Caregiver Codesigned Simulation Training for Paediatric Intellectual Disability Emergency Care.

BACKGROUND: Children and young people with intellectual and developmental disabilities (IDD) often face significant challenges in emergency departments (ED), where a high-acuity environment can exacerbate distress, leading to behaviours of concern (BOC). Identifying and managing BOC requires specialised skills, yet many healthcare professionals report a lack of confidence and structured training. Traditional educational models may lack real-world applicability by failing to incorporate the lived experiences of patients and families.

APPROACH: The Motivated for Change programme was codeveloped with caregivers to enhance healthcare professionals' ability to identify, mitigate, and de-escalate BOC in children with IDD using simulation-based education (SBE). The programme integrated prelearning modules, interactive lectures, and novel immersive simulations. SBE was codesigned with parents, clinicians and educators to reflect real-world ED challenges and guided child and family-centred approaches. Participants engaged in simulation exercises to practice communication strategies and implement reasonable adjustments in a structured, supportive learning environment.

EVALUATION: Eighty-two ED healthcare professionals participated in 11 simulation sessions. Postsession surveys revealed SBE was effective in consolidating skills in communication and engagement (100%), identifying BOC (99%), preventing escalation (99%) and de-escalation strategies (96%). Ninety-seven percent felt more confident applying reasonable adjustments in clinical practice. Reflexive thematic analysis identified key learnings, including parent partnership, effective communication, early recognition and intervention and environmental modifications.