Going to the doctor can be stressful for any child. For a child with an autism spectrum disorder (ASD), there may be additional challenges because of sensory, communication, and other symptoms related to the ASD. Here are some tips to help make visiting the doctor easier.
How can we prepare our child for a visit to the doctor?
Many children with ASDs have difficulty with changes in routine and new situations, so preparing ahead of time can help. Talk to your child about the doctor visit before you go so he knows what to expect. This may help your child respond better to what is required of him at the visit. Many books, videos, and other materials explain step-by-step and in a positive way, what will happen at the doctor's or dentist's office. They also point out that most steps don't hurt, and the ones that might are done quickly. Social stories may be helpful for your child. These stories have pictures about what to expect and how to behave or react in a certain situation, like going to the doctor or dentist. You can review these expectations and practice these behaviors with your child ahead of time.
Practice some of the procedures with your child at home. Take your child's temperature or blood pressure; look into his mouth, ears, and nose with a flashlight; and use a tongue depressor or a stethoscope. A toy doctor's kit might have some instruments that look like the real thing and can be fun for the child to practice with. This can also be done in play with a doll or stuffed animal.
Make a schedule board for your child so he knows what will happen during the visit. You can use photographs, drawings, or words for each step and provide a reward at the end. The reward can be a small treat, high five, verbal praise, or preferred activity such as a handheld electronic game or bubbles.
What if preparing ahead of time doesn't help? What else can we do to make the visit go smoothly?
Sometimes doctor or dentist visits are stressful even when you prepare ahead of time. Children with ASDs may have a hard time with language and may not understand what you explain. A visit to the doctor or dentist can be seen as a bad thing, as they may often be connected with getting shots or being sick. Uncertainty and fear can lead to problem behavior.
Try to ease anxiety and make a more pleasant link with the doctor's office by rehearsing visits. You can go to the office with your child and sit in the waiting room while doing something your child enjoys.
Organize yourself to keep the visit moving along. Bring a written list of questions or issues to discuss with the doctor. Some children do well if the doctor or dentist can review the order of the visit with them and check off (verbally or on a list) when each part of the visit has been accomplished.
Make copies of any related items (such as testing by specialists) and bring them to the visit to give to the doctor. If you can, bring another person to the doctor's office to help with your child. This way, you don't have to be rushed or worried about your child's behavior while you talk with the doctor. Some doctors can also have special visit times scheduled for you to meet alone with the doctor without your child if you have many questions and need more time or feel your child cannot tolerate a long visit.
You may want to bring activities or toys that your child likes to help keep her busy during waiting times and to make your child feel as safe and calm as possible.
Do what you can to reduce your child's time at the doctor's office. Try to get the first slot of the day or right after lunch, or at a time in the schedule when waiting times will be shortest and the waiting room will be quiet. Remind the office staff ahead of time and when you arrive that your child has an ASD so they will do their best to see your child as quickly as possible. Help the nurse or doctor during the examination by calming your child or assisting with procedures. Giving a special reward right after the visit might help your child to view the visit more favorably and to calm down faster if she is upset.
American Academy of Pediatrics HealthyChildren.org: www.HealthyChildren.org
Autism Speaks Dental Tool Kit: www.autismspeaks.org/family-services/tool-kits/dental-tool-kit
Bailey CA. Going to the Doctor: A Picture Social Skills Story Book. New York, NY: DRL Books; 2002
Family handout from Autism: Caring for Children With Autism Spectrum Disorders: A Resource Toolkit for Clinicians, 2nd Edition, developed by the American Academy of Pediatrics (AAP) Council on Children With Disabilities Autism Subcommittee (ASC).