Neuropsychiatric Stabilization in Youths on the Autism Spectrum in the Pediatric Emergency Department: A Call for Practice Standardization.

Introduction: Children and adolescents with neurodevelopmental and psychiatric comorbidities, particularly autism spectrum disorder and developmental delays (ASD/DD), present unique challenges in pediatric emergency department (PED) settings. Youths with ASD/DD are prone to sensory overload and frequently exhibit agitation and/or aggression, necessitating specialized interventions. However, PEDs lack standardized protocols for managing behavioral dysregulation in this vulnerable population, often relying on anecdotal treatment approaches that hinder the provision of safe, effective and individualized care.

Methods: A review of the literature and current agitation guidelines was conducted and analyzed inform the development of a clinical pathway tailored to the specific neuropsychiatric needs of youths with ASD/DD in the PED.

Results: A comprehensive clinical pathway was formulated to equip healthcare teams with safe and effective prevention, de-escalation and impact mitigation strategies, including environmental modifications, behavioral interventions, caregiver engagement and evidence-based pharmacologic guidelines.

Discussion: Implementing this standardized framework will enhance patient outcomes, improve safety, and ensure compassionate, patient-centered care in PEDs.