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The Doug Flutie Jr. Foundation for Autism has awarded Nemours Children's Hospital over $19 thousand to expand the REACH Program. REACH (Respecting Each Awesome Child Here), originally developed by Nemours for children with Autism Spectrum Disorder (ASD) in the emergency department, will now expand to the surgical care department. According to a recent Nemours study, REACH reduces the use of medication administered to kids who are prone to stress and sensory overload in this care setting.

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"We are honored to continue our partnership with Nemours, and so grateful for their careful attention to the diverse needs of all patients, including children and families affected by autism," said Doug Flutie Jr., founder of the Doug Flutie Jr. Foundation for Autism.

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The Flutie Foundation helped build out two REACH rooms currently in the emergency department. This grant will fund two new designated REACH rooms - one in pre-operative and another in the post-operative area of the hospital. The room will incorporate the use of sensory-friendly equipment, tools and resources to reduce an ASD child's anxiety level caused by stress and/or over stimulation. Both rooms will be equipped with appropriate calming and engaging resources for a wide age-range and skill levels.

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Anesthesia inductions before surgery can become traumatic for children with ASD and pose a challenge for the care team, that often needs to use pharmaceutical and/or anesthetic interventions to prepare a child for surgery.

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"Our program was designed to help prevent escalation of anxiety and agitation in children with ASD, therefore leading to the reduced use of sedatives and restraints," said Kelly Bradley, Surgical Nurse at Nemours Children's Hospital. "Since many of our ASD patients experience frequent hospital visits causing stress and anxiety, the ability to minimize the use of sedative medications, which do have side effects, is an added benefit for our patients and their families," said Bradley.

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Nemours' REACH Program, now in its third year, accommodates children with ASD, sensory disorders, mental health disorders and similar conditions. The care teams receive ongoing training regarding ASD, REACH concepts, procedure planning, and recognizing and managing anxiety and agitation.

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There is limited comparative research, but one study, not employing the REACH model, found that sedation or restraints were used in nearly one fourth of ED visits by children and adults with ASD.

An evaluation of two years of electronic health records at Nemours Children's Hopsital identified 860 pediatric ED visits in which the REACH model, was used for patients with ASD or similar conditions. With this approach, fewer than six percent of these patients needed an anxiolytic (anxiety medication). None needed an antipsychotic (for aggressive behavior) or an alpha-agonist (for hyperactivity and anxiety). Fewer, than one percent needed physical restraints.

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Nemours Children's Health System has focused on creating environments that enable us to deliver health care in a way that meets the unique needs of children with ASD, sensory, and mental health disorders. In addition to the REACH Program at Nemours Children's Hospital in Orlando, the Swank Autism Center at the Alfred I. duPont Hospital for Children in Willington, Delaware, were designed with input from families of children with autism.