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Emergency Room: Supporting Someone with Autism
Author: Dr. Vrolijk | Updated: August 23, 2025 | Disclaimer | Review Process | References
When you’re with someone who has autism in the emergency room (ER), you bring something staff don’t have: your knowledge of them. This page has tips for using what you know to help, like what to say when they’re overloaded, accommodations you can request, and how to take care of yourself too.
Do you have autism? Check out our guide Emergency Room: Autism Guide
I'm Supporting Someone Who's Overloaded
Tell a Staff Member
- [Their name] has autism and is overloaded. Their brain is having trouble processing everything that’s happening. That’s why they’re [what they’re doing].
Share What You Know
- That’s why they’re [describe what they’re doing]
- [What helps] may help. Is that possible?
You Can Ask for Things Like
- Help with noise
- The bathroom is a good option if in the waiting room or a hallway bed. Tell staff so they know where you are and can tell you if that’s safe.
- Some ERs have ear plugs for patients.
- Extra time
- Ask for a break or processing time. This may not be possible if your friend or loved one is very sick.
- Let staff know if they need a little more time to respond.
- Less light
- Ask to dim or turn off the lights.
- In the hallway? You can use a blanket to block light.
- They can wear sunglasses. Just let staff know why.
🚨 Important to Know
Staff may need to act quickly if your loved one is very sick. They may need to restrain them or give them medicine. When you’re able to talk to someone, you can ask why something is necessary.
What to Expect
Below are some phrases that can be helpful. These are to get you started. Use whatever words are best for you. To learn more about what to expect visit your Emergency Room Guide
Check-In
You’ll give your basic info at the front desk:
- Legal name and birth date
- Reason for visit
- Insurance card (if you have one)
Tips
Tell staff: I’m here with someone who has autism. They may need accommodations.
A better place to wait: Where’s the quietest place we can wait?
Triage
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.
Tips
Tell triage (even if you told check-in): They have autism and may need accommodations
Warning before being touched: Can you let us know what you’re going to do before touching them?
Explain how they display symptoms: They get very quiet and stare at their phone when they are in a lot of pain
Using sunglasses, headphones, earplugs, etc. (even if you told them at check-in): They’re using earplugs for sensory reasons
✷ Some ERs have earplugs. You can ask if they have some you can have.
Waiting
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.
Tips
Ask for a quieter place: Remind staff that they have a processing disorder and are overwhelmed. Ask if there is a quieter place to wait. Or if there is a single person room.
If they need a break: Ask staff if there is a single person bathroom nearby. You can take a break there.
✷ If you can leave your loved one or friend – many hospitals have gift shope. You may be able to buy earplugs or sunglasses there.
First Tests
You might get tests like a blood draw or x-rays before seeing a doctor. This helps them plan your care and saves time.
You Can Ask
What’s going to happen: Can you explain the steps of the test before starting?
Ask about breaks: Can they take breaks at any point? How should they tell you?
Support tools: Can they watch something on their phone?
Seeing the Doctor, Physician Assistant, or Nurse Practitioner
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.
Tips
Tell them about their autism (even if you’ve told everyone else): They have autism. They’re very quiet right now, because they’re in pain.
Ask for things that would help: Can you tell us before you touch them?
If an adult, explain how you’re helping: I’m helping explain what’s wrong, because they’re overloaded.
✷ Make sure that the person with autism can tell you when they want to take over the discussion. This could be tapping you or squeezing your hand. Then you can help by finding out what they want to communicate.
Treatment
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
You Can Say
Knowing what to expect: Can you explain each step?
Asking for a break: Can we take a one minute break?
Explaining stimming: This is how they deal with feeling sick and medical procedures.
Plan
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
You Can Ask
Need more time: Can you give us some time and then come back for questions?
Help understanding: Can you explain that in simpler terms?
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. You don’t need to use these exact words. They’re just example and here if you need them. The most important thing is communicating what you need.
Getting Accommodations
Environment
- Is it possible wait somewhere quieter?
- Could we dim some of these lights?
- Would it be possible to have fewer people in the room?
Communication
- They need extra time to process questions
- Could you write down the important information?
- They understand better when instructions are broken into steps
Procedures
- Could you explain what you’re doing first?
- They need warning before you touch them
- Showing them the medical tools first really helps
Explaining Behaviors
Repetitive Movements (Stimming)
- They need to move to cope with stress. That’s normal for them
- These movements help them regulate. Please don’t stop them unless medically necessary
Communication
- They process information differently and may need extra time
- Give them a few minutes and they may be able to respond
- They communicate better when [there’s less stimulation/you use written questions/they’re given more time]
- This is how they communicate when overwhelmed
Avoiding Eye Contact
- They’re listening even though they’re not making eye contact
- That’s normal for them. It doesn’t mean they’re not paying attention
Seeming “Difficult”
- They’re not being difficult. They’re overwhelmed
- This is how their brain responds to stress
- They want to cooperate but need extra time
Helping Them Be Heard
- They might be able to show you rather than tell you
- Give them extra time to think about your question
Getting Help
When You’re Not Sure
- I’m not sure about that, but I can tell you what I’ve noticed…
- I don’t know their exact medical history, but they usually [share what you do know]
Help Understanding
- I want to make sure I understand this correctly. Can you explain that again?
- Could you explain that in simpler terms?
Describing Pain & Symptoms
How They Show Pain
- They don’t show pain in typical ways
- When they’re in pain, they usually [describe what you’ve seen – get quieter/more agitated/rock more]
- They might not be able to point to where it hurts
Describing Symptoms
- They’ve been [describe behavior changes you’ve noticed]
- This is different from their normal behavior
- They can’t tell you directly, but I’ve noticed [specific changes]
If Staff Doesn't Seem to Understand
Sometimes ER staff won’t know much about autism. Here are a couple ways to approach communication challenges. We included examples, so you can see these tools can be used.
Try Focusing on
Your Concerns
- I’m concerned you’re misunderstanding how sick they are. They’re quiet because they’re overloaded and in pain.
- I’m concerned it’s hard to tell how much pain they’re in. They shut down when it’s really bad.
What Makes You Uncomfortable
- I’m uncomfortable with going home, because they seem to be getting worse. When we got here they had only thrown up once. But now they have a lot of stomach pain.
If You Are Worried about Their Safety
- I’m worried about their safety, because they can’t walk to the bathroom now.
- I think it’s a safety concern that their autism symptoms are the focus and not what brought us in
If You Need More Help
- Ask to speak to the charge nurse (the nurse who is managing that part of the hospital)
- See if a social worker or patient advocate is available
Supporting Yourself
Basic Needs
- Ask staff for water/snacks or directions to cafeteria
- For bathroom breaks: “Could someone stay with them while I step out?”
- If possible, call someone to come help so you can take breaks
If You're Overwhelmed
- It’s okay to ask for a break for yourself too
- You can tell staff you’re overwhelmed and if there are things that would help you
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Resources We Used
Clinical experience from multiple physicians
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