How Health Care Professionals Can Help People on the Autism Spectrum
The following blog post was submitted by Elizabeth and was originally published on Autism-mom.com
A reader recently sent me a question about meltdowns. Mary, a health care professional, shared that one of her patients had experienced a meltdown while she was working with him and she wanted to know what she could have done to help.
Moreover, she was worried that she had somehow contributed to it.
Meltdowns stem from overload. Meltdowns are different than temper tantrums because they are generally triggered by something – sensory, transitions, or anxiety, for example – and reflect an emotional overload response.
They can appear to take place without warning (because others are not aware of the emotional build-up prior to the meltdown), and can be violent, and long-lasting.
In the situation described by Mary, the overload could have been from something touching her patient that made him uncomfortable; a persistent unfamiliar sound that we might not pay attention to; a strong smell (maybe an antiseptic cleanser) that we might ignore; his not knowing what to expect next in an unusual situation; difficulty in being responsive to someone he didn't know; or some or all of those things combined at the end of a long day.
After explaining to Mary that there was likely nothing she could had done to end the meltdown, other than first ask how she could help (which she did), and then quietly support both the child and parent while the meltdown lasted (which she also did), I suggested that there were things she could do for her patients on the Autism spectrum to help prevent meltdowns.
For example, a visit to the office before the appointment day might be very helpful to instil familiarity before the date of the exam appointment.
Other suggestions included:
- Scheduling appointments for patients on the spectrum for times when there are no other people in the waiting room;
- Not keeping the patient waiting, even for a short period of time - if there is paperwork to be done, have it done via mail or email before hand;
- Staff being thoughtful of their sensory impact while the spectrum patient is there - being aware of the sounds they are making, their movement, the smell of food they just microwaved, wearing perfumes, etc.; and
- Reducing or eliminating fluorescent lighting (the flickering and hum can be aggravating) - maybe adding some incandescent or LED lamps available to be turned on when Autism spectrum patients were there.
After the patient is brought into the exam room, the health care professional can:
- Explain the exam in detail before starting - let the patient explore the room, touch things (as appropriate), and ask questions;
- Ask the patient or parent ahead of time what comforts the them (I used to have my son sit in my lap for eye exams to reassure him; at the dentist we sometimes use the lead apron for x-rays as a weighted blanket during exams). Invite them to bring comfort tools and to use them;
- Take your time - some people on the spectrum can sense impatience or being rushed, and it can add to the overload;
- Ask the patient how they are doing and if they have any questions. Don't be dissuaded if the patient isn't verbal - many non-verbal people on the spectrum can still communicate very clearly; and
- Wait for an answer - use the 8 second rule to allow the patient a chance to engage the speech centers of the brain.
The patient may stim to help manage feelings - this is an important self-management tool, don't stop them from doing it.
If the stimming interferes with the exam, ask if you can trade off - a few minutes of stimming, then a few minutes of exam, then a few minutes of stimming, etc. This cooperative understanding might even reduce the need to stim.
I strongly suggest reaching out to adult patients on the autism spectrum and asking for their advice on how to make their health care appointments more Autism-friendly.
Other health care professionals who specialize in serving patients on the autism spectrum can also be a resource to learn how they structure their practices, set up their offices, and generally support their patients.
Elizabeth W. Barnes runs Autism-Mom.com and is the mom to a wonderful boy on the Autism spectrum.
Autism Mom is about how author Elizabeth came to discover and learned to support her autistic son, who she refers to on the blog as the Navigator. While everyone’s path is different, this blogger hopes her writing will be useful to families with children on the spectrum.