Health Care Professionals

Appointments
Talking to patients with ASD
Physical Examinations
Patient Responses
Sensory Stimuli
Sensory Overload
Pain
Paramedics
Injections
Emergencies/Accidents
Opticians and Dentists
General Tips to Assist

Tips for Health Care Professionals:


Appointments:

  • Try to give patients with autism the first or last appointment of the day as waiting can increase stress and anxiety levels
  • If at all possible, allow family to wait in a separate room or side room
  • Alternatively, allow family members to wait in the car and then someone can fetch them
  • If you are running late, phone the family/patient to avoid them having to wait for you


Talking to patients with ASD:

  • Use simple, clear, DIRECT language
  • Explain exactly what you are going to do and if possible, use a picture to explain
  • Use concrete language
  • Avoid terms such as “it will only hurt for a minute” because people with autism take things very literally and so your patient will expect that in a minute the pain WILL be over
  • Be direct in your requests/instructions and check that your patient has understood you
  • Ask for information you may need (this may not be offered voluntarily)


Physical Examinations:

  • Warn the patient before touching them
  • Explain exactly what you are going to do
  • If needed, use a parent/caregiver to help you, especially if the patient is non-verbal


Patient Responses:

  • Patients may or may not make eye contact, but this does not mean that they are not listening to you
  • Allow for additional processing time
  • Do not assume that a patient who is non-verbal does not understand you
  • People with autism may not understand personal space and so may invade yours, or they may need more space between you than the average person
  • People with autism struggle with empathy and anticipation so they may not understand what you intend to do


Sensory Stimuli:

  • Some people with autism have challenges with their sensory processing
  • Some are over-sensitive to stimuli (their senses are heightened), while others may be under-sensitive (their senses are dulled)
  • Be very aware when using something like a penlight torch (dentists) or bright overhead lights as this may trigger reactions


Sensory Overload:

  • Sensory overload can occur quite easily for someone with autism
  • A busy waiting room, hospital corridor, emergency lights and sirens for example, can trigger this
  • Some people may withdraw (block their ears/close their eyes), while others may ‘stim’ (for example, flap their hands, or rock back and forth) as this is calming for them


Pain:

  • Some people with ASD have extremely high pain thresholds
  • Some may react unusually to pain e.g. laugh


Paramedics:

  • If transporting a patient with ASD, turn the siren off (if possible) as this can be painful for their ears. Certain patients, however, may find great delight in the siren
  • Consult with the patient/family before transporting them to assess which of the above applies
  • If you have to strap the patient onto the stretcher, be very clear about what you are doing and WHY as some patients may be terrified by this
  • You can request a parent/caregiver to assist with this as well


Injections:

  • Explain clearly what you are about to do and if possible, use a doll to demonstrate
  • Divert their attention elsewhere if the patient needs an injection
  • Some people are over-sensitive while others are under-sensitive to pain
  • Best idea is to assume that they are over-sensitive and to use a local anesthetic to numb the area you are going to inject


Emergencies/Accidents:

  • In an emergency, allow the parent/caregiver to take control as they will know best how to keep the patient with ASD calm
  • The patient may also exhibit challenging behaviours which the caregiver will be better equipped to handle
  • Try to eliminate the number of staff surrounding the patient as he/she is likely to be over stimulated by noise, bright lights, people (and possibly pain) as it is
  • If treating in the emergency room, allow the parent/caregiver to stay as this can help to reassure the patient as well as give valuable information about the patient’s behaviour
  • As much as possible, minimize the amount of time that the patient has to wait.


Opticians and Dentists:

  • People with ASD may react aversely to bright overhead lights or the sound of a drill or cold instruments in the mouth, or even the taste of the mouthwash
  • Similarly, the heavy eye glasses and equipment used by opticians may be challenging for people with autism to cope with
  • These may result in meltdowns. This is NOT a tantrum
  • Having someone who knows the child (and who possibly works with him/her) may help a great deal


General Tips to Assist:

  • Visit the health professional beforehand. Make it a casual visit where the child can get to know the professional and they can be shown the instruments, treatment room, etc. to reduce anxiety on the day of the visit
  • If there is a sibling, allow the child with ASD to accompany you to the sibling’s appointment so they may watch. It will then not come as such a shock when they have to go themselves
  • As with injections, you could use a doll to demonstrate the procedures you are about to do on the child