Original Article

Increasing Comfort with Sensory Processing Difficulties in the Prehospital Setting: Pre-Post Study of Education and Sensory Tools in EMS Providers

Authors: Nipam Shah, MBBS, MPH, Katherine Hert, BS, Ann E. Klasner, MD, MPH


Objectives: Interfacing with patients with sensory processing difficulties is challenging to healthcare providers and even more problematic for emergency medical services (EMS) personnel in the acute care setting. Sensory training may be an effective nonpharmacologic method to deal with these patient populations. The purpose of this study was to evaluate whether an educational session and placement sensory tools would improve the comfort of EMS providers in the prehospital setting.

Methods: EMS providers from two agencies in the Alabama Gulf EMS System were selected for this study. Preeducation questionnaires were administered to EMS providers to assess their frequency and comfort level in taking care of patients with sensory processing difficulties. The educational session included a video presentation of various topics related to sensory processing difficulties and education on sensory tools. Posteducation questionnaires were administered to EMS providers 3 months posteducational session to assess the use of sensory tools and their comfort in patient care. Comfort level was assessed on a Likert scale of 1 to 10, with 1 being not comfortable at all and 10 being extremely comfortable. We performed descriptive statistics and the nonparametric Wilcoxon signed rank test to compare medians.

Results: A total of 177 of 225 (78.6%) EMS providers completed the preeducation questionnaire. In the preeducation period, 159 (89.8%) EMS providers transported patients with sensory processing difficulties. The preeducation median comfort level was 7.5 (range 1–10). At postsurvey, 135 of 177 (76.3%) EMS providers received educational training; 37 (27.4%) used the sensory tools within the previous 3 months. The posteducation median comfort level was 8 (range 3–10). Pre- and post median comfort levels were significantly different using the Wilcoxon signed rank test (P = 0.006).

Conclusions: Sensory training can be an effective method for EMS providers to increase comfort levels in taking care of patients with sensory difficulties. Further research with larger sample sizes is needed to confirm/refute these findings.
Posted in: Emergency & Disaster Medicine5

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Baranek GT, David FJ, Poe MD, et al. Sensory Experiences Questionnaire: discriminating sensory features in young children with autism, developmental delays, and typical development. J Child Psychol Psychiatry 2006;47:591-601.
2. Cheung PP, Siu AM. A comparison of patterns of sensory processing in children with and without developmental disabilities. Res Dev Disabil 2009;30:1468-1480.
3. Rogers SJ, Hepburn S, Wehner E. Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders. J Autism Dev Disord 2003;33:631-642.
4. Ben-Sasson A, Carter AS, Briggs-Gowan MJ. Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. J Abnorm Child Psychol 2009;37:705-716.
5. Ahn RR, Miller LJ, Milberger S, et al. Prevalence of parents' perceptions of sensory processing disorders among kindergarten children. Am J Occup Ther 2004;58:287-293.
6. Gourley L, Wind C, Henninger EM, et al. Sensory Processing Difficulties, Behavioral Problems, and Parental Stress in a Clinical Population of Young Children. J Child Fam Stud 2013;22:912-921.
7. Engel-Yeger B, Ziv-On D. The relationship between sensory processing difficulties and leisure activity preference of children with different types of ADHD. Res Dev Disabil 2011;32:1154-1162.
8. Crane L, Goddard L, Pring L. Sensory processing in adults with autism spectrum disorders. Autism 2009;13:215-228.
9. Kong M, Pritchard M, Dean L, et al. A community-based sensory training program leads to improved experience at a local zoo for children with sensory challenges. Front Pediatr 2017;5:193.
10. Scattone D, Wilczynski SM, Edwards RP, et al. Decreasing disruptive behaviors of children with autism using social stories. J Autism Dev Disord 2002;32:535-543.
11. Hodgetts S, Hodgetts W. Somatosensory stimulation interventions for children with autism: literature review and clinical considerations. Can J Occup Ther 2007;74:393-400.
12. McGonigle JJ, Venkat A, Beresford C, et al. Management of agitation in individuals with autism spectrum disorders in the emergency department. Child Adolesc Psychiatr Clin N Am 2014;23:83-95.
13. Scarpinato N, Bradley J, Kurbjun K, et al. Caring for the child with an autism spectrum disorder in the acute care setting. J Spec Pediatr Nurs 2010;15:244-254.
14. Olejnik L. Understanding autism. How to appropriately & safely approach, assess & manage autistic patients. JEMS 2004;29:56-61.
15. Cheung V, McCarthy ML, Cicero MX, et al. Emergency medical responders and adolescents with autism spectrum disorder. Pediatr Emerg Care 2019;35:273-277.
16. McGonigle JJ, Migyanka JM, Glor-Scheib SJ, et al. Development and evaluation of educational materials for pre-hospital and emergency department personnel on the care of patients with autism spectrum disorder. J Autism Dev Disord 2014;44:1252-1259.
17. Wachob D, Pesci LJ. Brief report: knowledge and confidence of emergency medical service personnel involving treatment of an individual with autism spectrum disorder. J Autism Dev Disord 2017;47:887-891.
18. Nichols BG, Visotcky A, Aberger M, et al. Pediatric exposure to choking hazards is associated with parental knowledge of choking hazards. Int J Pediatr Otorhinolaryngol 2012;76:169-173.
19. Testa R, Morra B, Connal D, et al. Choking injuries and food products containing inedibles: a survey on mothers' perception in the United Kingdom. Acta Otorhinolaryngol Ital 2010;30:100-102.