day.

 When children are kept in hospital overnight they are accommodated away from other patients in a side room.

"Families with autistic children are significantly disadvantaged if hospital staff do not understand their special needs which is why our unique approach has been recognised as a major advance", Dr van der Walt added.

"Not only are parents reassured by our program, but our staff have been given confidence in the management of these children".

The program has been successfully extended to the management of children with other behavioural problems.

To arrange interviews please contact:
Dr Edna Bates
Manager, Research Communications
 618-8161-7388
email: batese@wch.sa.gov.au

or

Ms Chris Ostermann
 mobile 0401-125-630(after hours)
ostermannc@wch.sa.gov.au
Women’s and Children’s Hospital
http://www.wch.sa.gov.au












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