Abstracts

Rationale: EEG procedures in children with neurodevelopmental disabilities, particularly those with behavioral dysregulation, pose significant challenges that can compromise diagnostic quality and safety. Increased anxiety, sensory sensitivities, difficulty understanding procedures, and challenges with remaining still often result in incomplete studies, sedation use, and safety concerns for both patients and staff. Evidence shows that these barriers can be addressed through structured behavioral interventions, individualized accommodations, and multidisciplinary approaches. Techniques such as desensitization, reinforcement strategies, pre-procedural preparation, and caregiver involvement improve cooperation and procedural success. This quality improvement (QI) initiative aimed to refine institutional workflows by integrating evidence-based, patient-centered practices to enhance EEG completion rates, data quality, and safety.

Methods: A retrospective review was conducted on pediatric patients undergoing scheduled EEG placement in the Epilepsy Monitoring Unit at UCLA Santa Monica Medical Center from January 2023 to April 2025. Prior to April 2024, patients were flagged if they exhibited agitation during EEG placement, required assistance from more than two clinical staff, or failed to complete the procedure. Starting April 2024, a revised workflow incorporated a pre-screening tool to identify patients with neurodevelopmental or cognitive delays, autism spectrum disorder, sensory sensitivities, behavioral challenges, or difficulty remaining still. Identified patients were referred to child life specialists for preparatory support or evaluated for anesthesia. Fisher's exact test with a significance level < 0.05 was calculated. The primary outcome was the comparison of EEG completion rates before and after intervention.