The Intake

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Providing a better doctor’s visit for children on the autism spectrum

Tips and care guidelines for children on the autism spectrum for your medical practice.

A Black child trying on a stethoscope with a Black doctor and a parent to illustrate a successful doctor's visit for a child with autism

At a Glance

  • Autism spectrum disorder (ASD) affects 1% of the population, posing a challenge for pediatric practices due to medical staff’s general lack of confidence and knowledge in treating patients with ASD.
  • Doctor visits can be particularly stressful for individuals with ASD due to sensory overstimulation and communication barriers.
  • Healthcare practitioners can improve the patient experience by creating a welcoming environment, minimizing wait times, employing trained staff, and using clear, literal communication strategies.

An estimated 1% of the population has autism spectrum disorder (ASD). With such a large increase of potential patients on the spectrum, there is an increased chance of pediatric practices needing to provide care to them. In fact, 1 in every 36 children is believed to have ASD

However, many medical staff report a lack of confidence in their ability to serve individuals with ASD effectively. This lack of confidence is due to multiple factors: the wide variety of ways that autism can manifest, lack of prior training, and general lack of knowledge about autism. 

However, there are ways that medical practices and healthcare practitioners can provide safe and successful accommodations so that children on the spectrum can receive strong medical care. We'll start by giving an overview of what autism spectrum disorder is, and then cover what healthcare professionals can do to provide them with the best experience. 

What is autism spectrum disorder?

Autism spectrum disorder, otherwise known as ASD or autism, is a developmental disorder that affects an individual's communication and social interaction skills. Repetitive or restricted interests, behaviors, and activities can characterize ASD. 

While the cause of autism is unknown, factors that increase its likelihood include having:

  • A sibling with autism
  • Parents who were older at the time of pregnancy
  • Another genetic condition

Because autism can manifest very differently from person to person and with varying levels of severity, it is known as a spectrum disorder.

Signs of autism spectrum disorder

Some of the common signs of autism include, but are not limited to: 

  • Avoiding or not keeping eye contact
  • Having delayed movement, language, or cognitive learning skills
  • Having obsessive interests 
  • Becoming upset by minor changes and a strong need to adhere to the same routine
  • Having unusual mood or emotional reactions
  • Experiencing difficulties interpreting another's emotions or sustaining friendships

Individuals who are autistic may develop signs within the first 5 years of life, commonly evidenced by missing developmental milestones. Perhaps surprisingly, social media is playing a role in ASD self-diagnosis as individuals notice these signs and then seek out help from a professional.

However, because of the wide range of symptoms and severity from person to person, autism is often challenging to diagnose. A healthcare professional must assess one's developmental history, behavior, and progress. It is not possible to diagnose ASD through a medical test, such as a blood test. 

While regular healthcare is essential for everyone, many individuals with autism have comorbidities, such as digestive problems, other psychiatric disorders, or epilepsy, which require additional care. However, children with ASD often experience barriers to care because doctors may be unsure how to accommodate their needs. In addition, going to the doctor can be more anxiety-inducing than it would be for the general population. 

Why doctor's appointments are difficult for children with ASD

Doctor's appointments can be very challenging for people with autism because the sensory environment or experiences associated with doctor's visits, such as a change in routine, receiving a vaccine, getting care for a wound, or even having their blood pressure taken, can be overwhelming. 

Many children with ASD may struggle to communicate their symptoms or feel their doctor does not understand them. These concerns, compounded with the lack of education about autism, how it presents, and how to make children with autism feel comfortable in a doctor's office, can lead to breakdowns in the patient-provider relationship. 

Providing a more positive environment is essential to maintain the integrity of the patient experience, from how a patient and their caregiver perceive their doctor's visit to their overall satisfaction with their care to the likelihood of returning for additional care, should they need it. Luckily, there are steps that both parents and healthcare practitioners can take to make a doctor's visit more comfortable for children with autism. 

How healthcare professionals can provide the best experience for children with ASD

Creating a best-in-class experience for children with ASD begins from the ground up. Increasing one's knowledge about autism through continued learning can go a long way toward serving these patient groups effectively. When starting your medical practice or bringing on additional staff, hiring individuals with experience working with people with autism can help your practice connect better with patients. 

On a day-to-day operations level, a successful appointment with a child with ASD starts with the patient scheduling process. Offering an online scheduling portal for parents, complete with detailed intake forms, can help minimize the time in the waiting room. In addition, having a medically accessible website can signal to parents and caregivers that your practice is willing to go above and beyond to provide a comfortable experience for their child with ASD or any other disability.

One of the main ways to create a welcoming medical practice for children with ASD is to learn about and train all staff in communication strategies that can accommodate their unique needs.

Communication tips

Remember that, as a spectrum disorder, the communication skills of patients with ASD may vary wildly, and some children may be non-verbal. If possible, speak with parents ahead of time to determine the level of communication skills their child has and if they will need an interpreter.

It is also vital to keep a child with ASD in the conversation. Communicate with an autistic child with the same level of age-appropriate information and care that you would any other patient. 

While every child with ASD is different, there are some communication traits that many people with autism have. These are general approaches that may allow you to communicate with your patient more successfully. 

Tips for communicating with ASD children patients

1. Be literal and concise

Many individuals with autism have difficulty interpreting figurative language, choose to respond to questions in a very literal way, or have trouble focusing. Being literal and concise can help overcome some of these challenges and narrow the focus so the patient can respond more effectively. 

2. Don't ask broad questions

Children with ASD may have difficulty determining what information an individual already has in a conversation and may have trouble with the larger picture. Questions like, "What are your symptoms?" may be unhelpful. Instead, ask specific questions to narrow down the situation and provide tools such as diagrams of the body, visual storyboards, or other devices. 

3. Understand and interpret non-verbal cues

Children with ASD may have non-verbal cues that make them seem more closed off, inattentive, or upset. While it is essential to recognize the signs of an autistic individual under stress, there are familiar non-verbal cues that some individuals with autism may exhibit in their everyday lives.

  • Eye contact: For many children with autism, direct eye contact can be overwhelming. It's essential not to assume that their lack of eye contact signifies a lack of attention. Avoiding intense eye contact may help children with ASD focus better during conversations, as it reduces overwhelming sensory stimuli.
  • Body language: Expressing emotions through body language can be challenging for children with ASD, leading to mismatches between their feelings and displayed gestures. Parents or caregivers can play a vital role in identifying behaviors that indicate their child's reduced anxiety or heightened stress.
  • Facial expressions: Children with autism often exhibit more ambiguous facial expressions than typical individuals, and they may struggle to interpret the emotions conveyed by others' facial cues. Using visual cues with different emotions can assist these children in expressing their feelings more effectively.

Given the individuality of each child with autism, gaining a deeper understanding of the condition and fostering inclusive environments is exceptionally valuable. Therefore, the following resources can prove immensely beneficial.

How can parents prepare their child with ASD for the best experience possible? 

Parents are an essential liaison between a healthcare provider and their child with ASD. Parents and caregivers can ensure that a doctor's office visit goes as smoothly as possible by taking these steps ahead of time, beginning with setting expectations.

Setting expectations

It's important to recognize that a doctor's office visit is a break in an autistic child's routine. Setting expectations — such as when the appointment is, what the purpose is, and what will happen — can go a long way towards mitigating anxiety. Parents should ensure that their child has the skills needed for the appointment. For example, if their blood pressure needs to be taken, parents should ensure their child can extend their arm appropriately.

Role-playing the visit

Role play is a great way to teach a child with ASD social skills and can help reduce anxiety surrounding the visit. Many autistic children also benefit from being shown, as opposed to being told, what is and is not appropriate to do in certain situations. By role-playing the doctor's visit, parents can give their children the confidence to speak up during the appointment and also provide them with a road map for what the appointment will be like. 

Minimize wait time

Waiting rooms can overwhelm children with ASD due to new sensory experiences. Arriving at the appointment as close to the start time as possible and minimizing time in the waiting room is essential. 

Ask questions ahead of time

Finally, parents need to ask questions ahead of time about what the appointment will be like including: 

  • What the sensory environment in the doctor's office is lik
  • What disability accommodations are provided, and what will be needed;
  • Details about the procedures and evaluations that will take place so they can be incorporated into role play
  • Other questions to which the child with ASD wants answers

Incorporate this information into role-play scenarios and help to orient the child. Ideally, parents will act as liaisons for their child and their needs. 

Medical practices can assist with this process by providing information about and asking relevant questions regarding accommodations and services at their clinic during the patient intake process. This assistance is one way healthcare professionals can provide the best experience possible for children with ASD. 

Additional resources doctors can give to parents

Additional resources for healthcare providers

In addition to the above resources, healthcare providers will most likely benefit from these websites. 

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Andrea Curry, head of editorial at The Intake

Andrea Curry is an award-winning journalist with over 15 years of storytelling under her belt. She has won multiple awards for her work and is now the head of editorial at The Intake, where she puts her passion for helping independent healthcare practices into action.

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