Understanding and consideration when sedating children with autism spectrum disorder (ASD)

Abstract

  Unfamiliar and unpredictable situations which generally have no effect on children with normal development typically cause increased anxiety and fear in children with autism spectrum disorder (ASD). Children with ASD may feel a sudden visit to a hospital to be a disturbing event and may react with panic, tantrums, self-injuring behavior, and aggression due to extreme anxiety and fear prompted by medical procedures and examinations. Although sedation management is often performed even in older children prior to various examinations (CT, MRI, electroencephalogram, etc.) to reduce anxiety, suppress or minimize body movements, and ensure safety, many children with ASD suffer further distress if sedation is performed in the same way as with normal children, turning a procedure aimed at alleviating distress into a painful and negative experience for both patients and caregivers. To perform sedation in children with ASD appropriately, it is essential to recognize that these patients require special consideration ; the procedures or examinations should be explained to the patients in advance with the help of the caregivers, who have their trust, so as to minimize the anxiety arising from novel circumstances. In addition to building a trusting relationship with the children and the caregivers beforehand, a detailed assessment of each patient's characteristics is crucial for allowing the physician to respond in a manner more considerate of, and appropriate to, the specific characteristics of the patient.