Effective Planning for Crisis Management

Before I worked in a center-based behavioral intervention setting, I worked with children with autism in home, as a home-based instructor.  I consider myself fortunate that in the two years I worked in this role, I never encountered an emergency or crisis situation.  I did have one experience, though, that really changed the way I thought about myself as a service provider – especially as a service provider who often worked alone with clients in their homes while their parents attended to other familial needs.

At the time the incident I am about to share occurred, I worked with a little boy with autism both prior to the start of his school day, and after his school day concluded.  He was six years old and lived alone with his mother, who worked full-time, and primarily communicated, through the exchange of picture icons.  In the afternoons, I met him at the bus stop to get him off the bus, and after we had done our usual after school routine, we usually went into his designated instruction room for a couple of hours to continue working on his acquisition of a variety of functional skills.  With some regularity, he and I would venture out into the local community to a nearby park, to play on the playground and interact with other children.  As such, my client learned to readily identify my car, and would often point to its location on the street nearby after he got off the bus.  Most days, I reminded him of our schedule and he transitioned inside independently.  However, one day, he got off the bus and pointed to my car, and when I stated that leaving was not a choice right then and that we were going inside, he began to cry and stamp his feet.

I began to assist him in walking toward the house, but he dropped to the sidewalk and lay on his back, his crying escalated to a very loud volume, and his stamping escalated to rapid kicking of his legs and flailing of his arms.  As I knelt down to assist him to stand and walk inside, a neighbor across the street opened his window and asked if we were okay.  Still kneeling, I waved and responded that we were fine.  The neighbor then continued to ask me questions: What was I doing out there?  Was the little boy okay?  Was he hurt?  Did I do something to him?  Did I need the neighbor to come over?  Again, I responded that we were fine, that no one was hurt, thanked him, and then quickly assisted my client to his feet.  We had made it about halfway across the yard to the front door, my client still crying, when the neighbor called out, “If you don’t tell me what’s going on over there, I’m going to call the police.”  As I continued to walk with my client, I simply responded that the little boy and I were okay, and I thanked him again for his concern.  We had barely made it through the front door when the home phone rang – it was my client’s mother, calling to check in because her neighbor had called her at work with concerns about something going on with her son and the strange adult who was with him.  I explained to her what had happened and that I was worried about his threat to call the police, when Mom shared a critical piece of information with me that I had not previously known, nor had considered: she had not shared with her neighbors that her son had autism and was not verbal, nor that he regularly received instruction at home after school.  I then shared with Mom some of the questions her neighbor had posed to me and told her that I suspected he thought I may have been intentionally injuring her child – or worse.  She agreed that it would be best for her to talk to the families living nearby to prevent further concern about my working with her son, particularly when he was engaging in challenging behavior outside of their home.

I certainly appreciated the support my client’s mother offered me, in establishing communication with her neighbors.  I have often wondered since then, what would have happened had the police actually arrived to investigate?  What would I have said?  What would have happened if my client had been injured when he fell to the ground (and what would have occurred with the neighbor then)?  What would I have done if another emergency situation had occurred within the client’s home and I needed another adult to help before emergency assistance arrived (particularly since neighbors appeared to be very distrustful of me)?  While questions like these are easier for me to consider with regard to the setting in which I now work (in part because I have become a certified staff trainer in the area of crisis management and prevention), I think they are still relevant concerns to address in home and community environments.  Below are three helpful tips to consider when beginning to plan for emergency/crisis situations:

1.    Talk to first responders about your family’s individual needs before a crisis situation occurs.  Providing your local police force and fire brigade some information about your child, his diagnosis, as well as information about his specific needs related to his diagnosis, helps to broaden awareness within your community about the needs of people with disabilities.  It also helps first responders tailor the support they provide to more effectively serve your family, should they be called to respond to an emergency situation within your home.  A mother living in Delaware County in Ohio reached out to first responders in her area to provide them information about her son’s needs as they related to his diagnosis of epilepsy, and her efforts lead to specialized training for first responders specific to assisting community residents with disabilities.  They also inspired the township’s fire captain to create an HIPAA-compliant, county-wide registry for community residents to submit relevant information first responders would need to know, should they be called to respond to emergency situations within residents’ households (this story is shared in greater detail at this web address: http://www.snponline.com/articles/2011/12/07/olentangy_valley_news/newsr /ovallovreg_20111115_0229pm_1.txt, and the registry itself can be found at this web address:http://www.delcospecialneeds.com/ ).

2.    Share information with your neighbors that pertains to your child’s needs, prior to the occurrence of an emergency.  People who have not had relationships with an individual with autism may be ill-informed about what it means to be diagnosed with an autism spectrum disorder, and may have difficulty relating to your child and your family without some information from you.  While it is up to you to decide how much information to share, providing even some general knowledge such as information about how your child communicates or particular behavior your child regularly displays, helps to broaden understanding of the support your child may require on a day-to-day basis.  If your child receives behavioral intervention within your home, informing your neighbors of staff’s presence helps to prevent any feelings of suspicion that may arise.

3.    Create a crisis management plan for use at home.  A comprehensive crisis plan contains many elements, and needs to address multiple variables that may exist within your home.  Prepare a list of emergency contacts with a little information about who each contact is and his/her relationship to your family, and post it by each telephone within your home.  Be sure to update your list regularly, and discuss with members of your family as well as any staff who works within your home who is best to call in an emergency and in what circumstances.  Evaluate each room in your household and determine the best exit route, and review those exit routes with family and providers alike.  Finally, practice regular emergency response drills.  Doing so helps to familiarize all involved parties with what action to take in actual emergency situations – the more repetition you can provide means more opportunities to learn the best response.