What is autism?
Autism, or autism spectrum disorder (ASD), is a lifelong developmental disability that affects how people communicate and interact with the world. Each person with autism has a distinct set of strengths and challenges. Some people with ASD may require significant support in their daily lives, while others live entirely independently.
One in 100 people are on the autism spectrum and there are around 700,000 autistic adults and children in the UK. These figures just show how likely it is that you will meet and may need to support autistic people.
Home safety visits and other interactions
Communication is key to so much of the work of the fire and rescue service. These tips may help you to interact with an autistic person, whether it’s a child, adult, colleague or friend.
- Always use their name (if you know it) when you start to address them so that they know you are talking to them
- Say less and say it slowly
- Provide one instruction at a time, so that the person is not overwhelmed with information
- Don’t use too many questions, and keep them short
- Use visual supports such as photographs. Even if the child or adult is very good at communicating verbally, the use of visual supports can help support understanding. Autistic people are often very good at processing visual information and prefer this when communicating. For example, use maps, diagrams, flowcharts, lists, etc.….
- Be aware of the environment (noisy/crowded/flashing lights) that you are in. Also be aware if anything might happen occasionally whilst you are with them, such as fast movements or bells used for start/end of sessions, announcements over a loudspeaker.
- Avoid using irony, sarcasm, rhetorical questions, ‘sayings’ or exaggeration. For example: Avoid saying just a minute if you will be longer
Some autistic children are delayed in their use of language and some autistic adults don’t use speech. In these cases, other methods of communication need to be established. A parent or carer or advocate can support you in identifying the best way for communicating with the person.
Autistic children and adults may use some of the following to communicate with you:
- Looking at the object they want, or moving away from the object they fear
- Using pictures
Autistic children and adults often experience high levels of anxiety, especially in unfamiliar situations and when meeting someone for the first time. Consider preparing the family for your visit by sending information about yourself, including a photo, in advance. If this is not possible, ensure during the visit that you are giving the autistic person time and the interaction is led by their preferences.
In case of fire
Autistic adults are just as likely to hide, similar to children, in a fire situation to get away from the noise and the unexpected situation. So check wardrobes, under beds and behind furniture.
Autistic people may resist moving during a fire emergency, so try to reassure and repeat instructions. Describe the emergency procedure/escape plan in advance if possible, using a step by step approach. Assign one carer or family member to be responsible for getting the person with autism out of the home and to a place of safety.
If the individual is presenting with behaviours that cause you to suspect they have an ASD, make your colleagues/friends aware of this, so everyone can be sensitive to the person’s needs.
Autistic adults and children may wander off or bolt after rescue. Stay with the person with autism or hand over to another caregiver or advocate.
A reaction to the noise of a smoke alarm or a fire can be to run away. When autistic children and adults are in this ‘flight mode’ they may become oblivious to other dangers, such as road traffic or a barrier tape, and run towards a different danger. Make sure the person is supervised during this unsettling time.
Children and adults with ASD and anxiety may become frightened in response to sensory stimuli. They may feel overwhelmed due to sensory overload. This may manifest itself in different ways such as repetitive behaviour such as rocking; or repeating words.
Autistic adults and children may not have a typical range of sensations and may not feel the cold, heat, or pain in a typical manner. They may fail to acknowledge pain. They may show an unusual pain response that could include laughter, humming, singing and removing of clothing.
Children and adults with ASD and anxiety may become frightened in response to sensory stimuli. Some individuals with autism have difficulty telling people what’s scaring them, so may show fear with extreme avoidance of a situation. For example, someone might refuse to go to a place after experiencing the noise and confusion of a smoke alarm and fire drill. As a result people with sensory sensitivity:
- May not like the feel of certain materials (example: a blanket)
- May be sensitive to smells
- May even seek out fire
- May have strong reactions to sirens/flashing lights
- May not feel pain
- May not allow you to touch them
Meltdowns and shutdowns
Exposure to sensory stimuli may make someone feel completely overwhelmed, and the understandable result can be a meltdown. Meltdown symptoms can include shouting, screaming, crying, and lashing out.
Shutdowns are also caused by sensory overload and anxiety and during these times the person becomes still, and unable to communicate or move (‘freeze’ situation).
The strategies below can help if someone is having a meltdown or a shutdown:
- Provide reassurance about the situation
- Always ask the parent, carer or advocate if there is anything you can do to help. They will know the best thing to do during this difficult time.
- Not all calming strategies work all the time. Some people have a range of strategies that work in different situations, but sometimes they don’t suit how the person is feeling at that particular time.
- Make space - try to create a quiet, safe space as best you can. Ask people to move along and not to stare, and move away from bright lights or sirens – whatever you can think of to reduce the information overload: try it.
Some autistic people may show signs of distress before having a meltdown, which is sometimes referred to as the ‘rumble stage’. At this stage, there may still be a chance to prevent a meltdown by helping the person use calming strategies such as putting on headphones and removing potential triggers.
Explore ‘graded exposure’
You may be able to discuss preparing people for when they may hear a smoke alarm and help them to learn a safe response.
For example, you could suggest that a parent or carer records the noise of the smoke alarm on a phone or iPad and plays it back at a low volume.
However, it is very important not to stress the person out by trying to desensitise them. Then over several weeks gradually increase the volume, but again only if the person is not getting distressed.
You could also suggest practising the escape route several times by walking with the person, and then combine the low-level noise of the alarm with walking escape routes.
Some people find wearing ear defenders useful, so the person has control when they slip them over their ears to reduce the sound level.
Some people cope better with fire alarms better if there is an announcement or a soft noise before the actual alarm. This means that the person can prepare themselves for what is coming up and cope better.
This graded exposure may seem counterintuitive, but research indicates that this can be effective for getting over a particular fear, and learning safe behaviour.
Sussex Police are signed up to the Pegasus scheme for people who find it hard to communicate. If an adult signs up to the free scheme the Police keep the person’s pre-registered information safe and can access it quickly if the person calls 999. This means the person doesn’t need to repeat all their details.
Anyone can register who has a disability or illness that may make it hard to communicate with the police in an emergency or difficult situation.
Some neurodiverse people may find it difficult or even impossible to wear a face covering. Remember that people do not need to wear a face-covering if they have a legitimate reason not to. This includes neurodiverse conditions.
Carers may consider wearing face coverings with a see-through panel, if the person they are caring for, seems upset by looking at someone wearing a mask.
Although not legally required, some people may feel more comfortable showing something that says they do not have to wear a face covering. This could be in the form of an exemption card, badge or even a homemade sign.
There are various versions available online including the government exemption card template The Hidden Disabilities Sunflower lanyard, which can be bought online or are available free of charge at many supermarkets, train stations and airports, have become widely recognised.
GOV.UK Guidance - Face coverings: when to wear one and how to make your own