Article| Volume 36, ISSUE 6, P529-539, November 2022

Adaptive Care for Perioperative Patients With Developmental Disabilities: An Exploration of Interventions and Family Experience


      Patients with developmental disabilities commonly experience psychological distress during health care visits. There is limited research describing which individualized interventions are being implemented to promote optimal care in the perioperative area.


      In this prospective observational study of 60 patients with developmental diagnoses, aged 3–21 years, we recorded adaptive care plan (ACP) interventions and assessed family experience.


      Patients receiving ACPs had diverse diagnoses, including autism spectrum and 10 other unique syndromes. Most patients received previsit planning (90%), adaptations to standard protocols (60%), child life specialist preparation (67%), procedural support (90%), and were given fast-acting anxiolytics before anesthesia induction (68%). Families reported that ACPs were important for managing a child's stress (94%) and promoting safety (92%).


      ACPs promote safe, productive health care encounters for patients with various diagnoses, ages, and coping abilities. Families find ACPs important for stress management and promoting safety.


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      Abby V. Winterberg, Nurse Practitioner, Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, and Affiliate Assistant Professor, College of Nursing, University of Cincinnati, Cincinnati, OH.


      Emily Jones, Certified Child Life Specialist, Division of Child Life and Integrative Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.


      Lili Ding, Biostatistician, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, and Research Associate Professor-Affiliate, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.


      Lauren M. Hill, Registered Nurse, Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.


      Anna M. Varughese, Anesthesiologist, Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, and Professor, Department of Anesthesiology, College of Medicine, University of Cincinnati, Cincinnati, OH; Director of Perioperative Quality and Safety, Department of Anesthesiology, Johns Hopkins All Children's Hospital, St. Petersburg, FL; Associate Professor of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.