Improving management of patients with autism spectrum disorder having scheduled surgery: optimizing practice

J Pediatr Health Care. 2014 Sep-Oct;28(5):394-403. doi: 10.1016/j.pedhc.2013.09.007. Epub 2013 Nov 25.


Introduction: Surgical preparation for children with autism spectrum disorders can be a challenge to perioperative staff because of the unique individual needs and behaviors in this population. Most children with autism function best in predictable, routine environments, and being in the hospital and other health care settings can create a stressful situation. This prospective, descriptive, quality improvement project was conducted to optimize best practices for perioperative staff and better individualize the plan of care for the autistic child and his or her family.

Methods: Forty-three patients with a diagnosis of autism or autistic spectrum disorder were seen over 6 months at a suburban pediatric hospital affiliated with a major urban pediatric hospital and had an upcoming scheduled surgery or procedure requiring anesthesia. Caregivers were interviewed before and after surgery to collect information to better help their child cope with their hospital visit.

Results: In an evaluation of project outcomes, data were tabulated and summarized and interview data were qualitatively coded for emerging themes to improve the perioperative process for the child.

Discussion: Findings showed that staff members were able to recognize potential and actual stressors and help identify individual needs of surgical patients with autism. The families were pleased and appreciative of the individual attention and focus on their child's special needs. Investigators also found increased staff interest in optimizing the surgical experience for autistic children.

Keywords: Autism; autistic spectrum disorders; pediatric; perioperative process; presurgical assessment; quality improvement.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Autistic Disorder / psychology*
  • Caregivers / education
  • Caregivers / psychology*
  • Child
  • Female
  • Hospitals, Pediatric
  • Humans
  • Male
  • Parent-Child Relations
  • Professional-Patient Relations
  • Prospective Studies
  • Stress, Psychological / therapy*
  • Surgical Procedures, Operative / methods*