Fire Safety Teaching Plan for Autistic Adolescents

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Status: Finished  |  Genre: Health and Fitness  |  House: Booksie Classic

In my nursing program, we were tasked with creating a teaching plan for patients to share with our groups. I chose to cover fire safety for autistic adolescents and their families. I hope this can be helpful to someone. Thank you for reading.

Fire Safety Teaching Plan for Autistic Adolescents:

Lone Star College

Glinda G. Bustamante

LSC ADN Program

February 2021

 

Fire Safety Teaching Plan for Autistic Adolescents

As a parent of an autistic adolescent, you are your child’s most valuable teacher. In light of recent hazardous weather conditions our region has sustained, the urgency of fire safety education has intensified. Local adolescents may be confronting this type of threat for the first time. For others, it may be something that they have been partially exposed to but lack intimate experience with. Fear and desperation can be powerful motivators to learn, but it is most effective to teach your child about fire safety before an emergency so that they will know what to do when disaster strikes.

Familiarizing your child with what happens during a fire and what to do in an emergency can mean the difference between life and death, injury and health. This teaching plan is meant to guide parents of autistic adolescents through ways to stay safe when fire conditions occur due to hazardous weather or accidents. In addition, we will create a nursing diagnosis to guide individual interventions, as well as define short and long-term objectives to model your child’s goals after. Finally, we will outline specific concepts to teach and provide evaluation methods to ensure learning has occurred. For this teaching plan, we are utilizing the fire safety escape plan outlined on paautism.org. You can go at your own pace and can take a break whenever necessary. You are not alone; we are all in this together.  

Comprehensive Assessment

Prior Knowledge of the Material:  

12-16 yr. old autistic children have generally seen a firetruck, know that loud noises come from smoke detectors, and understand that fire is hot and can hurt their bodies in some way. Family members may have passively mentioned a wildfire in California, and students may have participated in fire drills at school. Many have seen a cartoon of Smoky the bear talking about prevention of forest fires on tv. Most adolescents have not had their houses burned down, lost a loved one due to smoke inhalation, or received severe burns due to fire accidents. They also probably haven’t received a dedicated lesson teaching fire safety concepts in a way that they can understand. This teaching plan is for children who have limited, passive prior knowledge of fire safety. The address portion of this teaching plan is customized for Americans, but can be modified to fit other territories.

Developmental Level:

This teaching plan is designed to instruct 12-16 yr. old children who are considered delayed for their age group in comprehension, reading, and social awareness compared to kids without autism of the same age group. This group generally cannot comprehend what they read on their own, find reading difficult, and mostly rely upon others to interpret written or spoken words for them. Retention of information may be a significant struggle. Recall of long or short-term memory might be impaired. They may need significant support to learn and require repetition to integrate new knowledge. These children might not inherently understand that signs are there to give them instructions and will need explanations of their purpose.

Physical Factors:

This plan is for children who can hear normally or with hearing aids in place, who can see normally or with corrective lenses, who can walk with or without aids, and who can speak and understand language at least at a pre-school level. The child does not need language proficiency for this teaching, just a working knowledge of common words and the ability to respond affirmatively or negatively. Just because your child cannot verbalize the lesson fully or does not make eye contact regularly, does not mean that teaching has not sunk in at least partially. Repeated exposure to the material will be most effective, and every little bit helps. This teaching is ideally for children who can sit semi-still for at least 10-15 minutes at a time with minimal distractions. Make sure your child has their hearing aids charged and fitted before teaching and is wearing their glasses, if indicated. To practice the fire drill, ensure your child has their walking aids handy near the bedside, if indicated.

Emotional factors:

If your child becomes fearful when talking about fire or has experienced a trauma due to fire, proceed sensitively to avoid escalating emotions. Allow your child to self-soothe by rocking or shaking, or whichever way they choose. As you already know, your child may not be upset; it is just their way of attempting to process their surroundings while passing time. This is completely acceptable as long as it does not interfere with participation. If your child starts crying, take time to comfort them and bring them back down to a state of composure. Speak with a calm tone throughout the teaching and make them feel safe by being fully present and reassuring them when necessary. It can be scary to talk about what might happen if a fire gets out of control. Emphasize that there are activities which will promote safety.

Motivation to Learn:

No one knows your child like you do. Illustrate concepts using their own interests to captivate them. If your child loves astronomy, point out that even astronauts prepare for emergencies. If your child loves riding their motorbike, insert bike-riding into the conversation.  Show them how staying safe relates to accomplishing their life goals. This is a highly individual component which will vary with each child. Guide them with what you have observed about their interests and behavior in the past. Fire safety is not thrilling to most people, but it can be made more fun by keeping a positive attitude and turning it into a game which can be enjoyed. Feelings of accomplishment can motivate your child to do their best and not give up.

Preferred Learning Styles:  

We will address cognitive and kinetic learning styles. You can choose whichever one your child learns best with or use a combination to help your child grow to draw new conclusions. If you choose both, plan to spread the teaching plan over multiple days. For example, one day can be spent visiting the fire department, the next day can be spent practicing the fire drill, with another day to practice learning the home address. Teaching is an ongoing process, not a one-time lecture. One concept per day is sufficient to prevent overwhelming the child’s abilities.

Environmental Factors:  

This teaching is best when given in a plain, noncompeting environment such as a living room, bedroom, or a study. If your child is accustomed to a certain routine which will preoccupy their thoughts at the time of teaching, perform this education afterwards so that your child will be able to spare the attention necessary to absorb it.

When practicing the fire drill, start in the room your child normally sleeps in. Utilizing your home’s smoke detectors can be an effective way to demonstrate how the process will actually unfold. Pushing the test button on your detector will show your child what it actually sounds like. Ordinarily, children with autism cannot naturally withstand loud noises, it sounds so much louder to them. The sensory overload may become intolerable, which is disorienting and frightening.

If your child cannot tolerate the loud beeping, provide earmuffs for him or her and keep them in a stable location (a hook on the wall next to their bed is a convenient idea). Teach your child where the earmuffs are so they can grab them easily. If you don’t have earmuffs, you can convert an old pair of headphones by cutting the wire off. Teach them that even if the earmuffs are missing from their spot, still follow the plan as practiced without them. Earplugs are another option of your child knows how to use them properly, which might not work for kids who can’t stand something being inside their ears. Alternatively, if you prefer, you can mimic the sound of the smoke detectors by using a sound byte on YouTube and just keep it mid-volume. Remind your child that the actual beeps from smoke detectors will be louder.

Learning Need/Diagnosis

Anxiety/Fear related to stressors possibly evidenced by apprehensiveness, distress, and feelings of fear. (Doenges, Moorhouse, Murr, 2019)

Measurable Goals

Short term goals: Your child will appear relaxed and report or demonstrate relief from manifestations of anxiety about fire safety by the end of the teaching plan today. (Doenges, Moorhouse, Murr, 2019)

Long term goals: Your child will engage in age-appropriate activities such as fire safety preparations at home in absence of parent or primary caregiver without fear or distress noted within six months after teaching plan. (Doenges, Moorhouse, Murr, 2019)

Interventions for Optimal Learning Environment

1.) Establish an atmosphere of calmness, trust, and genuine positive regard.

Rationale: Trust and unconditional acceptance are necessary for satisfactory therapeutic relationship. Calmness is important because anxiety is easily transmitted from one person to another, and children are often adept at sensing changes in the moods of adults around them. (Doenges, Moorhouse, Murr, 2019)

2.) Prepare your child for activities and procedures. Provide explanations in language appropriate for age and development. Use terms familiar to child. Provide opportunity for your child to ask questions, observe, or touch equipment as appropriate.

Rationale: Accurate and age-appropriate communication promotes trust and creates an atmosphere where the child feels free to ask questions. Based on the child’s developmental level, observation of “machinery” in action may help reduce concerns regarding the unknown. Note: Children may become frightened of things they cannot articulate. (Doenges, Moorhouse, Murr, 2019)

3.) Ensure your child of his or her safety and security—listen to child, identify needs, and be available for support.

Rationale: Strange people and surroundings, changes in routine, and loss of control in situations create anxiety and can be very frightening. Children may believe that the situation is punishment for some wrongdoing—imagined or real—on their part. Providing information and being available can be reassuring. (Doenges, Moorhouse, Murr, 2019)

Detailed Outline  

Ensure that your child has eaten, is well rested, and has visited the restroom before teaching begins. Silence telephones and turn radios and television sets off. Explain that this is a time to learn something new, make it as fun as possible. If little brother(s) or sister(s) is nearby, involve them in a quiet activity while you teach your autistic child one-on-one. You can train your other children one-on-one as well in a designated time period, so no child is left behind. Then practice all together when everyone has received individual lessons. If your child is unwilling, try again after a short nap or snack.

When teaching, use the words your child uses. For example, if your child says things like, “fire truckers,” follow their lead and say “fire truckers” to align with their thought process. Have your child explain what they know to you, and build upon that knowledge base. Use short, direct phrases throughout the teaching so there is no chance of confusion. Allow time between concepts for your child to ask questions and digest the new information.

Take time out to practice a fire drill at home and develop a family escape plan. Point out where all of your doors are and have your child practice how to unlock them. Work out several scenarios of where the fire could be, and locate at least two or more exits per room, such as a window and the door. Have your child identify an exit path for each hypothetical fire. Correct your child when necessary to help them understand why one path is safer than another.

Act out the sequence of actions to take with your child starting from the beginning: hearing the smoke detector going off while reclining in bed, getting out of bed, choosing the best exit, assessing the door, ignoring distractions, and getting out of the house safely. Seeing you demonstrate the process first will prime them for what they will need to do in return. Throwing variables in like changing the location of the fire will introduce reality and help your child remain flexible with the plan to reflect how fires start organically (not in a predictable location).

Check your child’s understanding by asking them questions after each concept taught. If your child has not understood a teaching, modify the way you phrase it so that they can grasp it more completely. If they still don’t understand it, switch teaching methods. If you are teaching using a pamphlet (like the fire safety pamphlet for autistic children from paautism.org), try playing a video to describe the concept. If you were playing a video when they did not comprehend, try acting it out in front of them to convey the meaning. Use props to make the teaching more powerful.

Plan to take a short trip to a local fire station if possible to demonstrate what the fire department looks like. If your local fire station gives tours, make an appointment to bring your child so they can see the firefighters, trucks, and hoses in person. Showing instead of telling your child may be beneficial so they can gain a holistic concept of fire safety in the community. If your fire department is not giving tours any time soon, play a video about firefighters in action so your child can see. Answer questions as they arise. Present solutions to the problems your child may express so that they understand that for every problem, there is an intervention to turn to. Skip words that arouse panic and instead apply peaceful, clear vocabulary. This will assist your child to feel empowered instead of frightened. Keeping your child in control of their emotions is the first step to fire safety.

Here is a guided script you can use to verbally explain what to do during a fire at home while following along with the steps outlined on the fire safety pamphlet from paautism.org. You can individualize this script however you see fit to make it more distinctive to your family’s home and situation. Feel free to change the wording to match your child’s interests specifically, this is only a template. Begin:  

If the smoke detectors start sounding, do not panic. Stay as calm as you can. You can use your earmuffs or cover your ears if it is too loud, but getting out of the house is the most important thing to do. When you hear the smoke detectors beeping, think, “I must get out of my house now.” Try your best to ignore the beeping, it will not last forever. If there is no fire in your room, get out of bed and walk to your door quickly. Leave all of your belongings in your room, do not try to save anything. You are the most important thing you have, everything else is replaceable. It is okay if you are not wearing your favorite pajamas or do not have proper clothes on, do not try to get dressed when your smoke detectors are beeping. No one will care if you are in your SpongeBob shorts, they will be happy that you are alive.

If your door is closed, feel the door, then feel the doorknob. If the door and doorknob are not hot, open the door. If it is hot, you can use a towel or shirt to turn the knob if it is your only way out of the room. (Alternatively, you can crawl out of the window if that is a safer part of your family’s escape route, depending on how close the fire is to your door.) Once you open the door, if you see fire, stay calm by remembering your escape plan. You are ready for this and have what it takes to get through it.

Scan the room with your eyes and locate the closest door that is not blocked by fire. This could be the front door that you use every day, or it could be a back door that you only use sometimes. It could also be a side door that you rarely use. Whichever door is not blocked by fire, commit to getting to that door. Do not change your mind when you get halfway there, this is the right thing to do. If the house is filled with smoke, drop to the ground and start crawling to the door. If there is no smoke or fire outside of your door, you still want to get out of your house as quickly as possible to understand why the smoke detectors went off. (Teach your child that smoke detectors are not powered by electricity, so they will still work in the case of a power outage. This may be reassuring to them.)

Once you reach the door that goes outside, tap the doorknob, if it is not hot, turn it and go outside to the end of your yard, driveway, or wherever else has no fire. If your parents are outside, listen to what they tell you to do. If you are home alone, you will want to walk to a neighbor’s house and tell them to call the fire department or 911. Tell them, “There’s a fire at my house. Please call help.” If you have a cell phone with you, you can call the fire department yourself by dialing 9-1-1, but you must tell them what your address is. Practice your address over and over beforehand so you will be able to tell them where to send the firetruck. Have your parents write your address on a whiteboard or keep it handy on the wall or refrigerator so you can look at it every day to help you remember. If you cannot remember your address, have your parents save it in a permanent place on your phone, on a sheet of paper on your wall or in your backpack so you can just grab it when you need it. Do not call 911 while inside your home. Getting out of your house is the most important thing to do.

Wait for the firefighters to come to put the fire out, do not try to put the fire out by yourself. Stay far away from the outside parts of your house, because burning wood or hot bricks could fall on you. When the firetruck comes down the road, you will hear a loud siren. This is a good thing, because help is on the way. You can cover your ears if you don’t have your earmuffs, but the sound cannot hurt you. It is just meant to let other cars on the road know that the big firetruck is coming and to move out of the way so the firefighters can get to your house faster.

Once the firefighters get there, listen to whatever they tell you. The firefighters are there to keep you safe, what they tell you is important. No one is in trouble. House fires happen, accidents happen. You are not to blame, and no one is going to be mad at you. You should stand where the firefighters tell you to stand. Answer questions if you can. If the firefighters shout, it is only because they want to make sure you can hear them, not because they are angry. They will not hurt you in any way. There is no reason to run away, staying with your parents and the firefighters will keep you safe.

Then wait. You will see firefighters hooking up hoses to fire hydrants, you might see your neighbors coming outside. If you don’t have warm clothes on, a firefighter might give you a blanket to keep you warm if it’s cold. If you are hurt or have burns, someone might put cream on your burns to make them feel better. You have succeeded at getting out of your house. You have your whole life ahead of you now. You are safe!

Method of teaching information:

Kinetic style: Walk or drive to the fire department in your neighborhood while verbally explaining what happens at the fire station. Point out fire hydrants along the way and explain how water is blasted through them when the hoses are connected. Visually show your child what the firetrucks look like, explain the function of the hoses and how they hook up. If your fire department gives tours, make an appointment so that your child can meet a firefighter in person and become familiar with the concept that firefighters are kind people who can be trusted.  

Cognitive style: At home, print a chart with steps to take in case of a fire and place it on the wall in the kitchen or in your child’s bedroom to surround them with reminders of what to do. Go through the steps outlined one by one and explain what they mean. You can print out a fire safety chart from paautism.org for free. Train your child to be observant of their surroundings and to recognize smells of smoke or burning. Explain how house fires usually start in the kitchen from cooking, from candles, and from electronics. Tell your child how to stay safe in the kitchen by not touching the stove or putting paper products, food, or anything else on the burners when they are lit (don’t roast marshmallows when parents aren’t looking…). Revisit the concepts regularly to ingrain the ideas.

Kinetic and cognitive combination: Autistic adolescents can struggle to understand what each part of their address represents. Practice teaching your child what a country is, what a state is, what a town is, and what their street name is. If you child has struggled with understanding maps in the past, make a large circle with your arms above your head and say, “This is a country.” Make the circle smaller with your arms and say, “This is a state.” Bring your arms down and put your hands together in a circle and say, “This is a town.” With two fingers (thumb and index is easiest) pressed with an inch between them, say, “This is a street.” This will help your child to see that their country is the “big land”, and their state is a smaller piece of land inside the country and so forth. Drawing the circles (or squares, whatever shape you want) on a sheet of paper can also be helpful to illustrate the concept of how each part fits inside one another.

Tell your child that the house number is the first part to say when telling people where you live. Then teach the street, the town, the state, and the zip code. The zip code can be confusing, so start with the house number first. If your child can only memorize one number today, let it be the house number; the zip code is less important. Keep working on remembering the two numbers by having a ‘first number’ and a ‘last number’ to say if they can’t remember which one is the house and which one is the zip.  Teaching your child about geography on an ongoing basis is the best way to help them absorb it. Keep maps around your home and have conversations about land masses to help them grasp how distances and sizes relate to location. Repeat these exercises until you are confident your child has comprehended the steps and can recite their address to first responders.

If all else fails and your child cannot remember their address for the time being, place it all around your home on the refrigerator, a whiteboard, your child’s room, in their backpack, written in their lunchbox and in notebooks, and on your child’s phone in a permanent place so they can reference it in an emergency. Never stop introducing the information, one day your child might just surprise you. If you move, remember to create a new escape plan in your home and refresh the address on your child’s phone and on the charts around the house. Do not assume that your child knows the new address, they might still have the old address in mind. This can take time and persistence. Be patient.

Method of Evaluation of Learning:

Ask your child to verbalize what they learned by answering questions like,

  • “What will you do when you hear the smoke detector beeping?
  • What are you going to do if you see fire blocking the front door?
  • What should you do while the firefighter is putting out the fire?
  • Should you go back inside the house to grab your money bag? Why not?
  • What street do we live on? What is the number of our house?”

Correct and reinforce when your child answers. If your child is nonverbal, have them demonstrate physically what they will do when they hear a smoke detector beeping, and how they will tell first responders where they live. You can allow your child to mimic your actions if necessary. At the very least they will have been exposed to the information and it will familiarize them with the process of getting away from a fire in their home safely. This may include showing their address to someone who can verbalize this for them. The main point is to make sure they can communicate when they need to. Significant support is necessary, but a level of independence is possible.

Method of Teaching Information:

Kinetic and cognitive combination: Utilizing a fire safety pamphlet from paautism.org, explain the sequence of actions your child needs to take when the smoke detectors go off. Practice a fire drill in your home according to the steps in the template. Direct your child to make decisions of what to do next according to what you have shared from the pamphlet. If you live in a one-story home, have your child practice opening the window in case the door is blocked by fire. If you live in a high-rise apartment or your child’s room is on a second-story or higher, map out a route that will allow them to escape. Train them that there is more than one way to accomplish a goal. Flexibility can be learned, but going slow is your best strategy.

Kinetic style: Practice both a scenario of the whole family all being home during the fire, as well as a scenario of the child being home alone during a fire, even if you never leave your children alone. We cannot know what might happen in the future. Allow your child to gain exposure to the possibility of both situations just in case. You can place signs with pictures of the next step to take at strategic locations such as near your child’s bed, at the door or window, by the front door, and so on through your family’s whole escape plan. This might help your child to remember without your verbal commands step by step. This can also help them to become independent and feel proud of themselves for following instructions without your constant assistance. This is their accomplishment; they are a capable individual.

This will also help them to understand that signs are all around them to communicate information. This will train them to look for signs when needing help and to interpret what the pictures are trying to say. Repeat these exercises until your child shows habitual understanding without much prompting. Keep the signs up as long as your child still depends on them to know what to do next. Try removing one sign at a time. Just seeing the door might trigger a memory of what comes next in a domino effect, until the signs are repeatedly unnecessary. This will be different for every child, and it is okay if the signs are necessary permanently. Revisit the lessons weekly until it becomes second nature for your child.

Method of Evaluation of Learning:

Direct your child to role-play what they would do if their smoke detector went off in the middle of the night. Start in their bed. Mimic the smoke detector sounds or play a sound byte from YouTube. Coach your child (after giving them a chance first) if they forget what comes next. Go all the way outside and pretend the firetruck has arrived. Correct when necessary. Praise their efforts, help them to recognize that what they are doing matters. Repeat until you observe that your child is demonstrating a more fluid sequence of actions to take and no longer requires frequent prompting. Take breaks if necessary and revisit the teaching regularly until you are confident that your child knows what to do.

Evaluation of Teaching

Did learners meet short term goals? The parents taught their child using both kinetic and cognitive styles on 2 different teaching days. First, they laid a foundation by visiting their local fire department, and the child was able to see a firetruck in person. When they got home, they formed a family escape route for each room. The child remained calm when practicing the fire drill by using earmuffs while the parents coached the child. The next day, the child practiced their address and was able to understand that there are different parts that need to go together for the address to be correct. The child struggled with understanding the components of the address, but was able to repeat half of it. The child was able to demonstrate several of the steps of the fire drill learned yesterday and verbalized more understanding about the process than before the teaching. The child became excited to participate and felt in control of the situation and more prepared for a real emergency. By the end of the teaching plan, the child had not panicked and remained positive.

Did learners meet long term goals? The parents continued to revisit the teaching plan by making it a twice weekly lesson, both the fire drill and the address. The child became more and more proficient at reciting the address independently, and could repeat it without significant prompting by the end of the six months. The child retained sufficient memory of the steps to take when the smoke detectors start beeping and can quickly get out of bed and outside safely following the escape plan. The parents removed some of the reminder signs but still needed to keep some of them up for their child to remember what to do next without prompting. The child developed a tolerance to the noise of the beeping and can withstand it now without significant distress. The child is prepared for an emergency, and the parents can sleep better at night knowing their child is as safe as can be.

 

References

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nursing care plans guidelines for individualizing client care across the life span (10th ed.). Philadelphia: F.A. Davis

Fire safety: How to stay safe social story. (n.d.). Retrieved February 11, 2021, from https://paautism.org/resource/fire-safety-social-story/

 


Submitted: March 14, 2021

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