The Child with Autism Spectrum Disorder

Children with autism spectrum disorders (ASD) require procedural sedation for a variety of diagnostic and therapeutic reasons. Patients with ASD present a challenge to the sedationist due to a variety of issues, including impairment in social interaction, barriers to communication, complex behavioral patterns, stereotyped repetitive behavior, mental health issues, and a need for consistency in terms of environment and caregivers. Children with ASD, especially teenagers, can exhibit aggressive behavior, self-injury, and temper tantrums, which can lead to issues with efficient and safe preparation for procedural sedation. Other challenges include the need for additional resources, difficulties in approaching the patient to perform a physical examination, delays in administering premedications, and difficulty obtaining intravenous access prior to the procedure. Children with ASD are more likely to be referred for general anesthesia due to these problems. This chapter discusses the role of the sedationist in the procedural sedation of these children.