4. preventing escalating behaviours in the ed

In this episode, we focus on one of the most critical aspects of caring for autistic patients in the ED: preventing behaviour escalation before it begins. We explore the underlying causes of distress-driven behaviours—such as meltdowns, shutdowns, or aggression—and show how they often stem from anxiety, fear, sensory overload, or a communication breakdown.

We unpack the early warning signs clinicians can look for—those subtle shifts in body language, tone, or movement that signal rising distress. Then, we dive into practical, evidence-informed strategies for calming the environment, adjusting our approach, and giving patients the predictability, choice, and control they often need to stay regulated.

We also share real-world examples of simple actions—like explaining what will happen next, dimming the lights, or offering noise-cancelling headphones—that can differentiate between escalation and de-escalation.

This episode is about being proactive, not reactive. It's about recognising that our actions as clinicians can amplify or soothe distress—and that preventing escalation is not just possible but often surprisingly simple when we know what to look for and how to respond.