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Autism Training for First Responders Expands Across Virginia

A successful program piloted by UVA and the Thomas Jefferson EMS Council sparked a new law and a grant to train emergency personnel.

Audrey Breen

University of Virginia researchers are expanding a successful training program across the state to help ease encounters between first responders and people with autism.

The Supporting Transformative Autism Research initiative, or STAR, has received a $888,251 grant from the U.S. Department of Defense to expand the training model after last year’s pilot program proved a success.

The researchers partnered with the Thomas Jefferson EMS Council. The program’s success  resulted in expanded partnerships, a new Virginia law, and inquiries from across the country on how to replicate it.

Emergency situations can be challenging for individuals with autism and other developmental disorders. People with autism are seven times more likely to encounter emergency personnel than the general population due to being at increased risk of having a meltdown and needing de-escalating, getting lost and needing help being found, or getting into trouble during social interactions with others.

Unfortunately, a negative encounter with first responders can be life-altering, or even fatal.

“Assaulting a police officer is a felony and many people with autism who are experiencing a crisis or meltdown can flail and kick without understanding what that means,” said Rose Nevill, assistant professor at the UVA School of Education and Human Development and a lead researcher at STAR.

With training, first responders including firefighters, emergency medical technicians and police officers can be better prepared to support people with autism and de-escalate situations.

“De-escalation at home is the goal,” Nevill said. “Typically, family members call 911 because they are not able to successfully de-escalate a situation without support. Our hope is to both train first responders to aid in de-escalation and provide families with resources to help de-escalate without the need to call emergency services.”

Almost 200 first responders from 29 different agencies have been trained through the Central Virginia pilot program. Results show that first responders who complete the training have significant increases in knowledge, confidence and self-efficacy in responding to someone with autism during an emergency, even three months after completing the training.

Rose Nevill stands in front of screen during a first responder trainer.
Rose Nevill speaks during a 2023 autism first responder training.

Under the expanded program, an instructor team has been established for Central Virginia,  comprising Rebecca Killmeyer, an autism mom; Shannon Frye, an autism dad and fire fighter/EMT; and Brendan Oakes, a self-advocate. This team will continue to offer autism trainings to first responder agencies served by the Thomas Jefferson EMS Council.

In addition, four additional teams of trainers comprised of first responders, community partners and autism self-advocates will lead the training of up to 300 first responders across the state, beginning in January.

The grant will fund a randomized control trial to identify the effectiveness of the training, including which approaches are most effective. One challenge the team will wrestle with is that encounters with autistic individuals are infrequent for first responders but are high-risk encounters for the individuals with autism. 

“We’ll also be developing and testing a performance change tool so we can present simulated activities to see if, as a result of this training, your performance is actually going to change while you’re at a scene,” Nevill said.

The team’s efforts to identify the most effective training approaches will be most important for areas where resources are limited and funding the full program is not possible. 

Virginia and Other States

The success of the team’s Central Virginia pilot program also played a role in a new state law passed in April that mandates all law enforcement officers be trained in autism by the end of the summer of 2027. The Autism Society of Central Virginia led the efforts on the new bill, including sharing findings from Nevill and her team.

The team is also receiving inquiries from other states, including California and North Carolina, to share their findings and model.

“Few states have mandated autism training,” Nevill said. “This is a really important area that needs some attention. Thankfully, there is a web of connections across states that is slowly growing.”

Nevill hopes to work with community collaborators to eventually organize a coalition of organizations across states.

“Police are typically first to arrive at a scene because there are more of them and they are integral in protecting other first responders, like EMS crews,” Nevill said. “They end up in a tough spot because that sometimes results in them having to use force to de-escalate people. So, I think that’s why law enforcement is the important first step with these mandates.”

Training emergency medical technicians and paramedics is equally important, Nevill said.

“They end up playing the role of patient advocate,” she said. “During a lot of these crises, they are the calming, supportive folks who are addressing pain or injuries. All branches of the emergency response play an important role.”
 

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Audrey Breen