Imagine for a moment that you’re a child coming to a new hospital. You’re sick, and going to the hospital isn’t part of your routine. Everyone around you is wearing scrubs with a mask. The hospital smells funny, and the lights are too bright. It’s loud near the nurses’ station, and it’s hard to understand what people are saying to you. You see big people’s lips moving, but it’s so loud you don’t understand what they’re telling you to do.

“You can imagine how the hospital setting is a big setup for problems and barriers, not just to diagnosis management, but also to the experience for the family and patients when they come to the hospital,” says Dr. Michele Kong, MD, MBA, Professor of Pediatrics at the University of Alabama and practicing intensivist at Children’s Hospital of Alabama. “We must understand that because there are many special-needs patients out there, across all settings, we need to remove the barriers to take better care of them.”

During the recent NRC Health 2022 Pediatric Collaborative at Children’s Hospital of Alabama, Kong explained that one in five patients within the community has a sensory barrier. “Wherever the patient presents, this is the environment that this regulation and particular issue can become a real problem for someone with an invisible disability,” she says.

Sensory-processing challenges are common in special-needs children. Sensory overload can also exacerbate symptoms and become a barrier to assessment, diagnosis, treatment, and a positive experience.

Challenges can include:

• Atypical response to sensory input
• Communication challenges
• Variability in range and severity of symptoms and needs
• Rigid insistence for sameness of environment and routine
• Inability to understand expectations or social norms
• Attention problems and difficulty with transitions

Altering communication strategies and making environmental modifications can help guard against sensory overload. To address the growing needs of patients with sensory sensitivities, Children’s of Alabama created the Sensory Pathway to offer patients resources to decrease sensory overload experienced during their hospital visits. Two main ways to initiate a patient to the Pathway are caregiver identification or staff intervention. Once a patient is placed on the Sensory Pathway, tools like noise-canceling headphones or weighted lap pads and other resources are used to help support a patient’s sensory needs. Staff in all areas where the Sensory Pathway is active are trained in effective ways to communicate and work with patients who have sensory sensitivities.

To ensure that the Sensory Pathway is successful, Children’s of Alabama focuses on four main components with their staff: training, communication, environmental changes, and utilization of resources.

Staff training topics include:

• Awareness of sensory processing challenges
• Identifying dysregulated behaviors
• Shifting from a reactive to a proactive care approach
• Communication strategies
• Environmental modifications
• Familiarization with available tools, resources, and unit workflow

When it comes to environmental changes, Certified Child Life Specialist Chelsea Brown, BS, CCLS, AC, at Children’s of Alabama, says that being more cognizant of the environment that patients are in will help every patient have a better experience. “We can guard against sensory overloads by dimming the lights, reducing the noise on the TV—things that we just kind of naturally drown out,” she says. “When we can, we want to place patients in less-stimulating areas, like the corners of our units; reduce staff in the room; use the same staff when possible; and utilize one voice to speak during the procedure to reduce stimuli.”

Brown, also a Sensory Pathway Coordinator, says that they also use social stories that are written-out explanations of how the procedures take place. Each social story is written in first-person language and gives sensory-specific information, providing patients with their social norm—which is important, because these patients are very routine-driven. “Routine is predictable,” Brown says. “Predictability gives us control and comfort. When we lose that, we lose our comfort; we lose control. When we give more information, that gives them more certainty, more control, less threat, and better coping.”

Based on emerging themes from caregiver feedback, the Sensory Pathway has provided a new feeling of comfort and improved the overall experience at Children’s of Alabama.

Other NRC Health patient-experience feedback from Children’s of Alabama include:

“From the time I hit the door, I think the staff was not only welcoming but paid close attention to my son’s sensory issues. They put us in a separate room and truly catered to him in the situation that we were in. I am very grateful for that and would highly recommend them.”

“My daughter has autism and is non-verbal. She’s three, so she’s very unhappy at any healthcare facility. Children’s went above and beyond to provide us with the best possible care to keep her comfortable with her sensory sensitivities, and to a mom, that means everything.”

“The staff working to make sure that my child’s sensory sensitivities were respected made a huge difference in our visit, which meant it was a much more positive experience for my child.”