ASD in the ED

Why I Created This Mini-Series: A Personal and Professional Journey

Episode Description: Emergency departments can be overwhelming for autistic patients, often leading to distress, miscommunication, and unmet medical needs. As an emergency physician, an ADHD-diagnosed clinician, and a father to an autistic child, I’ve experienced firsthand the gaps in understanding and care. This episode shares my journey—why I created this podcast, how my personal and professional experiences shaped my approach, and why this series is essential for healthcare providers looking to improve care for autistic patients.

Understanding Stress & Conflict in Healthcare

Emergency departments are high-stress environments where conflicts can easily arise between patients, families, and healthcare providers. In this episode, we explore how human brains react to stress, why conflicts escalate, and how healthcare providers can navigate difficult interactions. Using insights from conflict strategist Ryan Dunlap, we’ll discuss practical strategies for managing stress, de-escalating tense situations, and improving patient interactions.

Communication Barriers-Why ASD Patients Struggle to Express Their Needs in the ED

Many autistic patients struggle with communication, especially in stressful environments like the emergency department. This episode explores the neurobiological reasons why communication can be challenging for autistic individuals, the impact of stress, and associated conditions such as ADHD, Pathological Demand Avoidance (PDA), and Oppositional Defiant Disorder (ODD). We’ll discuss how these conditions influence communication difficulties, how they affect interactions in healthcare settings, and what strategies can help mitigate these challenges. Additionally, we’ll address controversial practices such as insisting on verbal responses and misinterpreting delayed speech as noncompliance and why these approaches can be harmful.

Meltdowns-What to Do When a Patient Loses Control

Meltdowns in autistic patients are often misunderstood, leading to unnecessary restraint, security intervention, or even sedation. In this episode, we’ll explore the difference between a meltdown and a tantrum, what triggers meltdowns, and how healthcare providers can respond effectively. We’ll also discuss why restraint and forced compliance can be harmful and offer strategies for de-escalation and patient-centred crisis management.

How Healthcare Providers Can Regulate Their Own Responses in High-Stress Situations

In the fast-paced, high-pressure environment of the emergency department, healthcare providers often face stressful encounters, particularly when treating autistic patients experiencing distress or meltdowns. In this episode, we focus on self-regulation techniques for healthcare providers—how to stay calm, think clearly, and respond effectively in emotionally charged situations. Drawing from conflict resolution strategies, neuroscience, and mindfulness techniques, we explore how managing your own responses can significantly improve patient interactions and outcomes.

Preventing Escalating Behaviours in the ED

Escalation doesn’t start with shouting. It starts with subtle signs—an anxious look, a shift in body language, a moment of silence that most of us miss. In this episode, we explore how to recognise the early signs of distress in autistic patients before behaviours escalate. We break down what’s really going on beneath the surface, why the emergency department can be such a triggering environment, and what practical steps clinicians can take to reduce anxiety and create a sense of safety. From communication and sensory strategies to clinician self-regulation, we cover the small, intentional actions that can prevent big outcomes. This is about being proactive, not reactive—and learning how to hold the line when it matters most.

Allies in Care - Supporting Families of Autistic Patients

In this episode, we focus on the families and carers accompanying autistic patients into the emergency department. For many, the ED is not just stressful—it’s overwhelming, exhausting, and sometimes even traumatic. And while we often focus on the individual patient, the reality is that we’re caring for a family unit. We explore parents’ and carers' emotional load, especially when advocating for their loved ones in a busy, unfamiliar, and sometimes unaccommodating system. We discuss their challenges—being dismissed, not listened to, or blamed for behaviours their loved one can’t control—and how these experiences can affect trust and engagement. We offer strategies for supporting families effectively: listening without judgement, valuing their expertise, offering reassurance, and involving them as partners in care. We also explore the importance of empathy, transparency, and small gestures that build connection in moments of chaos. This episode is about recognising that when we care for a patient with autism, we’re also caring for the people who know them best. Supporting families isn’t just kind—it’s clinically essential.