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School Nurses on the Front Lines of Health Care: How to Help Students with Autism Spectrum Disorder Navigate a Meltdown in School

This article discusses the evaluation and treatment of symptoms related to autism spectrum disorder (ASD) in the pediatric community, with mnemonics as a recall tool. While students mostly have physical complaints in the school nurses’ office, there are many mental health issues in the school-age community with emotional and physical effects especially among students with ASD.

The “School Nurses on the Front Lines of Health Care/Medicine” series will present cases reflecting emergencies commonly encountered in the school setting, focusing on an evidence-based approach to the initial management, stabilization, and disposition of the ill or injured child. Special features unique to each article are Extra Credit Points and Report Cards. Extra Credit Points are trivia questions or clinical pearls scattered throughout the article related to the topic at hand. Report Cards are concise tables summarizing key points in each article that you can photocopy and laminate or photograph and keep on your smart device for easy access.

After a long day at the school, you are called down to Mrs. Finnigan’s 5th-grade classroom due to a student who is behaviorally “out of control.” When you arrive at the classroom, you immediately recognize that the student in distress is Walt, an 11-year-old diagnosed with autism spectrum disorder. Walt is throwing classroom materials, pushing chairs and desks across the classroom, and yelling very loudly, “Everyone leave me alone!” The classroom teacher reports that Walt grew distressed during the math lesson for “no apparent reason” and when the teacher suggested that Walt should go to take a break in the resource classroom down the hallway, Walt grew even more distressed and yelled, “I do not need to calm down! I am calm!” From that point, Walt quickly escalated and became physically aggressive, throwing classroom materials, pushing furniture, and yelling loudly. What do you do?


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