Children with developmental disability in acute care — branching viva

Opening (2 minutes)

Examiner: "How do you approach this child?" [6]

Strong answer: ABC first like any child. Then caregiver baseline, search medical causes of behaviour change, apply reasonable adjustments, and score pain with an observational tool such as r-FLACC. Avoid diagnostic overshadowing. [1] [3] [6]

Branch A — Overshadowing

Examiner: "A junior says it is just the disability." [6]

Strong answer: That is diagnostic overshadowing. New change needs a medical differential: pain, infection, constipation, seizure, device failure, safeguarding. [6] [9]

Branch B — Pain

Examiner: "How will you measure pain?" [1]

Strong answer: Self-report if possible; otherwise r-FLACC or similar observational tool validated for cognitive impairment; treat and reassess; use caregiver pain signature. [1] [9]

Branch C — Adjustments

Examiner: "The bay is noisy and full." [3] [4]

Strong answer: Move to quieter space, reduce people, predict each step, keep caregiver present, batch procedures. These are clinical interventions supported by autism ED practice literature and parent experience data. [3] [4]

Close

Examiner: "One-line summary?" [6]

Strong answer: "Same emergencies, better method — baseline, adjustments, pain tools, and never stop at the disability label." [1] [6]