Personal approach enables MRI in autistic patients

Other factors for success include availability of special educational needs (SEN) specialists in MRI departments and specific guidance for radiographers in managing exams on autistic patients, according to Nikolaos Stogiannos, an honorary research fellow at City, University of London and a research assistant at University College Cork in Ireland.

“All of these will certainly contribute to a better MRI experience, inclusive MRI environments, and high-volume scans,” said Stogianno in his presentation on the current practice and challenges in the UK related to providing MRI to patients with autism.

ISMRM is holding this week’s meeting in conjunction with the European Society for Magnetic Resonance in Medicine and Biology (ESMRMB) and the International Society for MR Radiographers and Technologists (ISMRT).

An overwhelming experience

There are estimated to be over 700,000 people with autism in the UK And the noise, isolation, and unfamiliarity of an MRI scanning environment can easily overwhelm both neurotypical and autistic patients, impacting the quality of the exam and the patient’s experience, according to Stogiannos.

Although sedation or general anesthesia may be used in autistic patients, those procedures come with their own risks, he said.

“It is therefore vital to explore efficient ways to avoid seduction, improve patient experience and image quality, and increase scan completion rates for a clinically useful examination,” he said.

To delve into the issues involved with providing MRI exams to autism patients, researchers from the University of London performed three separate studies.

  • First, they systematically reviewed studies in the literature describing adjustments made to facilitate MRI in these patients without the use of sedation or anesthesia.
  • Next, they surveyed radiographer practitioners in the UK to assess current practice for these patients.
  • Finally, they performed a cross-sectional survey of autistic patients to explore the perspective of these individuals in the UK and to determine the most important barriers and enablers for a successful and safe MRI scan.

Communication, distraction

After analyzing 21 studies in the literature, the researchers found a number of major themes. For example, there’s a need for effective communication, including all aspects related to pre-visits and on-site communication between the radiographers, the MRI department, and the patients, or between the radiographers and the patients’ carers, Stogiannos said.

Although identified in the literature as an effective psychology-based intervention, applied behavior analysis (ABA) is largely condemned by the autistic community as a type of “conversion therapy,” he noted.

It’s also important to provide adjustments aimed at alleviating the sensory challenges autistic patients may experience before, during, or after the MRI exam.

“To ease any sensory issues, provision of an autism-friendly MRI environment by adjusting lighting, temperature, acoustic noise, and the number of staff involved was widely recommended,” he said. “Ensuring the patient’s physical comfort is also essential for a successful examination.”

Simulation, familiarization

Another major finding was the benefit of simulation and familiarization techniques, performed both at home and on-site.

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