Going to the doctor or dentist can be stressful for any child, but for children with autism, these visits can be especially challenging. “Many children with autism tend to have sensory sensitivities and they also tend to have communication challenges that can make both verbal communication and understanding the steps of an event difficult,” explains Jennifer Thomas, Ph.D., BCBA-D, LBA, Director of Clinical Standards at Healing Haven, a Madison Heights-based ABA therapy center for children and teens. “If they don’t understand the expectations, medical visits can be aversive to children with autism.”
Because they occur too infrequently in a child’s life, parents can find it difficult to build routines around visits to the doctor or dentist — yet they’re critically important to a child’s well-being, says Dr. Thomas.
Helping your child with autism build confidence for medical visits
The key to successful medical visits for your child with autism is to determine their current comfort level and use tools and techniques to help them understand and prepare for what to expect. Your ABA therapy team can help tremendously, too.
Here, Dr. Thomas shares some tips for making your child’s next doctor or dentist visit proceed as smoothly as possible.
1. Assess your child’s current comfort level
“First, what is your child’s current experience with going to the doctor? Do they have fear or anxiety about it? Can they express how they feel about the situation?” asks Dr. Thomas.
Think about how your child responds to having their temperature taken at home or if they comfortably allow you to clean a scraped knee and apply a bandage — then build on their strengths. “As a baseline, this is a good indication of how much they will allow someone else to do that or more,” she says.
If you’re preparing for a dental appointment, gauge your child’s amenability by their current degree of comfort with brushing their teeth. “Understand where your child’s comfort level is and work from there by teaching them to gradually tolerate the steps that come after that,” she says. “You can do that through preparation in your child’s ABA programming.”
2. Create a visual plan for medical and dental visits
A social story can help your child prepare for an upcoming doctor or dentist appointment, especially if they can see themselves within the experience, says Dr. Thomas.
Customize the social story or activity schedule to your child’s needs. Some children just need a basic idea of what to expect, while others feel more comfortable when they can see the faces of the receptionist, nurse and physician or dentist who will care for them. Visit your provider’s website to see if these pictures exist or reach out to the office and ask them to send them directly to you.
“You can download these and put them in a book and go through it with your child,” says Dr. Thomas.
Seek out books and videos that share information about medical and dental visits on your child’s developmental level. There are many social story videos from pediatric dentists and doctors on YouTube. Visit your local library and talk with the children’s librarian about what you need.
3. Visit the office
Your child may need gradual exposure to the new environment. You might start by going to the medical building to see what it looks like from the outside. In time, you’ll walk into the waiting room, then go into an exam room or sit in the dental chair.
“Your child may be able to sit in the chair and see the dental equipment around them, hold the dental mirror and maybe be exposed to the sounds of the equipment,” says Dr. Thomas.
4. Work with your ABA team to prepare your child
Your ABA therapy team should be skilled at helping your family achieve the goal of successful doctor and dentist visits for your child with autism — and they can help you determine how many days, weeks or months in advance you should begin to prepare your child.
“At Healing Haven, we have a dentist’s chair and an exam table in our clinic, to work with children to practice sitting in the chair and opening their mouth. We practice using the tools present in that environment,” Dr. Thomas says, adding that the closer you can replicate what will happen, the more likely you’ll find success during the real appointment. Your child’s BCBA may also accompany you to the medical office as you are exposing your child to the new environment.
Other issues to consider
Partnering with trusted medical and dental providers who understand the needs of children with autism can make the appointment part of the visit less stressful — for you and for your child. In family discussions at Healing Haven, one of the most asked questions is about medical providers who understand the unique needs of children with autism.
Your medical insurance company may have suggestions for finding just the right provider. And, here in Michigan, parents can reach out to the Autism Alliance of Michigan and talk to a member of their MiNavigator team or search AAoM’s provider resource library.
Along your journey to prepare your child with autism for doctor and dental visits, remember to celebrate the small wins. Each step, no matter how small, is a step closer to helping your child build a lifelong skill of health and wellness.
“Our BCBAs always share success stories and we love to celebrate the wins with our families!” Dr. Thomas says.
Expertise brought to you by Healing Haven. Discover Healing Haven at thehealinghaven.net.