Dealing with medical appointments

A recent study found that 80% of autistic people reported difficulty visiting a GP. Over half cited the waiting room environment as a major barrier.¹ Many autistic children find medical appointments difficult as they can be confusing, unpredictable and painful. They may not understand why they are there, what is happening and what is expected of them. Appointments with unfamiliar people in unfamiliar, busy or noisy places can create a stressful environment which may upset them. This stress is then also often felt by parents.

Over the last year at Park House School we have been working on a range of programmes to give our pupils the support they need to feel more comfortable at GP, optician, and dentist appointments. In this blog we will share some of the techniques we used, the progress our pupils have had made and tips that schools can take into their own settings or that parents can use at home with their child.

The process

The programmes we use with our pupils are based on gradual exposure.

For example, if a child is scared of having their breathing checked with a stethoscope, there are lots of small steps you can take to work towards them feeling comfortable in that scenario. Such as:

1. Introducing a toy stethoscope into play scenarios acclimatising them to the instrument
2. Watching someone else using the stethoscope
3. Getting used to having it over their shirt/jumper
4. Feeling it on skin
5. Taking a trip to visit the GP
6. Sitting in on the procedure

This shows the sort of gradual approach needed. Although for a situation like this there would be lots of additional small steps in between.

Similar techniques can be implemented in a range of different scenarios across settings. Understanding the cause of the child’s anxiety will help you to break down the process and focus on the areas where your pupil needs most support. Using play in these scenarios can be a great way to help pupils feel more comfortable. For example, if they don’t like attending the medical room, you could set up a play session in the classroom with the nurse in an environment where the pupil feels comfortable.

There are lots of different ways you can approach it, the main thing is always to ensure the pupil feels safe and happy.

What you can do in your setting

There are lots of small things you can do to support progress.

1. Make things fun

If a pupil finds something scary or upsetting, try and bring some fun into it. Bringing play into the situation can help relax the pupil. If they dislike having their temperature taken, involve the thermometer in a play session. Ask them if they want to take your temperature. Building play into a scary situation can help reduce anxiety when it comes to the actual procedure.

2. Visual stories

Visual stories are a great way of simplifying something complex. If a child is anxious about an appointment create a visual story explaining what is going to happen as well as when and why. This is something you can set up yourself. When creating a visual story, it is important to keep some things in mind:

• Keep it as simple as possible for the person. It needs to suit their level of understanding – pictures can be a good aid to the words
• Only include the essentials – take out any unnecessary detail
• Keep it positive and reassuring

For more information on creating visual stories, head over to our resource hub.

3. Medical books

We have been fortunate to have several books donated to our schools on a range of medical topics. There are loads of great children’s books about visits to appointments. If you don’t have access to any, you could reach out to your local medical centres or library to see if they have any you can borrow.

4. Dummy medical equipment

This is a great way to use play to help pupils with autism to feel more comfortable and relaxed around medical equipment before they attend appointments. Again, medical centres may have some equipment they could share, we were generously gifted a used examination chair. Do make sure the equipment is safe before letting pupils use it.

5. Acclimatisation

If your local GP, Dentist or Optician are happy with it, do some test runs with your pupil. If they allow it, this is a great way of getting them used to the journey to get to their appointment as well as the sign in process and waiting rooms. We have seen brilliant progress with our pupils taking them on weekly trips to get used to the environment. Or if you have issues with pupils visiting the medical room at school, you could set up different visits with a pupil or a group to try and relax them in that environment. Keep it fun!

6. Be patient

These things take time. Perseverance and consistency is key to seeing those small steps begin to make a difference.