Use these tools to prepare information, reduce interpretation errors, make handoffs clearer, and structure post-incident review. They do not replace 911, 988, medical assessment, clinical judgment, law-enforcement authority, or local policy.
Which door are you trying to open?
Do not use this chart to delay an emergency response. If there is imminent danger, serious injury, fire, weapons, traffic exposure, severe violence, overdose, unresponsiveness, breathing trouble, seizure emergency, or another urgent medical/safety emergency, use the appropriate emergency service.
IMMEDIATE PUBLIC-SAFETY / MEDICAL EMERGENCY
911 / EMS / police / fire
Use when immediate response is needed for concrete danger or urgent medical conditions.
Say the danger first.
Then state autism/communication/sensory information that changes the response.
Do not assume dispatch can guarantee a specialized responder.
MENTAL-HEALTH / SUBSTANCE-USE / EMOTIONAL CRISIS
988
988 provides 24/7 call, text, or chat crisis support. Arkansas operates an in-state Lifeline call center as part of the 988 network. Local in-person options depend on the situation and available services.
Explain if the person is autistic/non-speaking/overloaded.
Ask what local response or stabilization options are available.
If danger becomes immediate, emergency response may still be required.
Use outpatient/community routes for prevention, medication issues that are not emergencies, respite/support planning, follow-up, accommodation, safety planning, and service navigation.
PPauseStabilize the scene. Stop adding words, people, and pressure that are not solving the immediate problem.
AAssessImmediate danger, injury, medical signs, intoxication, victimization, communication, sensory load, elopement, baseline and recent change.
CCommunicateOne lead voice. Concrete language. One question/instruction at a time. Processing time. Writing/AAC/visual communication when usable.
EEngageComplete the lawful/safety task with the least avoidable friction and make the handoff/next step explicit.
Threat
What can hurt someone right now?
weapon / dangerous object
traffic / unsafe location
active assault
severe self-injury
medical instability
fire / environmental danger
Task + avoidable pressure
What must be accomplished, and what can change without defeating that task?
number of speakers
language complexity
physical proximity
unnecessary touch
speed of questioning
lights/sirens when operationally feasible
communication method
30-second responder / caregiver checklist
60-second scene brief builder
Emergency-department handoff card
Information the receiving team should get
reason for transport / actual safety concern
baseline communication and current change
usable communication method
sensory / touch / proximity factors
medications, allergies, seizure history, relevant medical concerns
what responders already tried and the effect
restraint/force/sedation exposure if relevant
caregiver/support person contact and what they know
unresolved safeguarding or abuse concerns
Questions before discharge
What medical/psychiatric concerns were ruled in or out?
What remains uncertain?
What changed in medication or treatment?
Who owns the next referral/action?
When should the family expect contact?
What should trigger urgent return?
What alternative route should be used if follow-up fails?
Communication access is part of clinical accuracy. A patient who cannot reliably communicate pain, symptoms, medication effects, consent, or questions may need a different communication method, more processing time, or other effective communication support. Autism does not remove the need to assess new medical causes.
First 20 seconds: 911 / 988 call-prep card
If calling 911 / emergency services
“I need emergency help for an autistic person. The immediate safety problem is: ___ . They communicate by: ___ . The main thing likely to make this worse is: ___ .”
Say weapon / no known weapon if relevant and safe to state.
Say traffic, fire, injury, seizure, overdose, severe self-injury, violence, or other urgent hazard first.
Then add elopement, touch sensitivity, AAC/phone use, support person, or one-speaker need.
If contacting 988
“I am calling about an autistic person in a mental-health / substance-use / emotional crisis. Current safety risk: ___ . Communication needs: ___ . What crisis-response or stabilization options are available where we are?”
988 is not a replacement for 911 when emergency public-safety or medical response is needed.
Do not assume a mobile team is available on every call or in every location.
Ask what happens next and who owns the next step.
Traffic-stop access: Arkansas Blue Envelope + general communication
Arkansas Blue Envelope
Arkansas's Blue Envelope Program is designed to support communication between autistic drivers and law enforcement during motor-vehicle interactions. It is a traffic-stop tool—not a universal crisis credential.
A communication need still exists even without a diagnosis card or ANCHOR tool.
When safe, state that the phone/AAC device is being used for communication before reaching for it.
Follow lawful officer instructions; the tool does not exempt a driver from the stop.
Responders should use accessible communication based on actual need, not only possession of a special identifier.
Emergency-department access request card
“This patient has a communication/sensory disability. Current communication is ___ . Baseline is ___ . Please use one speaker / writing or AAC / extra processing time / warning before touch / a quieter waiting area when feasible. New symptoms or behavior change still need medical assessment.”
This is a request for usable care, not a demand to bypass triage, safety procedures, medical assessment, or necessary treatment.
After-action review: learn from the actual failure
For agency/program quality improvement, aggregate recurring patterns instead of building unnecessary permanent disability dossiers. The ANCHOR Public Safety Access Codex specifically treats documentation, role boundaries, legal authority, controlled simulation, supervisor review, and pilot data as part of implementation—not optional extras.
Scope: Educational support and training aid. It does not create legal authority, establish a diagnosis, replace emergency/clinical protocols, or guarantee availability of any local crisis service. PACE is an ANCHOR training framework, not an adopted statewide Arkansas mandate unless a responsible authority formally adopts it.