When 14-year-old William Callaghan went missing recently at Mount Disappointment, Australia collectively held its breath. There were fears for his safety; no protection from the elements, no food, no warmth. However, for those who knew William, there was an added reason to pause. William has autism. He does not like to wear shoes, and he is very sensitive to auditory stimuli. He does not necessarily have the same ability to call for help, to find shelter, or to understand how to survive in the wilderness as other boys his age might. And he also loves Thomas the Tank Engine – which became a very important fact.
The search for William was not to be conducted with hundreds of volunteers loudly yelling his name. People were advised not to shine bright torches in every crevice of the mountain. Instead, music was to be played softly and food was to be left on doorsteps in an attempt to encourage William to walk towards assistance himself.
Fiona Sharkley, the Chief Executive of autism advocacy organisation Amaze, praised the public and the Victorian Police, describing the search as very ‘person-centered’. The volunteer who found William did not rush and grab him. Instead, he sat quietly beside William, playing Thomas the Tank Engine music. The volunteer took the time to gain his trust to avoid startling him. As a result of this thoughtfulness, William was found and brought to his mother – safe, warm and calm.
“The actions of the Australian public highlight the benefits of providing sensitive and adaptive care to people with additional needs.”
As a medical doctor, I have treated a number of non-neurotypical patients. One patient I had the privilege of getting to know was a young man named Jack*. Jack often presented to the emergency department by himself. However, Jack was selectively non-verbal. He would not tell us why he came to hospital. He did not like answering questions. He was extremely afraid of needles. He would not have an x-ray. He did not like to be touched. This made it challenging to diagnose the cause of his pain.
In the few hours I spent with Jack, his nurses and I came to learn quite a bit about him. He loves parrots. His favourite food is Oreo biscuits. He is very scared of the colour orange and he loves Michael Jackson. While eating chocolate, he let us gently take his blood. When the room was dark and we gave him a heated blanket, he let us examine his abdomen. When we played Michael Jackson on our iPhone, he allowed us to take an x-ray. And after a while, when Jack felt warm and safe, he told us where it hurt.
A trip to a busy metropolitan hospital can be an incredibly stressful event to a person on the autism spectrum. It is challenging enough to foster a safe, calm and supportive environment in an emergency department – which is often synonymous with pain – but this feat can be rendered even more difficult when you throw additional needs into the mix. There can be elements of sensory overload in a foreign, bright and loud environment, and the lights and sirens can be enough to trigger a meltdown for some.
However, my experiences with patients with additional needs have taught me that open communication, mutual understanding and trust are key to creating positive relationships in any context, and can mean the difference between a patient suffering or thriving in a challenging environment. I have seen that communication comes in many forms, and can be elevated through creativity and originality. And I have realised that every unique individual should be respected, appreciated and celebrated for the colour they bring to life.