Medical Professionals

Advice and support for physicians, nurses, dentists and other medical professionals to serve autistic children and adults and their families.

For Physicians & Other Medical Professionals

Tips for Appointment Scheduling

• Ask parents to tell the scheduler that their child has special needs and the appointment may require more time than a typical visit.
• For new patients, have your office send release of information to the parents before their visit so that you have access to important information from school and specialists. Also, send any medical history or insurance forms to the parents so they can fill out the paperwork in advance.
• If a child is bothered by noise, do not schedule them at the same time as well child visits.
• Have autism or developmental disabilities follow-up appointment slots that allow more time with the patient and family.
• Provide information about the order of what will happen during the visit to help parents prepare their child with a social story and/or visual schedule. (For example, check in at the desk, wait, take off shoes and coats and get weighed on scale, stand against wall to measure height, go to check-up room, have temperature taken, have blood pressure taken, etc.)

Preparing for the appointment 

Suggest that parents:

• Write a social story that includes photos of your office that you provide.
• Write a schedule or checklist for the child to cross off as each step is taken.
• Bring activities their child enjoys for while they are waiting as well as something the child can share with the professional, such as their favorite toy or book. This will help build rapport and help you assess general communication skills.
• Start a 3-ring binder or online file to keep track of medical visits. Include names of all providers, medications, interventions, etc.
• Get a play doctor’s kit and role play (i.e. listening to the heartbeat and breathing, taking temperature, looking in ears, giving shots, etc.)
• Bring a reinforcement for the end of the appointment and let the child know they will get it when they are done.

During the Appointment

• Ask the parent or child if the child prefers a light or firm touch and any other sensory issues that would be helpful to know. For example, children may find it difficult for you to look in their ears.
• Ask the parent or child how the child likes to be called.
• Tell the child what you are going to do before you do it (except for giving shots).
• Have a room with no fluorescent lights for children who are bothered by them.
• Assess whether some level of sedation is appropriate for invasive procedures.

Resources

• Have on hand our list of recommended resources to give to parents at their visit:
  • Milestones Autism Resources
  • CCBDD (Cuyahoga County Board of Developmental Disabilities)
  • Legal Aid
  • Social Security
  • Bright Beginnings (formerly Help Me Grow)
• See the American Academy of Pediatrics for information about caring for children and teens with autism.

Additional Tips for Nurses and Other Hospital and Medical Staff

• Be clear, brief and specific in your instructions. Break down what you want the child to do into simple steps.
• Describe what you are going to do before you do it.
• Discuss plans for the exam with the parent to see if they have suggestions on how to handle certain tasks.
• Giving choices may or may not be appropriate. A choice might be “Do you want to sit in a chair or lie on the table for your exam?”. If there is no choice, you need to phrase it definitively, “We need to take your blood pressure now. Do you want to sit in your parent’s lap or in the chair while we do it?”
• Be prepared that in certain situations (especially when giving shots) you may need more than one person in the room to assist.

Tips for Dentists

• Suggest that parents prepare for a visit to your office by writing a social story and provide parents with photos of your office.
• Recommend that parents come in with their child a couple of times before their first appointment to build tolerance and success at the office. Start the child just sitting in the chair for a moment and getting a reward. Come back another time to build tolerance for being touched with rubber gloves and metal tools. Eventually have an exam.
• Provide a checklist that can be checked off with the order of what will happen during the visit to help parents prepare their child with a social story and/or visual schedule. (For example, check in at the desk, wait, sit down in special dentist chair, chair will lean back, flossing, brushings, scraping, etc.)
• If it is feasible, give the patient sample tools to take home prior to their exam to practice with.
• Assess whether some level of sedation is appropriate for invasive procedures.
• An article from the New York Times offers one point of view on the importance of helping autistic children get used to dental visits. Read article