How Nurses Can Support Children With Autism During Medical Visits

Medical visits can be stressful or intimidating for any child. They can be especially uncomfortable for young individuals with autism spectrum disorder (ASD), who may experience adverse reactions to a change in their routine, overstimulation caused by an unfamiliar environment or other factors. 

These barriers to care can have negative effects on the health of individuals on the autism spectrum: Research suggests that many young people with ASD are less likely to receive critical preventive services, such as flu shots and other vaccines. Anxiety about medical visits can become a lifelong challenge, as many adults with autism struggle to communicate with providers and are less likely to have their routine health needs met. 

Nurses and other healthcare professionals can take steps to support children with autism and build relationships with parents to make medical visits less stressful for everyone involved.

Autism spectrum disorder (ASD) is a developmental disorder that can manifest in a variety of ways and  affect how an individual communicates and interacts socially. Every case of autism is different, and each individual diagnosed with ASD has different strengths and challenges. However, to receive an official diagnosis, they must show symptoms of ASD in two areas: 

Because of these factors, children with autism may be more likely to experience distress during a medical visit than neurotypical children.

Challenges for Children With Autism During Medical Visits

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Waiting. Sitting in a waiting room for an unknown amount of time in an unfamiliar environment may cause distress for children with autism.

Unpredictability. Some children with autism are most comfortable following routines, which can make it stressful to go through a set of procedures during a medical visit without knowing what to expect ahead of time.

Communication. Varying levels of verbal communication, use of communication aids and other challenges may make it difficult for children with autism to connect with a nurse or physician during appointments.  

Overstimulation. Children who experience sensory issues may be sensitive to lighting, loud sounds or the feeling of surfaces and fabric they may encounter in a medical setting.

Sources:

Nurses and other healthcare providers can support children with autism by helping to mitigate environmental factors and common sources of fear or discomfort. Doing so may require providers to spend more time with a patient during health checkups, diagnostic tests, emergency care and other medical situations.   

The following strategies can serve as a starting point for nurses and other healthcare providers to better understand the needs of young patients with autism spectrum disorder.

Challenges for Children With Autism During Medical Visits

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1

Talk to parents before the visit. Having a conversation with parents before a child walks into the medical office can help healthcare teams provide accommodations (e.g., lighting adjustments) and gives parents the chance to prepare for potential challenges. 

2

Schedule a walk-through. If possible, it can be helpful to give parents and their child a tour of the facility and a run-down of how and when procedures will be performed. 

3

Consider communication. Children with autism may communicate differently than neurotypical children. In addition to accommodating individuals who use communication devices, it’s important to think about how to explain things. For example, children with ASD may take things literally, making it critical to use clear statements. 

4

Take notes for future reference. Listen to the parents and the child; record information regarding their needs, preferences and aversions; and add key details to their care plan that can be accessed by other providers. Doing so can improve the continuity of care over time.

5

Encourage parents to bring sensory tools and comfort items. Noise-canceling headphones, fidget toys and other objects can help a child stay calm and content during a visit. Comfort items, such as a favorite stuffed animal, can also make them feel safe.

6

Allow repetitive movements. Behaviors such as hand flapping or rocking back and forth can help a child regulate their emotions. As long as it does not interfere with care, give them space to engage in these behaviors during their visit. 

7

Build a connection. Asking a child about their special interests can help establish trust and make them feel more comfortable. Take cues from information their parents share, toys or items they bring with them and topics they bring up. 

Sources:

Autism Science Foundation 
This nonprofit organization funds research on autism and provides information and resources that can be helpful to healthcare professionals and parents of children with autism alike. 

Autism Society
The Autism Society focuses on education, advocacy, support and programming for the autism community. They offer a variety of resources about understanding autism, related news and updates and more. 

Centers for Disease Control and Prevention | Autism Spectrum Disorder (ASD) 
This resource page from the CDC links to information on autism spectrum disorder, including signs and symptoms, statistics and data, and guidance for parents and healthcare providers. 

Child Mind Institute | Sensory Processing Issues Explained 
Published by the Child Mind Institute, this article covers the basics of sensory issues, which are common among children with autism and other disorders. 

Connecticut Children’s Hospital | How to Prepare a Child With Autism Spectrum Disorder for a Visit to Connecticut Children’s
To support parents of children with autism, this resource from Connecticut Children’s Hospital offers step-by-step suggestions and actionable tips on how to prepare for a visit to a medical facility. 

Interagency Autism Coordinating Committee (IACC) | About Autism
The IACC is an advisory committee that coordinates federal efforts related to autism spectrum disorder. The organization’s resources page includes links to research reports, toolkits, guides and more. 

Nursing Made Incredibly Easy | Nursing Care of Patients With Autism Spectrum Disorder 
This peer-reviewed article provides an in-depth look at autism spectrum disorder and nursing best practices for working with patients who have ASD. 

The Atlanta Journal-Constitution | How Nurses Can Support Patients With Autism 
Published in The Atlanta Journal-Constitution, this article offers advice to nurses on how to work with patients of all ages with autism spectrum disorder. 

Please note that this article is for informational purposes only. It is not intended to be a substitute for professional advice and should not be relied on as health or personal advice.

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