Traditional Poster Round
Background: : For many patients with Autism Spectrum Disorder (ASD) the sensory experience of a clinical electroencephalography (EEG) study can be upsetting leading to patient, parent, and caregiver anxiety and distress, need for restraint, poor study results and difficulty with future testing (Nijhof, 2005). As epilepsy is more common in children with ASD than in the general population (Achkar, 2015) there is a need for improved ways to prepare this population for EEGs. Because children with ASD have difficulty with the unpredictability of new experiences, simulation is an effective preparation method as it involves breaking down tasks and practicing component parts in a realistic and supportive setting (Roussin, 2017).
Research Question: : Study aims to demonstrate feasibility and utility of simulation combined with behavioral strategies to help children with ASD prepare for clinical EEGs, as well as determine the effect of EEG simulation for patients with ASD on measures of the child’s behavioral distress and parental anxiety.
Methodology: : Our child life specialist creates and implements a behavioral plan for the simulation including preparatory strategies, modeling, medical play, and distraction techniques. An EEG technologist follows the same steps for lead application as done during a clinical EEG. We collect parental anxiety measures (Spielberger, 1983) before and after the simulation and child distress measures (Tucker, 2001) during the simulation. The same measures are then collected at the time of the subject’s clinical EEG in order to identify changes in anxiety level and behavioral distress as a result of simulation preparation.
Results: : Preliminary results have identified effective EEG preparation techniques using simulation and demonstrate the feasibility of this study in children of varying ages and developmental levels. Parent feedback has been generally positive.
Discussion/Conclusions: : Future aims include determining the effect of simulation preparation on the quality of the clinical EEG, identifying which patients with ASD benefit most from EEG simulation, and establishing effective strategies to combine simulation and behavioral interventions in this
population. In order to reach study aims, we plan to continue enrolling patients with ASD between the ages of 3-17 with upcoming clinical EEGs at Boston Children’s Hospital.
This study will provide relevant data to determine outcomes and best practices for the inclusion of patients, families and caregivers in healthcare simulation.