DOI: 10.1097/DBP.0b013e31822460ee

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PMID: 21743352

Issn Print: 0196-206X

Publication Date: 2011/10/01


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In Plane Sight: A Commentary on Community Inclusion for Families Affected by Autism

Wendy J. Ross

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Excerpt

The airline would only let my patient, a nonaggressive little girl with autism, preboard with 1 family member. The mother had tried to explain that the child had autism, and it was not how they had prepared her. After boarding the plane, in a relatively new environment with only 1 parent and not the rest of her family, the child simply panicked and lashed out. Everyone stared at them, and they disembarked, totally mortified. The parents were told not to fly again without first sedating their child and they were dispatched to the airport physician.
When the airport physician called, wanting me to prescribe chloral hydrate for the flight home, I refused, fearing for the safety of the child and thinking that a bit of understanding could have prevented the entire debacle. I faxed a letter of explanation about autism and a request for a different boarding experience. The next day, with just a bit of Benadryl on board, they reboarded together and made it home.
Before the plane even landed, I had contacted the American with Disabilities Act (ADA) coordinator at Philadelphia International Airport. Over the course of the next several months, I met with the ADA committee leader and leaders from the Transportation Security Administration and Southwest Airlines to initiate an Airport Autism Accessibility Program. The biggest challenge was getting the use of a plane and volunteer crew for practice sessions for the families, but persistence paid off.
During the previous 3 years, I had been working with a multidisciplinary group of professionals to improve the accessibility of the area museums for children with autism. We convened and applied lessons learned to the airport accessibility program. We contacted Carol Gray, international autism expert and creator of Social Stories™, and asked her to write Social Stories™ for us. Airport personnel collaborated by taking photographs to accompany the stories and provide the framework for picture exchange communication systems, as well as picture schedules. The enthusiasm of the airport personnel was truely inspiring.
We united with the ADA committee leader at his annual ADA workshop, done at all shifts, to train airport, airline, and Transportation Security Administration personnel about autism. We created a pre- and postquestionnaire about the training to measure its efficacy. We piloted it among our pediatric residents and sent it to other national experts for face validity. We were gratified by the interest shown by attendees of the training and to see that all but 1 person opted to complete both surveys, allowing us to refine our training sessions over time.
Finally, we created a simulated travel experience for families affected by autism and social cognitive difficulties. After being cleared through background checks, families were prepared with Social Stories™ and other materials. They packed bags and came to the airport for a practice. To obtain the use of a plane, the practices were initially conducted on Saturday evenings, when the airport was less crowded than usual, but the circumstances were still more realistic than a home-based simulation. We printed boarding passes, checked luggage, and proceeded through security and to the gate. A Southwest crew volunteered to stay late to host us on their plane. Their chief pilot flew in to be sure that everything was going well. Without our even having to ask, ground crew members filled in seats to make the plane seem more crowded.
Once on our “flight,” take off and landing protocols were followed with all of the variations in lights and sounds that normally occur. A snack was served and people were encouraged to use the bathrooms. We did everything except actually fly.
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