49 Implementation of a Sensory Toolkit in the Emergency Department for Children with Autism Spectrum Disorder

Abstract Background Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and restricted, repetitive patterns of behaviour, interests, or activities. Children with ASD frequently visit the emergency department (ED), and present more for primary care-related issues and other non-emergent reasons than children without ASD. Visiting the ED can be challenging and stressful for children with ASD, their caregivers, and the healthcare professionals caring for them. Sensory Toolkits are a collection of sensory items that can help to distract and calm children, including during times of stress. We hypothesized that a Sensory Toolkit will improve the experience of children with ASD and their families in our ED. Objectives The primary objective of this study was to evaluate the effect of a Sensory Toolkit on the experience of children with ASD and their families visiting a tertiary-care hospital ED. Design/Methods After ethical approval was obtained, a pre-implementation survey was conducted on parents of children with ASD about prior experiences in the ED and their interest in a Sensory Toolkit. A Sensory Toolkit specific to children with ASD was developed through literature review and in consultation with families of children with ASD. The Sensory Toolkit, which included a light wand, squeeze ball, push-pop bubble toy, and other items, was launched in a tertiary-care hospital ED in June 2021 with 50 Toolkits. A post-implementation survey was conducted to explore parents’ experiences of their child using the Sensory Toolkit in the ED and to obtain feedback to help improve the Toolkit. Results In the pre-implementation survey, 80% (32/40) of parents felt that a Sensory Toolkit would improve the experience of children with ASD in the ED. Post-implementation, 100% (12/12; response rate ~25% from 50 Toolkits) of parents felt that the Sensory Toolkit was helpful for their child. Parents reported that the Sensory Toolkit was “AMAZING” and “A really great idea, thank you!”. Feedback provided regarding improvements that could be made to the Sensory Toolkit was highly patient-specific and often contradictory. One parent suggested more items to chew on while another parent suggested elimination of the chewable items and one parent loved the light up toy while another suggested to remove it. Conclusion The Sensory Toolkit contributes positively to the experience of children with ASD and their families in a tertiary-care hospital ED. This study will help inform improvement of the Sensory Toolkit in the ED, including consideration of more specialized Sensory Toolkits to meet individual patient needs. Given the success in the ED, the Sensory Toolkit could be expanded into other areas of the tertiary-care hospital and beyond.