What Are The Barriers And Needs Regarding The Clinical Care For Autism/Neurodevelopmental Disorders in the Emergency Department For Patients, Caregivers, and Healthcare Providers?

Niro, Julia

Please use this identifier to cite or link to this item: http://hdl.handle.net/11375/32273

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DC Field	Value	Language
dc.contributor.advisor	Bilgic, Elif	-
dc.contributor.author	Niro, Julia	-
dc.date.accessioned	2025-09-02T18:35:04Z	-
dc.date.available	2025-09-02T18:35:04Z	-
dc.date.issued	2025	-
dc.identifier.uri	http://hdl.handle.net/11375/32273	-
dc.description.abstract	Children and youth with autism (ASD) and related neurodevelopmental disorders (NDDs) frequently present to the Emergency Department (ED) settings, and face disparities in care due to challenges in communication, behaviour management, and health care provider (HCP) preparedness. This combined work explores the knowledge-to-practice continuum among ED providers to identify gaps and opportunities for improving care for patients with ASD/NDDs. A study was conducted to examine the experiences, perceptions, and needs of ED HCPs and patients with ASD/NDDs to understand how knowledge about best practices is integrated into clinical care. Complementing this, a scoping review was conducted to map the existing literature on the translation of knowledge into practice in ED settings for patients with ASD/NDDs, highlighting recurring themes such as limited HCP training and exposure, environmental concerns, interdisciplinary collaboration, and systemic barriers. Together, our studies reveal critical gaps in knowledge and practice, emphasizing the need for targeted training and guidelines to narrow these gaps. In order to ensure equitable, high-quality care in EDs for neurodiverse children, these findings offer a foundation for future intervention development and health system improvements.	en_US
dc.language.iso	en	en_US
dc.subject	Autism Spectrum Disorder	en_US
dc.subject	Neurodevelopmental Disorders	en_US
dc.subject	Emergency Department	en_US
dc.subject	Healthcare Providers	en_US
dc.subject	Caregivers' perspectives	en_US
dc.subject	Clinical care	en_US
dc.subject	Patients' experiences	en_US
dc.subject	Health care access	en_US
dc.subject	Barriers to care	en_US
dc.subject	Support needs	en_US
dc.subject	Intervention development	en_US
dc.subject	Overwhelming stimuli	en_US
dc.subject	Behavioural presentations	en_US
dc.subject	De-escalation strategies	en_US
dc.subject	Continuity of care	en_US
dc.subject	Inclusive healthcare	en_US
dc.title	What Are The Barriers And Needs Regarding The Clinical Care For Autism/Neurodevelopmental Disorders in the Emergency Department For Patients, Caregivers, and Healthcare Providers?	en_US
dc.type	Thesis	en_US
dc.contributor.department	Medical Sciences (Division of Physiology/Pharmacology)	en_US
dc.description.degreetype	Thesis	en_US
dc.description.degree	Master of Science (MSc)	en_US
dc.description.layabstract	Emergency departments (EDs) are not ideal settings for any individual. However, those with special needs such as autism (ASD) find it particularly challenging. The ED is a vital point of care for children experiencing health needs, including those with ASD/neurodevelopmental disorders (NDDs). NDDs can include intellectual disability, ADHD, learning, motor, and sensory processing disorders. Despite best efforts, these individuals often encounter significant barriers in ED settings, where high sensory stimulation, long wait times, communication challenges, and a lack of health care provider (HCP) training contribute to negative care experiences and inequitable health outcomes. This thesis includes two parts to explore the ASD/NDD-related experiences in the ED and suggest improvements. To better understand how EDs can be improved for patients with ASD/NDDs, a mixed-methods study was conducted examining the knowledge-to-practice continuum of ED providers in a single-centre Pediatric ED. It was conducted to first-hand observe the above-mentioned issues within an ED setting. This study explored gaps and barriers experienced by ED HCPs and the impact on care for children with ASD/NDDs. Key facilitators and barriers were identified to translating knowledge into effective care. Findings revealed important gaps in HCP confidence, systemic support, and preparedness, underscoring the need for targeted interventions and education. Building on this foundation, a scoping review was conducted to map the existing literature on knowledge translation related to the care of neurodiverse children in ED settings and find connections between the primary study and what other studies have found. Our main focus was on identifying other problems that exist and how patients, families and healthcare providers feel about the encounters in the ED. The review identified evidence highlighting common challenges, such as insufficient training, environmental inadaptability, and a lack of interdisciplinary communication, as well as a lack of continuity and healthcare system barriers. The review did outline promising strategies for improving care delivery. Together, these two components of the thesis provide a comprehensive understanding of the knowledge-to-practice continuum in EDs for children with ASD/NDDs. They showcase opportunities for health system reform, professional development, and research to enhance the quality, equity, and responsiveness of EDs for neurodiverse populations. These findings also serve as a guideline to help ED staff be better prepared to treat children with ASD/NDDs, and help streamline pre- and post-care and communication with all parties.	en_US
Appears in Collections:	Open Access Dissertations and Theses

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