News and Knowledge

Scary. And necessary. Plenty of adults are reluctant to visit the doctor or dentist. But we’re also aware of the necessity and benefit that good health care provides in keeping us from serious illness.

For children, however, particularly those with autism, fear can outweigh the benefits. So how can you as the parent make the visits less scary? Here are some suggestions from doctors, dentists, and researchers across the country.

Before You Go

1. Do some research. Ask other parents who have children with autism if they have healthcare providers or dentists they recommend. Call around to recommended providers and tell them about your child and their needs. Ask if and how they could accommodate your child to make the visit as smooth as possible.

2. Let the provider with whom your child has an appointment know about your child’s needs. In a blog post on the Children’s Hospital of Philadelphia’s website, Judith S. Miller, PhD, MS, a psychologist and training director in the hospital’s Center for Autism Research, provided a list of what to include in that conversation:

• Any special communication needs your child has
• Whether your child finds going to medical appointments, haircuts, etc. difficult
• If there are times of day that would be best for an appointment
• If your child reacts to specific triggers and what those triggers are

Kristin Sohl, associate professor of child health at the University of Missouri, offered another point:

“Doctors need to use simple, direct communication when talking to a child with autism. They can be confused by idioms or turns of phrase that might have a different literal meaning. Providers should explain what they’re doing before they do it to reduce anxiety and encourage the patient’s understanding of the procedures.”

3. Schedule a desensitization visit. In a blog post he wrote for OAR in October 2018, Steven DeLisle, DDS, a pediatric dentist and founder of Children’s Dentistry in Las Vegas, noted that the office staff and healthcare provider can show the child things like the dental chair or exam table. Your child can see the tools and instruments that will be used. If it works for you and your child, think about taking your child with you when you get your teeth cleaned or go for a flu shot. That gives your child familiarity with what happens in a medical office and shows them that it’s not something to dread.

4. Schedule your appointment for the first slot of the day or the first one after lunch, suggests Larry Yin, MD, medical director of The Boone Fetter Clinic at Children’s Hospital Los Angeles. In a blog post on the hospital’s website, Dr. Yin wrote that doing so can reduce wait times. He also recommended that parents ask to get forms in advance so they can be filled out at home. Forms your child’s school requires can also be filled out and sent to the healthcare provider in advance.

5. Prepare your child for the appointment. Dr. Yin’s suggestions included developing social stories and/or visual schedules to walk them through what a medical appointment will be like and role-playing the visit. He also suggested practicing calming activities and exercises beforehand so you can use them with your child if and when they are needed during the visit.

When You Go

6. Take whatever your child needs for comfort. In addition to items like stuffed animals or tablets, bring sunglasses and headphones to block out/reduce light and noise.
7. Use rewards and reinforcement for each step of the appointment your child completes.
8. Bring another adult to help you, if possible, by taking notes or comforting your child.
9. Have a backup plan with the provider to determine when to stop a procedure or call in more assistance.

After the Appointment

10. Praise, praise, praise your child for his or her successes during the visit.

For Adults with Autism

If you are the parent of an adult with autism, the same suggestions apply, modified as needed to fit your adult child’s situation. Leah Stein Duker, assistant professor of research at the USC Chan Division of Occupational Science and Occupational Therapy, recently completed a study in which she and her team conducted interviews with adults with autism, their caregivers, and their providers to better understand the types of problems they face during primary care.

A 2014 study by a research team that included OAR Scientific Council member, Dora Raymaker, Ph.D., provides detailed information and suggestions for adults with autism in the section titled “Facilitating Effective Health Care Interactions.” The research team noted that “autistic adults described examples of how failure to accommodate communication, sensory integration, and executive functioning resulted in poor outcomes. They also reported that their “uneven skills led providers to make false assumptions about their abilities to understand health care issues, communicate, or navigate the health care system.”

They pointed out that “access to health care can be improved by using alternative communication strategies, reducing sensory stimuli, providing additional structure to visits, allowing extra time, and using visual aids.”

Good health care is vital to all of us. Ensuring that your child has access to care that accommodates their needs can provide a foundation for your child’s good health for years to come.

Sources and Resources

Read the articles this advice came from and a few additional ones for more information:

• Autism Integrated Care Program Resources
• Clear Communication Can Make Doctor Visits Successful for Children with Autism
• Easing Clinic Visits for Kids With Autism
• Eleven Great Ideas to get the Best from Your Child’s Health Care Visit
• How to Create a Positive Dental Experience for Your Child with ASD
• How to Ease Anxiety for Adults With Autism During a Doctor’s Visit
• Preparing Your Child With Autism for a Medical Visit
• Primary Care for Adults on the Autism Spectrum
• Tips for More Positive Office Visits for Patients with ASD