Autism Response Protocol: Pilot Evaluation of a Community-Informed Autism Training for First Responders

<title>Abstract</title> <p> <bold>Background</bold> : Autistic individuals experience increased contact with first responders due to elevated rates of co-occurring medical conditions, elopement, and behavioral crises, yet first responders frequently lack sufficient autism-specific training. While prior research and training efforts have predominantly targeted law enforcement, emergency medical technicians (EMTs) play a critical role as patient advocates during crises and remain underserved by autism-specific training initiatives. This study evaluated the efficacy of the Autism Response Protocol (ARP), a training developed by integrating community stakeholder input with evidence-based practice, among a cohort of EMTs. <bold>Methods</bold> : Fifty-one EMT and fire-rescue personnel from nine agencies participated in a three-hour, in-person training combining lecture, video examples, discussion, and case scenario practice. The training and accompanying one-page guideline were developed and refined in collaboration with a community advisory board, including an autistic consultant. Participants completed self-report measures of autism knowledge, confidence, and self-efficacy at pre-training, post-training, and 3-month follow-up. Satisfaction was assessed post-training. Longitudinal mixed-effects models examined change over time and potential moderating effects of personal relationship with an autistic person, years of experience, and prior autism training. <bold>Results</bold> : Knowledge, confidence, and self-efficacy significantly improved from pre- to post-training (all ps &lt; .0001). Confidence and self-efficacy gains were maintained at 3-month follow-up, while knowledge scores showed a slight but significant decline from post-training, though improvements over baseline persisted. Training benefits held regardless of experience or prior autism training. Participants reported high satisfaction (M = 4.60/5), and most indicated they were likely or very likely to apply the ARP in future practice. Autism Response Protocol 3 <bold>Conclusion</bold> : A community-informed autism training for EMTs produced meaningful and largely durable improvements in knowledge, confidence, and self-efficacy. Findings support the value of integrating lived experience with evidence-based practice in first responder training and underscore the need for continued investment in autism training tailored to EMS professionals. </p>