Child with ASD in the Emergency Department: A Critical Integrative Literature Review of ASD Child and Family Experience

Abstract

Background: The Emergency Department (ED) serves as a crucial space for urgent medical care, grappling with challenges like overcrowding, extended waiting times, and communication barriers, affecting both patients and professionals globally. Despite efforts, the ED remains strained with medical emergencies. Simultaneously, Autism Spectrum Disorder (ASD) prevalence has risen significantly, leading to increased utilization of ED services by individuals with ASD, who often present with complex needs. Addressing these challenges requires a patient and family-centred approach, emphasizing communication, informed decision-making, and collaboration between healthcare providers and families. However, implementing such an approach in the fast-paced ED environment remains challenging, compounded by varying healthcare providers’ knowledge and attitudes towards neurodevelopmental disorders. Aim: This study aims to highlight ASD children and their families’ experiences in ED settings, identifying specific aspects within the ASD child-ED interaction and provide actionable insights, to meet their needs effectively. Methods: A critical integrative review of literature carried out to characterize the experiences of autistic children in ED, in order to identify ways to enhance their interactions for improved care. Utilizing the PRISMA checklist, a systematic search of five electronic databases and hand searches conducted, for studies published between 2013 and 2023. Eligibility criteria developed based on the PICOS framework, ensuring relevance and quality. Results: Thematic analysis identified four dimensions of experiences in the ED for children with ASD. Insights from each dimension drawn into a roadmap of 6 blocks, informing strategies for improving the ED environment, enhancing staff training, optimizing healthcare delivery, and identifying areas for research to better support the autistic child and their family, throughout their overall experience in the ED. Conclusion: Despite available evidence of resources to enhance ASD care, persistent obstacles and challenges exist, with a pattern of information needed by the family. Data is key and relevant to support the organisation of sources that will enhance the experiences of children and their families within the ED environment.