Imagine you arrive at an incident scene. A child sits rocking back and forth. You call to him and he looks away, playing with his fingers and flapping his hands. The harder you try to communicate, the closer you get to him, the more he turns away and retreats into himself, seemingly oblivious to smoke, heat, pain or danger. This is autism, writes Bill Davis, who explains what signs firefighters should recognise, and what they need to know in order to help autistic people in an emergency.

As Emergency Service Responders, you will eventually come face to face with an ever increasing epidemic. You must know how to recognise it, deal with it effectively and learn a different type of rescue.

It is not terrorism, anthrax or small pox – It is autism – an ever growing, neurobiological disorder that affects language, communication, socialisation and sensory perception.

Imagine that you arrive at the scene: A raging fire or horrific auto accident – a child sits rocking back and forth, staring at a cloud of billowing smoke – you begin to call to him and he looks away, playing with his fingers and flapping his hands. The harder you try, the louder you talk, the closer you get, the more he turns away, the faster he moves his head from side to side. He repeats what you say robotically, while at the same time disappearing deeper into his home, seeking his place of comfort.

He is seemingly oblivious to the smoke, the heat, the pain, the danger; this is a child so overwhelmed with stimuli assaulting him constantly. This is autism.

I have many stories, feelings and theories that I would love to share with you, but as firefighters, you need to become familiar with some hard, cold facts about this disorder. You need to know what you might encounter, how to communicate at the scene, and how to develop the ability to recognise developmental disabilities. You need to keep yourself and our children safe during these encounters.

Autism is a lifelong disorder. It is a gut-brain disorder. autism is a spectrum disorder, meaning that people with autism may pocess some or all of the following characteristics in varying degrees.

People with autism exhibit self-stimulatory behavior. They may rock, spin, or finger play. My son likes to flap his hands. They may transfix on spinning objects, streams of smoke or floating ash from a fire. They may be self-injurious. This can appear very frightening. They might hit or bite themselves, or bang their heads. You do not need to stop harmless self-stimulatory behavior, but of course you must intervene if a child is hurting himself.

Remember they can be very physically aggressive. This is usually due to frustration, lack of communication or pain.

Many times they seem to defer or appear insensitive to pain. My belief is that they simply choose not to deal with it. Our kids may not be able to tell you about their pain. Sometimes, physical touch can be painful to them. Respect their sensitivity. They sometimes avoid eye contact and even go limp at touch. People with autism may be echolalic or echoic, that is they may repeat what you say or mimic what you say. Many of our kids are non-verbal, and will communicate with computers, sign or picture cards. They may not understand your facial expressions or that they are in danger. They may appear deaf, and can be very sensitive to noise, smell and light.

So you now have developed some understanding of how harsh and overwhelming this disorder can be.

You arrive at the scene – Perhaps there is a warning sticker "Child with Autism" (Contact unlockingAutism.com). Or during your search and rescue, you make the determination that this child exhibits the characteristics of Autism. Let me suggest the following:

Please be aware that people with autism will usually seek their "quiet place" – they might move to their bedroom, closet or crawl space despite the fire. The sirens, your gear, uniform and the excitement are very disturbing, so keep calm. Don’t shout or wave rapidly. Use short, repetitive requests "Come here! - Come here! - Come here!"

Gain their attention. You may encounter this child rocking, staring straight ahead, oblivious to your commands, already so overwhelmed that he or she is dealing with the situation the only way they know how. Don’t waste time – Don’t risk retreat! Grab and rescue. Bring the child to a quiet place and try to explain (perhaps with gestures and pictures) that they are out of danger and that you will allow them their space.

Evaluate very carefully for burns, injuries, broken bones. Remember children with autism may not be able to tell you they are hurt or they may simply not want to deal with it. Keep them calm, comfortable and contact parents or an expert immediately.

I could relate many stories about rescues gone wrong, but a funny anecdote comes to mind. We do a lot of safety training at home with my son. We cross the street utilising our therapists as drivers. We teach Chris to show his I.D. card, we demonstrate escalator and elevator safety. We take Chris to the security office at the mall, and teach him to dial 911 for emergencies. One night my wife and my sons’ therapist Jenny were alone with Chris. His TV and VCR broke down and he became very upset. My wife attempted frantically to make some repairs as Chris ran into his sister’s room crying. They fixed his television and all calmed down. A few moments later my wife went into my daughter’s room to make a phone call. On the line was a 911 emergency operator asking if she was OK, they had kept the line open waiting for a reply because 911 was dialled. They had traced the call and were about to dispatch a police unit to our home. Well, you guessed it, Christopher dialed 911 because to him a broken television was indeed an emergency!

We applauded his independence and initiative and then shaped our training so that Chris learned what a true emergency was!

I admire and respect the work that emergency responders do. You are heroes. So is my son – he is my best friend. He is a happy, strong, intelligent boy. I love him dearly. He is truly my best friend. Sometimes you just have to "step outside of the box" and realise that my little guy and others like him are not strange or frightening – they simply look at the world in a different way. They want love, friendship and harmony. They deserve understanding and respect. I know you will serve Chris, my son, and his friends well.

They deserve your understanding and respect.

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Bill Davis is an author, advocate and lecturer who lives in Lancaster, Pennsylvania, USA, and is married to noted autism expert Jae Davis. Their son Chris – one of three children – was diagnosed with Autism six years ago. Bill and his family actively campaign on Autism awareness and he provides the Bill Davis Emergency Responder Training Course to Police, Fire and EMS providers. Check out his website at www.breaking-autisms-barriers.com

One of the most recent books Bill has published is ‘Dangerous Encounters – Avoiding Perilous Situations with Autism.’ Most emergency workers know very little about Autism. This book explains what to look for and how to successfully handle encounters with people who have autism. It takes emergency responders and parents through everyday situations, stressing safety and awareness. This helps to avoid the many problems that can arise when encountering autism in emergencies.

In addition, this book is aimed at retailers and retail security, as people with autism can look extremely suspicious in shops. For instance, a person with autism may well start to rearrange CDs or books by colour. This can give the wrong impression to a retailer and lead to the police being called.

Both parents and professionals can work to prevent escalating situations. If given proper educaiton, serious situations can be avoided when a person with autism is involved. This book contanis practical appendices, such as emergency ID card instructions and how to make a travel communication safety book, as well as safety social stories that teach a person with autism how to act safely in emergency situations. It outlines a number of steps everyone can take and guidelines that can be followed.

A ‘video version’ of Dangerous Encounters – Avoiding Perilous Situations with Autism has also been produced, directed at emergency responders. The video provides general information, where Bill Davis reviews: Why training is needed; characteristics of autism; why emergency responders might be called; and how to communicate.

He then breaks his discussion into areas of speciality where he spends a brief time speaking to ambulance and ER workers, fire and rescue personnel and retail security staff.

The video is available in NTSC format ($39 plus postage) in the USA and PAL for European purchasers ($44 plus postage). When ordering, customers will be asked to indicate their preference. Discounts are offered for purchases of more than five copies.

To order the video, or to see a complete description and preview small segments of Bill’s presentation, visit http://www.discountlearning.com/autism/