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Consider these two examples
"We tried x but pt freaked out and wouldn't let us continue"
Spend a moment & imagine getting this report. What are your thoughts? What image do you have? Are you frustrated? Upset? Exasperated? 2/
"We tried x but pt freaked out and wouldn't let us continue"
Spend a moment & imagine getting this report. What are your thoughts? What image do you have? Are you frustrated? Upset? Exasperated? 2/
Now this report
"Pt is Autistic & very sensory overloaded. We tried x but we decided to stop bc the pt was in a lot of distress. Pt is willing for us to try again & is cooperative"
Now ask yourself those same questions above 3/
"Pt is Autistic & very sensory overloaded. We tried x but we decided to stop bc the pt was in a lot of distress. Pt is willing for us to try again & is cooperative"
Now ask yourself those same questions above 3/
Both reports could be viewed as accurate, but one is a holistic view of what's really happening.
Now imagine you're seeing this pt in a subsequent appointment & read note #1. How are you already framing this pt based on this previous note? What about #2? 4/
Now imagine you're seeing this pt in a subsequent appointment & read note #1. How are you already framing this pt based on this previous note? What about #2? 4/
Pt notes have profound consequences on pt care & #2 is not just accurate, it engenders compassion & understanding. You learn how to support the Autist. 5/
Understand that procedures are already overwhelming & we're in an environment that's VERY loud to us & also very bright. Now we're also in pain & scared. Our reactions are not out of proportion for our neurology, they're actually appropriate 6/
Simple things to do:
Avoid turns like "freaked out" & "uncooperative"
Say "Overwhelmed", "overloaded", "Autistic meltdown"
"Pt tried hard to work with team but became unable due to pain"
Frame it in a way that explains the reality 7/
Avoid turns like "freaked out" & "uncooperative"
Say "Overwhelmed", "overloaded", "Autistic meltdown"
"Pt tried hard to work with team but became unable due to pain"
Frame it in a way that explains the reality 7/
If you know the pt is Autistic ask up front how you can support them.
Ask "What does a meltdown look like for you" "What should we do to help you?"
Turning off lights, reducing noise, monitoring temp (too hot/cold) will allow us to tolerate pain better 8/
Ask "What does a meltdown look like for you" "What should we do to help you?"
Turning off lights, reducing noise, monitoring temp (too hot/cold) will allow us to tolerate pain better 8/
Be kind. Don't demand eye contact /solicit touch. Reduce demands. Ask direct questions. Remove all ambiguity. Don't use open ended questions. Provide time for us to think & respond. Allow friends to accompany.
Give us the benefit of the doubt. I promise you we're *trying* fin
Give us the benefit of the doubt. I promise you we're *trying* fin
I'm loathe to tag people & promise I won't do this again, but this is an important issue & so far only Autists have really amplified it. Pls consider spreading this message @gradydoctor @jmugele @GamerEMDoc @formerlypissed @Disabled_Docs @RanaAwdish @rabihmgeha @choo_ek @medrants
An amazing translation of this thread 
https://mobile.twitter.com/leticiamacielf1/status/1286733225503666176
https://mobile.twitter.com/leticiamacielf1/status/1286733225503666176
