The term “neurodiversity” refers to variation in the human brain regarding sociability, learning, attention, mood and other mental functions. Some examples of these neurological differences that you may already be familiar with are autism and ADHD.
According to the Autism Spectrum Disorder Foundation, 50% of individuals with autism are nonverbal throughout their lifespan and another 20% may present as nonverbal when highly stressed. As a result, those with autism or other conditions that fall under the umbrella of “neurodivergent” may not respond as expected when faced with emergency conditions, such as a fire or even a fire drill.
Understanding how to support neurodiverse populations improves the ability of your volunteer firefighters to better support those with autism and other conditions in emergency situations and may even prevent unnecessary fire deaths.
Neurodivergent Responses to Emergency Conditions
Autism Speaks has a great resource specifically for firefighters on what you need to know when responding to an emergency where a neurodivergent individual may be present. For instance, they note that people with autism can’t be identified by appearance. Instead, they are identified by behavior. In fact, some people with autism do not have a typical range of sensations and may not feel the cold, heat, or pain in a typical way.
Some other things to be aware of are that:
- A neurodivergent person may fail to acknowledge pain, despite significant pathology being present
- They may show an unusual response to pain such as laughter, humming, singing, or removing clothing.
- Many people with autism may have an underdeveloped upper trunk area, and that positional asphyxiation could occur if steps are not taken to prevent it. For example, you may need to frequently change the person’s position and not keep them face down.
- Another common response during a fire or other emergency situation is hiding or running away after rescue.
By familiarizing your volunteer firefighters with these responses, they’ll be better prepared to provide support safely to neurodiverse populations.
How to Support Neurodiverse Populations in Fire Situations
Before a Fire
Regularly review common responses and practice scenarios involving the rescue of neurodiverse individuals. Enlist the services of a specialized training program when possible, such as these listed below:
- Autism Risk Management
- Autism Alliance for Local Emergency Responder Training
- Autism Risk and Safety Management
- Project Lifesaver
Another great idea is to adapt your community education programs, to the extent possible. Departments can do school visits or “touch a truck” programs to familiarize neurodiverse children that may have different sensory requirements with what they can expect to see during an emergency scenario.
Preparing communication aids in advance may be helpful as well. As an example, the North Riverside Fire Department in Illinois underwent training that included learning how to build toolkits with visual descriptors to help neurodiverse individuals understand what is happening during a rescue. The items in the toolkits included:
“Cards that assist police and paramedics understand the problem they’re confronting – whether someone is in pain or needs to take their medication – or to obtain information like the phone number of a relative. If the person needs to be taken to the hospital in an ambulance or in a police vehicle, picture cards explaining the process of what’s about to happen or dry-erase cards where that process can be written out can help reassure them.”
Clearcreek Township Fire Department in Ohio offers another great example. The department took the step of creating sensory bags that help firefighters and paramedics when they respond to a scene involving someone on the autism spectrum. The bags contain items that keep the person’s hands busy, reduce the noise happening around them, and even help them communicate.
Items that could be included in these bags could be noise reducing earmuffs, dry erase boards and markers, stress balls or fidget spinners. Clearcreek FD was able to provide all three of their stations with these bags for less than $300.
At a Fire
When responding to a fire where you are aware a neurodivergent individual is present, it’s best to arrive without sirens and lights if possible. It’s also encouraged for responders to consult with family members or caregivers to understand the likely responses of any neurodiverse individuals on-site.
Understand that families often need to lock doors, including interior doors, to keep individuals with autism from wandering. This may include barred, nailed or locked windows along with Plexiglas or Lexan windows. The presence of these safeguards may make you mistakenly suspect a possible abuse and may make the rescue more difficult.
Expect the need to perform a more thorough search that normal, as neurodiverse individuals may be hiding. If you come across a person with autism or a related condition, try to speak in short, clear phrases such as “Get in” or “Wait here”. It often takes individuals with autism longer to respond to directions because they may not understand what is being asked of them or they may be scared and not able to process the demand.
Supporting your community means supporting its most vulnerable members. Those with neurodivergent conditions may not respond to emergencies the way you expect, which makes it critical that your volunteer fire department regularly engage in training to help all members better understand what it takes to keep them safe.