Improving EEGs for Children with Autism
How do you perform an EEG on a patient that is sensitive to touch, possibly uncomfortable with unfamiliar places, and prone to overstimulation? Few can fully grasp what it's really like to have autism. There are movie and book characters with autism, studies of how autism affects the brain, and of course first-hand accounts from those with autism spectrum disorder (ASD).
What we do know is that undergoing EEGs can be stressful for patients with autism. Unfortunately, since seizures and autism are often linked, EEGs are a medically necessary procedure. While not a physically painful experience, a patient that is unwilling to complete an EEG will result in the loss of valuable data that could improve the patient’s life.
How can children be more comfortable during an EEG test?
Brad Levy, COO of Brain Science Technologies, EEG to Go, and expert in caring for children with autism, shares his experience and advice. His foray into the world of neurodiagnostics started when his daughter was diagnosed with epilepsy. After starting his own business to give back to the epilepsy community, he recognized a dearth of EEG technologists trained to work with autistic patients - especially children. His “out-of-the-box” approach has clients requesting his services from countries all around the globe.
Pediatric Training is Paramount
“Know how these kids work,” says Levy. The right training will ensure technologists have the patience and abilities necessary to prepare their patients for the study. While some patients are more than happy to sit quietly while electrodes are being placed on their scalp, the reality is that not all patients will respond to orders in the same way. Some patients may need to be gently coerced while others can be charmed into wearing the head wrap.
Photo provided by EEG to GO
Levy adds, “Just because the child may not be speaking back to you doesn’t mean they don’t understand.” People with autism are still people. An extra layer of care can help the EEG proceed smoothly if you know how to interact with your patients. If you’re looking for an EEG technologist, try looking for a seasoned pediatric tech if your child has autism.
Prepare the Patient for the EEG
Well before the EEG takes place, it's important to prepare the patient mentally and physically.
Levy doesn’t just tell - but he also shows the patient the exact procedure so that there are no surprises on the day of the EEG. From videos to PowerPoint slideshows, he gives his patients every chance to fully understand and prepare for the EEG. Even at the time of the study, Levy and his team walk through the process with his patients and sometimes has them repeat back what the next step is. By this time, the patients are so familiar with the process, the EEG has become a part of their routine.
Parents and guardians should also be prepared. Assurances of the necessity of this procedure from a friendly face can help patients feel at ease. At any time during the EEG study, the patient may try to remove their headwrap or forget that they can’t take a shower. Levy has only had a handful of data collection failures, and they’ve stemmed from a lack of supervision - not equipment malfunctions.
A hospital can be an intimidating place for an autistic child. Bright lights, strange people, and a cold bed do not make for a familiar environment. If possible, have the child stay in a more relaxing place. This could be their own home, a hotel room, or Levy’s office with its trademark green walls and purple couch. From his instructional materials, patients see the recognizable room and furniture so they know exactly what’s coming next. Continuous EEG monitoring can be done with an ambulatory EEG, so many patients and their families choose this option.
With autism, some patients don’t like to be touched, nor do they like the feeling of electrode gel on their scalp. The slight itching and dryness caused by the gel are uncomfortable for most - perhaps extremely discomforting for some autistic children. Levy sends physical samples of anything that might be touching the patient so they have a chance to familiarize themselves before the test...a roll of gauze, an electrode, or a sample of the scrub. Levy confidently states, “Be focused on the comfort of the patient, and less overstimulation is possible.”
Zulem Fernandez (left) and Brad Levy (right) with William (center) at ease with his head wrapped.
Photo provided by EEG to GO