Emergency Room: Autism

Author: Dr. Vrolijk   |   Updated: August 23, 2025   |   Disclaimer   |   Review Process   |   References

Author: Dr. Vrolijk   

Updated: August 23, 2025   

Disclaimer   |   Review Process   |   References

The emergency room (ER) is overwhelming for everyone. Even medical students can find it stressful. It’s even harder when you have autism or other processing differences and aren’t feeling well. This page covers what to expect in the ER, accommodations you can ask for, and tips for communication.

If you’re in the ER, the scripts on this page can help you ask for what you need. You can also show them to staff instead of saying them out loud.

Parent or Support Person? Check out our guide for Supporting Someone with Autism in the ER

What to Expect

The ER is overwhelming for everyone. Even medical students can find it stressful! It’s extra hard when you’re not feeling well and have autism or other processing differences.

Below is the usual process in the ER. For each stage, there are accommodations that can help and how to ask for them. You can show staff instead of saying them. These are to get you started. Use whatever words are best for you.

You’ll give your basic info at the front desk:

  • Legal name and birth date
  • Reason for visit
  • Insurance card (if you have one)
Important: Right away, tell them about serious health issues like a bleeding disorder.

Scripts

A better place to wait: Where can I wait that’s quieter?

Using accommodations: I’ll be using headphones/sunglasses for sensory reasons

Using augmented/alternative communication (AAC): Write – I need to communicate by [communication method]. I am able to hear.

A nurse will check how urgent your problem is. They’ll take your:

  • Vital signs (blood pressure, heart rate, temperature)
  • Brief health history
  • Current symptoms

Remember: Patients aren’t seen in the order of arrival. The sickest go first.

Scripts

Extra time: I need extra time to answer questions

Warning before being touched: Can you tell me before touching me?

Explaining what’s going to happen: Can you explain what you’re going to do first?

Using sunglasses, headphones, earplugs, etc. (even if you told them at check-in): I am using earplugs for sensory reasons

          ✷ Some ERs have earplugs. You can ask them if they have some that you can use.

You might wait in the waiting room or be taken to a bed right away. The wait time depends on:

  • How busy the ER is
  • How many very sick patients came in
  • How dangerous your problem is

Important: If you start to feel worse, tell a nurse right away.

Scripts

Taking care of your needs: If you can, sit somewhere next to a wall or where there are fewer people. Use any sensory tools you have (earplugs, sunglasses, etc.)

If you need a break:  Ask staff if there is a single person bathroom nearby. You can take a break there.

✷ If you have someone with you – Many hospitals have gift shops. Your support person may be able to buy earplugs or sunglasses there.

You might get tests like a blood draw or x-rays before seeing a doctor. This helps them plan your care and saves time.

Scripts

What’s going to happen: Can you tell me what’s going to happen step by step?

Support tools: Can I keep my headphones on?

They will:

  • Ask about your symptoms
  • Do a physical exam
  • Review your test results
  • Order more tests if needed

Tip: You might tell your story more than once to different staff. This helps them understand all the details of what’s happening.

Scripts

Need more time: I need a moment to think about that

Warning before being touched: Can you tell me what you’re going to do first?

Help understanding:  Can you explain that in simpler terms?

Often you will get some treatment while getting tests. Based on what they find, you might get:

  • Medicine
  • Fluids through an IV
  • Treatment for pain
  • Other care based on your needs

Scripts

Knowing what to expect: What will this feel like?

Asking for a break: Can we take a one minute break?

Help with noise/lights: Can you mute that machine?

The ER team will decide if you’re safe to go home. If not, they might recommend to:

  • Keep you for more watching
  • Admit you to the hospital
  • Transfer you to another hospital

Scripts

Need more time: Can you give me the written instructions first? And then come back to talk to me.

Help with next steps: Is there someone who can help me make these appointments?

Communication Support

These scripts are here to get you started. They are created by doctors who would want a patient to tell them these concerns. These are examples, so you don’t need to use these exact words. You can also just show staff instead of saying them. The most important thing is communicating what you need.

✷ Let staff know: Tell staff at check in that you’re autistic. Tell them if you are nonverbal by writing it down or a card. You should tell new staff that you see. For example, “I’m autistic and may need accommodations”

Loud
  • Can I wear earplugs or use headphones?
  • Can we mute that machine?
  • Can I get a blanket to cover my ears?
Bright
  • Can we dim the lights?
  • Can I wear sunglasses?
Touch
  • Please tell me before you touch me or use equipment on me
  • Do I need to keep this monitor on me?
Deep Pressure
  • Deep pressure helps me. Is it possible to get a lead vest?
Descriptive Word Examples
  • Sharp
  • Dull
  • Burning
  • Pressure
Compare It to Something
  • It’s like a bad sunburn.
  • It’s like hitting my funny bone.
How It’s Effecting You
  • I can’t move my arm normally.
  • I’m having a hard time breathing.
Processing Time
  • Can you speak slower?
  • Can you give me a second to think?
Need It Written
  • I understand better when I can read information. Can you write it down?
  • Can you come back to talk after I read this?
Tell Staff
  • I shut down when my brain is overwhelmed. This happens because I have autism. 
  • Point to this on your phone if you can’t explain it.
Ask for a Break
  • Can I have a few minutes to regulate before we continue?
  • I need a one minute break. I’m overwhelmed.
If You Can’t Speak
  • Point to these scripts on your phone
  • Ask for a piece of paper and pen
Ask Your Support Person to Help

Have your support person communicate (if you have one).

→ See our Supporting Someone with Autism in the ER page

When You Go Home

You’re recovering from two things: whatever brought you to the ER, and the overstimulation of being there. Your body and nervous system needs time to recover.

This can mean feeling more tired, sensitive, or drained than you’d expect. Be kind to yourself while you recover. Lower sensory input when you can, like wearing noise canceling headphones. If things like shopping or cooking are hard, order groceries or pick up premade food if you can afford it. If you can’t, buy groceries that are easy to make like sandwiches or salads.

If you have someone who can support you, ask them to help schedule your appointments or pick up medicine. A trusted friend or family member can help you track symptoms too.

Related Articles

Getting Clear Information

Learn what to ask when your doctor's explanation doesn't make sense, so you leave with information you actually understand.

Speaking Up During Your Visit

Ways to advocate for yourself during medical appointments, including what to say when you need more time or disagree.

Emergency Room Guide

Learn what to expect, ways to speak up for yourself, and how to leave the ER with the information you need.

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Clinical experience from multiple physicians

 
Nicholas DB, Muskat B, Zwaigenbaum L, et al. Patient- and Family-Centered Care in the Emergency Department for Children With Autism. Pediatrics. 2020;145(Supplement_1):S93-S98. doi:10.1542/peds.2019-1895L
 
Samet D, Luterman S. See-Hear-Feel-Speak: A Protocol for Improving Outcomes in Emergency Department Interactions With Patients With Autism Spectrum Disorder. Pediatric Emergency Care. 2019;35(2):157. doi:10.1097/PEC.0000000000001734
 
Zwaigenbaum L, Nicholas DB, Muskat B, et al. Perspectives of Health Care Providers Regarding Emergency Department Care of Children and Youth with Autism Spectrum Disorder. J Autism Dev Disord. 2016;46(5):1725-1736. doi:10.1007/s10803-016-2703-y
 
Caring for Adults With Autism Spectrum Disorder in the Emergency Department: Lessons Learned From Pediatric Emergency Colleagues. Journal of Emergency Nursing. 2021;47(3):384-389. doi:10.1016/j.jen.2020.12.013

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