BY TIMOTHY A. LEIDIG
Most individuals in American society have received some sort of fire safety education in school, on television, or from some other source. Even with basic knowledge, when a smoke or fire alarm sounds, the question can be posed: Why do these individuals experience a brief sensation of fear, panic, and confusion? Generally, the sensations pass, and the individual is able to rely on basic knowledge and take appropriate actions of notification, evacuation, or problem solving. These actions can be carried out when an individual is out of his normal surrounding-for example, people visiting a movie theater will subconsciously locate the nearest exit or, if in a hotel, locate the exits for an emergency escape. This all becomes second nature for adults exposed to fire safety education and able to use appropriate skills for the emergency.
An autistic individual put into this type of an emergency situation, even with fire safety education, may not act appropriately because of fear of the alarm noise or the need to be moved from what he considers a place of safety; the unanticipated situation places the individual in a total panic. The Columbia Encyclopedia, Sixth Edition, defines autism as a developmental disability resulting from a neurological disorder that affects the formal function of the brain.1 The number of fire departments conducting fire safety education for autistic children is minimal; it is nonexistent for adult autistic individuals. The need for fire safety programs for individuals with autism must be addressed because of serious safety concerns. The dangers to an autistic person without fire safety education are tremendous. When supervisors, parents, or caregivers are present to provide directions, the dangers are slightly reduced. For a young adult autistic individual who may have to be self-reliant or potentially reliant on someone else with or without the same disorder, there is no reduction in the threat.
In the case of special-needs children, specifically autistic children, only very basic foundation educational materials are issued to teachers and facilitators to deliver to students, and no follow-up evaluation is completed. The provided information may or may not be appropriate because of the cognitive level of the autistic student, and with no follow-up the success levels are undetermined. This problem continues to escalate at each consecutive grade level. When the autistic student reaches high school, there is a segment of society whose members have to be prepared and self-reliant to appropriately handle an emergency in their homes, college dorms, or group-living settings. Since 2001, the number of programs increased from 22 to more than 250 in 2010.2 Although colleges and universities in the United States are increasing the program offerings for incoming students with learning disabilities, advocates and others say most students with learning disabilities are unprepared for college life.
A study of young adults diagnosed with Autism Spectrum Disorders (ASD) revealed that individuals with ASD had “invisible disabilities,”3 meaning there were no identifiable physical characteristics to make the disability apparent. To design a successful program, a clear definition of the individual’s characteristics that correspond with the levels of the spectrum must be known.
| “The absence of visual clues increases the likelihood that associated behaviors such as hypersensitivity to sounds and lights, failure to speak or make eye contact, and high pain tolerance will be identified incorrectly as unlawful behaviors or behaviors stemming from drug abuse or mental illness.” (3) |
Some research defines autism as a neuro-developmental disability that starts early in life while the brain is developing that involves differences and difficulties in several areas: social interaction; communication; the presence of narrow, repetitive behaviors; and difficulty adjusting to change.4 This makes providing a program that will meet the needs of all autistic individuals difficult. Individuals in the spectrum can vary from high functioning, defined as an individual with normal learning capabilities and cognitive skills who struggles with language but can become verbally proficient with therapy, to the opposite end of the spectrum, individuals with Pervasive Development Disorder (PDD), defined by severe deficit areas of development including social interaction and communication or by the presence of repetitive, stereotyped behaviors. One ASD diagnosis being made more frequently is Asperger’s Syndrome, a mild form of autism in which individuals tend to isolate themselves socially and have some communication issues that vary in severity. The varied characteristics of ASD illustrate how difficult it is to develop an accurate curriculum for persons with autism.5
THE STUDENT POPULATION
An eight percent increase in individuals between 18 and 34 years of age with ASD means that a significant portion of this population is at risk for deadly effects of fire. Autistic adults mainstreamed into independent living facilities are seven times more likely to have contact with emergency responders.6Considering the growth of the ASD population, the fire service needs to increase its preparation to teach these individuals to be self-reliant during an emergency.
The alarming facts show that 86.4 percent of fire departments do not have programs for young adults with autism and 84.6 percent do not offer programs to ASD individuals in college dorms or monitored housing.7 Research on this subject reveals that most ASD individuals receive fire safety education in grade school or in their homes. Both situations raise concerns. If the ASD individual is educated at home, considerations have to be made for accuracy, consistency, and effectiveness of the teaching method. If the individual with ASD has to rely on memory for fire safety education, we must consider whether the information is accurate and whether it can be accurately recounted and used.
There has been a significant amount of research pertaining to how first responders can interact with autistic individuals during an emergency. Most of this research came about as the results of first responders misdiagnosing autistic patients as being intoxicated or on drugs, but there is still much research needed on how to educate autistic individuals. (7) As the population of autistic individuals continues to grow and mature, so does the need to provide a self-reliant educational process that will ensure fire safety.
Defining the characteristics of individuals on the spectrum is critical in understanding the types of education methodologies that will be successful. One of the reasons the ASD population is difficult to define is that the spectrum is consistently broadening. There is a wide range of intellectual abilities in ASD individuals; IQs range from below 25 to above 150.8
The characteristics noted in a child with ASD are present in the adult and generally become more noticeable because of the increased expectation of self-reliance in adulthood. One of the more prevalent skills missing in the autistic young adult is the ability to identify a situation and subsequently put together a process that will alleviate the problem or remove the individual from the situation. This process is defined as “sequencing.”9 Research has found that sequencing is a very difficult skill for individuals with autism, as they do not understand when a task is presented in a series of steps.
When an adult is involved in a fire emergency, the following sequence of actions can be anticipated: building evacuation, activation of an alarm, placing a 911 phone call, and so on. Sequencing and the ability to cognitively put together a plan to appropriately react to a situation are lost on an autistic individual. People with autism are considered “visual thinkers,” meaning their thoughts are continual videotapes running in their imagination. Logic does not work for this population; their ability to integrate different sources of information is limited, and misinterpretations can occur. (9)
Most autistic individuals have sensory issues that can have adverse reactions in response to situations. Sensory issues have been defined as the means by which the body processes information such as lights, sounds, smells, touch, and taste to gain information about your surroundings and environment. People with autism might have more difficulty when overstimulated by a sensory environment-i.e., sights and sounds that will cause anxiety and terror. (4) The inappropriate behaviors brought on by anxiety are more evident in a fear response that has been found to be the last significant obstacle affecting an autistic individual’s learning ability.
During an emergency, panic is a normal emotion. Panic compounded by having the sensory abilities overwhelmed to a point where they cannot think cognitively may prevent autistic individuals from responding to direction because they do not understand what is being asked of them. In addition, when fearful, they may not be able to process language. (5)
TEACHING METHODOLOGIES
To determine which teaching methodologies can be successful with an adult with autism, it is first necessary to overcome the characteristic found with the specific individual to ensure learning has occurred. Autistic individuals learn by experience and education but do not possess the innate ability to detect danger. Role-playing, scenarios, and detailed preparation are essential for them to function in a learning environment. As noted, not all individuals with autism exhibit the same characteristics; therefore, the learning obstacles will be different. A strong practice of maintaining directions with no more than three steps helps the autistic individual frame a picture in his mind, avoiding verbal overload.10 When the instructor perceives that the student does not fully understand the main points or is not grasping the important information, he should use shorter sentences. The educator’s ability to communicate with this population will take resourcefulness, knowledge about autism, patience, and understanding.
To reduce sensory overload anxiety and fear, training programs should be offered in short time spans and repeated. (10) Even with reduced anxiety, an autistic young adult can become overwhelmed with the lights, sirens, and frantic activity at an actual incident. Numerous cases have been found where autistic adults rescued from a fire died after running back into the building to find a place of safety. Research has shown that a plan in which everyone involved with an autistic individual exits a burning building is essential. Once outside, create a self-help network of neighbors, relatives, and friends who will provide an environment in which the autistic individual can de-stress. Offering an emergency contact handout model identifying specific information on the autistic person would help. Fire and life safety educators must team up with local experts to ensure that messages delivered are consistent, appropriate, and complementary. Although this approach requires more effort than most public education programs, it also presents the greatest potential for reducing death and injury rates among the members of a high-risk group.
The research of Dr. Temple Grandin, a high-functioning ASD individual and an engineer, recommends creating a system for each topic associated with an emergency and emphasis on eliminating any potential fearful experience, such as extreme noise volume, visual overload, or sensory overload to an excited environment. She explains that the ASD individual must be allowed to master one sequence before moving to the next educational experience. (9)
The Minger Foundation’s research and development of programs focuses on safety education for individuals with special needs. It identifies three areas of concern: safety in the home, evacuation, and prevention. All special-needs individuals participate in the Foundation’s video programs, offering learning experiences from peers with challenges to students with challenges, increasing the learning experience significantly. Because these programs are offered on DVD or through Internet-based programs, the individual can review the information at will. Grandin states that for a successful sequence, the informational reviews must be done on a scheduled basis and generally should not exceed a period of one month. (6)
To effectively educate individuals with ASD, the educational curriculum must be a cooperative effort among the fire service educator, the parent or caretaker, and the officials housing the ASD individual. As part of the joint understanding, it is critical that the information be consistent, repetitive, and reviewed regularly. This format will allow the individual with ASD to develop proper sequencing during an emergency. Fear, anxiety, and overwhelming amounts of information would hinder the educational process. Should the individual with ASD become frustrated by exposure to any combination of these obstacles, stop the educational process immediately to avoid a breakdown of the learning process. It can be resumed after a time delay.
For the individual with ASD to be successful in sequencing, the information must be consistent. Accurate sequencing can be achieved only through thorough, slow, repetitious education. Once the sequencing is learned, the topic should be reviewed at least once a month. (9) This re-education can be done by an appropriately trained parent, caretaker, or resident facilitator. Do not combine educational topics, and ensure that the student can competently execute the skill before changing topics.
In addition, it is critical that the public educator foster a trust relationship with the ASD individual prior to beginning the educational process. It is also important that the educator be able to read the emotions of the ASD individual and see when frustrations are building and develop mechanisms to defuse the frustration before continuing with the educational process. Developing trust and identifying emotions help to ensure that the educational program will be successful. As the autism spectrum continues to broaden and research into autism continues, the fire service must continually evaluate its programs and this student population.
Author’s note: As a proud parent of a young adult with autism, I dedicate this article in the memory of Michael H. Minger and in honor of Gail Minger, the proud mother of a talented, high-functioning college student on the autism spectrum who was lost to a fire much too early in his young life.
References
1. The Columbia Encyclopedia, Sixth Edition, (2008). Retrieved April 24, 2011, from http://www.encyclopedia.com/topic/Autism.aspx.
2. Banco, E. (August 2010).College-bound Kids with Learning Disabilities Get Help. Retrieved May 24, 2011 from http://www.usatoday.com/news/education/2010-08-11-disabilitystudent11_ST_N.htm.
3. Davis, B., & Schunick, W.G. (2002). Dangerous encounters: Avoiding perilous situations with Autism. Philadelphia: Jessica Kingsley.
4. Debbaudt, D., Mesibov, G. & Taylor, K. (2009). Autism in the criminal justice system. Retrieved May 25, 2011 from www.Autismsociety-nc.org.
5. Autism Spectrum Disorders (ASD), (2005), Retrieved May 30, 2011 from http://www.Autism- pdd.net/Autism-spectrum-disorders.html.
6. United States Census Bureau, (2007). Census Demographic Profile Highlights: Lake County, IL., Retrieved May 31, 2011, from www.factfinder.census.gov/servlet/QTTable?_bm=y&-geo_id=01000US&-qr_name=DEC_2000_SF3_U_DP2&-ds_name=DEC_2000_SF3_U&-_lang=en&-_sse=on.
7. Martin, A. & Mims, T. (April 2009). Autism Awareness for Responders. Fire Engineering, 56-58.
8. Good, D. (March 2011). Autism Spectrum Disorder: FireEMS Challenge. Fire Engineering, 42-55.
9. Grandin, T. (Winter 2000). My mind is a web browser: how people with Autism think. Cerebrum 2000, 14-22.
10. Grandin, T. (2002). Teaching tips for children and adults with Autism. Retrieved April 5, 2011 from www.Autism.com/ind_teaching_tips.asp.
ADDITIONAL RESOURCES
Debbaudt, D. (2005). Are you prepared for an Autism emergency? Retrieved April 6, 2011 from www.poac.net.
Minger, G. (August 2009). Fire Safety for Student with Disabilities at Institutions of Higher Education. Retrieved May 18, 2011 from http://www.mingerfoundation.org/downloads/minger-dhs-safety-report-081809.pdf
Mims, Tilda L. (July 2008). Seeing an invisible disability: Autism spectrum disorder awareness training for firefighters in Tuscaloosa, Alabama. Retrieved April 2, 2011 from www.usfa.dhs.gov/pdf/efop/efo42306.pdf
Moreno, S. & O’Neal, C. (n.d.). Tips for teaching high functioning people with Autism. Retrieved April 5, 2011 from www.poac.net.
Olejnik, L. (June 2004). Understanding Autism. Journal of Emergency Medicine. 57-64.
Russell, R. (June 2009). Fire prevention criteria on which to base an autism protection program. Retrieved April 2, 2011 from www.usfa.dhs.gov/pdf/efop/efo43848.pdf.
TIMOTHY A. LEIDIG, MBA, CFO, EFO, is a deputy chief in the Mundelein (IL) Fire Department.
