Quiet care

No one likes being in a hospital. The environment there is loud, chaotic and unpredictable, certainly not one that’s conducive to feeling better. Those issues are amplified for children with autism, who are often hypersensitive to noise, light and touch and can be stressed by deviation from their normal routine.

A new study, published in the 2012 issue of Autism Research and Treatment, suggests that adapting the hospital environment to suit the needs of children with autism can help, cutting down the time that children spend there and the rate at which they return.

This type of program could be especially important given the lack of autism-focused inpatient psychiatric programs. According to the study, there are only nine in the entire U.S., all in the northeast.

As much as 72 percent of children with autism suffer from psychiatric disorders such as anxiety and depression, putting them at risk for psychiatric hospitalization. Those who also have intellectual disability are especially vulnerable.

In the study, researchers at Children’s Hospital Colorado developed a program designed to make the hospital stay or outpatient treatment more tolerable for children with autism. They created a structured environment, which included clearly defined spaces for different activities — such as socializing in a group, relaxation time and working with the staff — adding visual reminders of each space’s purpose.

The researchers analyzed medical charts from 79 children in an intensive day program and 26 hospitalized children, ranging in age from 3 to 18 years.

The children had a variety of medical and psychiatric problems, such as mood instability, suicidal or homicidal threats or actions, impulsivity, aggression towards others, destruction of property or severe self-injury. All but 11 of them had either autism, intellectual disability or both.

The researchers compared how well these children did with children and teens who had been treated in a general psychiatric ward before the program was developed.

The average length of stay for children admitted to the hospital decreased from 45 days to 26 after the program began, the researchers found. Only 11.5 percent of these children came back to the hospital during the one-year duration of the study, compared with 33 percent in a comparable time period before the program began.

One important caveat is that the researchers analyzed existing medical charts rather than tracking children’s progress themselves, and they compared children treated during two different time periods.

Still, the paper suggests that fairly simple steps to modify the environment for people with autism can significantly change their response. That may not be enough to make children enjoy the hospital, but it certainly can improve their experience.