TJ Boyce will always recall the day he positively impacted the patient experience for a child with autism.

The Children’s Minnesota emergency medical technician (EMT) was working in the Minneapolis ER in 2017, when a mom brought in her son with autism. The mother was able to keep him calm, but as soon as she left the room, anxiety for her son ensued. Her child quickly became agitated and his behavior began to escalate. Boyce, however, knew exactly what to do. Recognizing that the patient was hypersensitive to touch, Boyce suggested that the staff use a floor mat to curtail unnecessary stimulation for the child.

Boyce was using an item that is part of a “sensory toolkit,” which was developed by a group of Children’s Minnesota nurses and staff in partnership with the Autism Society of Minnesota (AuSM). The goal of the toolkit is to provide children with autism the highest quality of care while recognizing the special needs and adjustments needed to aid in their treatment. The toolkits are comprised of a variety of sensory-related items, such as the floor mats, ear plugs, sunglasses and various toys, and can help kids better process any of the body’s senses. The toolkits are available in nearly all Children’s inpatient units, perioperative units and emergency departments. They are an essential tool for hospital staff – especially nurses who care for so many Children’s patients every day.

Toolkits fulfilling vital patient needs

Children with autism are known to process senses differently, which is why the toolkit was developed. For instance, some kids with autism experience sensory activity more intensely than their peers, while others may display sensory-seeking behavior, meaning that they need additional sensory activity to feel comfortable. As a result of these responses, children with autism may exhibit escalating behavior such as anxiety, agitation or aggression when they are in an unfamiliar setting – and that makes it hard for them to communicate. The items provided in the toolkit are meant to make it much easier for kids to explain what they need.

Single-use items, which are sent home with the patient, are the most frequently used items in the toolkits. Sunglasses, for instance, are extremely helpful for patients who are hypersensitive to visual stimulation because they reduce the brightness of the hospital or clinic lights. Chubuddy items, which consist of a lanyard and a kid-safe chewy tube, increase stimulation for children who are hyposensitive to touch.

Overall, the toolkits help Children’s Minnesota care teams by getting children with autism to focus on something other than the treatment.

“Our hope is to prevent escalating behavior and improve the care experience for the child and everyone involved,” said Melanie Kuelbs, a clinical nurse specialist at the Minneapolis hospital. “Word of the successful use of the toolkits in the in-patient units has spread, and multiple requests have been received to expand beyond in-patient areas.”

She noted that in a recent hospital-wide survey, nurses provided many examples of how the toolkit and accompanying education gives nurses a way to partner with parents and create a plan that will work for the child.  Nurses reported a stronger partnership with parents and an improved connection with the child. When shown the toolkit, parents are pleased with the variety of options and most often are able to find an item that works.

Leading the way

While many hospitals have access to various toys and tools to help communicate with and calm children with sensory issues, Children’s Minnesota is a leader in standardizing the toolkits and provides staff with unparalleled education to support their use.

This year, Children’s is excited to move forward with plans to expand the use of these toolkits beyond the hospitals to Children’s clinics. It’s an innovation that was made possible in part by Children’s Minnesota nurses and the organization celebrates the invaluable contributions they make every day.