Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Jun 9, 2025; 14(2): 99975
Published online Jun 9, 2025. doi: 10.5492/wjccm.v14.i2.99975
Management of critical care emergencies in children with autism spectrum disorder
Mohammed Al-Beltagi, Nermin Kamal Saeed, Adel Salah Bediwy, Rawan Alhawamdeh, Reem Elbeltagi
Mohammed Al-Beltagi, Department of Pediatric, Faculty of Medicine, Tanta University, Tanta ‎ 31511‎, Alghrabia, Egypt
Mohammed Al-Beltagi, Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, ‎Ministry of Health, Kingdom of Bahrain, Manama 26671, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Muharraq, Bahrain
Adel Salah Bediwy, Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta ‎‎ 31527, Alghrabia, Egypt
Adel Salah Bediwy, Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
Rawan Alhawamdeh, Department of Pediatrics Research and Development, Sensoryme Dwc-llc, Dubai 712495, Dubai, United Arab Emirates
Rawan Alhawamdeh, Department of Pediatrics Research and Development‎, Genomics Sensory Play and Creativity Center, Manama 22673, Manama, Bahrain
Reem Elbeltagi, Department of Medicine, The Royal College of Surgeons in Ireland-Bahrain, ‎Busiateen 15503, Muharraq, Bahrain
Co-first authors: Mohammed Al-Beltagi and Nermin Kamal Saeed.
Author contributions: Al-Beltagi M was responsible for conceptualization, study design, drafting the manuscript, and critically revising it for important intellectual content; Saeed NK contributed to data analysis and interpretation, provided clinical expertise, and reviewed the manuscript for accuracy and clarity; Bediwy AS assisted with the literature review, data acquisition, and editing of the manuscript. Alhawamdeh R contributed to drafting specific sections, organizing references, and formatting tables and figures; Elbeltagi R reviewed the final manuscript for coherence and alignment, supported graphical content preparation, and provided administrative oversight. All authors reviewed and approved the final version of the manuscript, ensuring its integrity and quality.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose regarding the publication of this manuscript. All authors have contributed to the work and have no financial, personal, or professional affiliations that could influence the content or interpretations presented in this study.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MBChB, MD, PhD, Chairman, Full Professor, Research Scientist, Department of Pediatric, Faculty of Medicine, Tanta University, Al-Bahr Street, The Medical Complex, Tanta 31511, Alghrabia, Egypt. mbelrem@hotmail.com
Received: August 4, 2024
Revised: December 13, 2024
Accepted: December 30, 2024
Published online: June 9, 2025
Processing time: 206 Days and 24 Hours
Abstract
BACKGROUND

Managing critical care emergencies in children with autism spectrum disorder (ASD) presents unique challenges due to their distinct sensory sensitivities, communication difficulties, and behavioral issues. Effective strategies and protocols are essential for optimal care in these high-stress situations.

AIM

To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD. The review focuses on key areas, including sensory-friendly environments, communication strategies, behavioral management, and the role of multidisciplinary approaches.

METHODS

A comprehensive search was conducted across major medical databases, including PubMed, Embase, and Cochrane Library, for studies published between 2000 and 2023. Studies were selected based on their relevance to critical care management in children with ASD, encompassing randomized controlled trials, observational studies, qualitative research, and case studies. Data were extracted and analyzed to identify common themes, successful strategies, and areas for improvement.

RESULTS

The review identified 50 studies that met the inclusion criteria. Findings highlighted the importance of creating sensory-friendly environments, utilizing effective communication strategies, and implementing individualized behavioral management plans. These findings, derived from a comprehensive review of current evidence, provide valuable insights into the best practices for managing critical care emergencies in children with ASD. Sensory modifications, such as reduced lighting and noise, visual aids, and augmentative and alternative communication tools, enhanced patient comfort and cooperation. The involvement of multidisciplinary teams was crucial in delivering holistic care. Case studies provided practical insights and underscored the need for continuous refinement of protocols.

CONCLUSION

The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD. Sensory-friendly adjustments, effective communication, and behavioral strategies supported by a multidisciplinary team are integral to improving outcomes. Despite progress, ongoing refinement of care practices and protocols is necessary. This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.

Keywords: Autism spectrum disorder; Critical care emergencies; Sensory sensitivities; Behavioral management; Communication strategies; Multidisciplinary approach; Pediatric intensive care; Emergency protocols

Core Tip: This comprehensive systematic review highlights the importance of tailored approaches in managing critical care emergencies in children with autism spectrum disorder (ASD). The study examines various case studies by examining the need for sensory-friendly environments, effective communication strategies, and multidisciplinary care. Key strategies include minimizing sensory overload, using visual aids, involving caregivers, and implementing structured routines. The findings underscore the significance of individualized care plans and the potential for improved outcomes through targeted interventions and training programs for healthcare providers. This review advocates for continuous refinement of protocols to better meet the unique needs of children with ASD in emergency settings.