Autism and Anxiety
AUTISM
Medical Visits and Autism: A Better Way
Strategies to reduce anxiety during doctor visits.
Posted April 6, 2019
Going for a medical visit can be a scary proposition for any child. A child on the autism spectrum has to cope with all of the usual fears associated with seeing a doctor. However, for the autistic child, there are a host of other factors that can make seeing the doctor not only unpleasant, but also downright terrifying. Some of these factors are:
Waiting
Waiting is unpleasant and difficult for most children to do. However, for the autistic child, waiting can result in very high distress. Children on the spectrum may struggle with the concept of time, and thus may not find comfort in being told that they will be seen in X number of minutes. Waits at the doctor's office also tend to be unpredictable, and this unpredictability often creates high anxiety for autistic kids.
Abrupt Transitions
Doctor's offices are busy places. When it is time to move from one part of the visit to another, there is often pressure to do it quickly, without advance notice. These types of abrupt transitions can be very unsettling for the child on the autism spectrum.
Sensory Sensitivities
Doctor's offices are not very sensory-friendly places: bright lighting, unfamiliar sounds, unpleasant smells, and multiple intrusions on the tactile senses (e.g., blood pressure cuff, feel of stethoscope) can be very difficult for an autistic child to process and cope with.
Language Processing
Being asked multiple questions—often at a quick pace—can quickly overwhelm the language-processing capacity of a child on the spectrum. The use of abstract language and unfamiliar medical terms can further contribute to anxiety.
The Consequences of Health Care Anxiety
Health care-related anxiety can have serious consequences. The child on the spectrum may be distressed not only during the visit, but for days (or even weeks) before. Challenging behaviors during the visit (due to anxiety, not intentional) can prevent health care providers from conducting a thorough evaluation, and may make it difficult for parents to ask questions or to express their concerns.
A Better Way
Fortunately, there are a number of strategies that parents and health care providers can use to substantially reduce the anxiety associated with medical visits. Ideally, parents and providers should work together in developing a plan that will target each individual child's needs.
These strategies include:
Bring comfort items. A favorite toy or stuffed animal can help to reduce anxiety during procedures.
Use distraction. Distraction can divert attention away from fear-filled procedures. Distractions can be physical items (such as toys or video games) or the use of a familiar person that the child feels comfortable with.
Do a "dry run." Visit the office and meet the staff before the first official appointment.
Use clear language. Health care providers should use concrete terms and a conversational pace that is manageable.
Bring communication systems. Ensure that communication systems include words and phrases which may be used during an appointment.
Use a visually supported schedule. This can help the child to understand what will occur next during a visit.
Use familiar staff. Ensure that staff the child feels comfortable with are available on the day of the appointment.
Get paperwork done ahead of time. Office staff should send forms and other paperwork home for completion ahead of time to avoid unnecessary waiting.
Address sensory sensitivities. Health care providers and office staff should address all sensory aspects of the visit and minimize unnecessary noise, smells, and other forms of stimulation.
Summary
Health care visits can be really scary for kids on the autism spectrum, but it doesn't have to be this way. With some minor accommodations, health care visits can become a much more tolerable experience for autistic children and their families
Christopher Lynch, Ph.D., is a psychologist who specializes in stress and anxiety management for children with autism. He is the Director of the Pediatric Behavioral Medicine Department at Goryeb Children's Hospital.