Enhancing emergency department care for individuals with autism spectrum disorder across the lifespan: a systematic review
Abstract
Objective: This systematic review aims to synthesize existing evidence on emergency department (ED) experiences, service-delivery challenges, and environmental and communication factors affecting autistic people and to identify strategies and interventions reported to improve patient comfort, safety, and satisfaction.
Methods: A comprehensive search was conducted across databases, including PubMed, Scopus, Web of Science, and the Cochrane Library, for peer-reviewed articles published between January 1, 2014, and December 31, 2024. Data extraction was performed using standardized forms, and quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). Data synthesis involved narrative thematic analysis to identify key barriers and facilitators to emergency department care for autistic people. The reporting of this review follows the PRISMA guidelines.
Results: Eleven studies met the inclusion criteria and revealed consistent barriers affecting autistic people in emergency departments. Across settings, communication difficulties, sensory overload, long waiting times, and limited staff preparedness were the most frequently reported challenges. These factors contributed to heightened distress, behavioral escalation, and reduced satisfaction for patients and families. Facilitators identified in the literature included ASD-specific staff training, sensory-adapted environments, structured care routines, and active caregiver involvement. While not all barriers are…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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