By Erica Kearney, M.A, LABA, BCBA
Children with autism spectrum disorder (ASD) and other developmental disabilities often have a difficult time during visits to the doctor or the dentist. This is understandable. Most of us do not look forward to getting a shot, being poked or prodded, getting cavities filled, or having our teeth scraped clean. And, for children who may have sensory issues and be adverse to bright lights and unusual noises, these experiences can be quite frightening.
How can parents make medical and/or dental visits more pleasant for their child with special needs? Below are a few suggestions to consider.
Prior to going to the appointment, make sure your child has the skills necessary to make the trip successful. Can she follow simple directions such as: “open your mouth,” “say ah,” or “look at the light”? Is she able to sit in a chair that reclines? If she does not have these skills, it is important to teach them to her before you make that appointment.
When possible, schedule the visit in advance so you, your child, and everyone involved can adequately prepare. Notify the doctor's office that your child has special needs and tell them anything else that will be helpful for them to know. Most offices can be very accommodating by scheduling your child for the first appointment of the day, or the first appointment after lunch, so she will not have to wait a long time to be seen.
Prepare your child by letting her know about the appointment ahead of time, using a calendar or a social story. Social stories are usually written in the first person and give short, positive descriptions about a social or life skill-related situation. They can also include pictures or drawings. For some children, using a social story for doctor or dentist visits can reduce their anxiety by helping them understand what to expect during the visit. You may even want to set up a practice visit or “practice” at home, pretending to go to the appointment and practicing what will happen.
Who will be assisting the child during the appointment? Choose people with whom your child has a good rapport and from whom she will take direction. It is best not to have too many people attend the visit. This can make the environment overwhelming for her and difficult for her to know who and what to attend to. If there is more than one individual present during the visit (other than the medical or dental professionals), select a leader who will deliver instructions.
Don't forget to bring reinforcers/rewards for your child. Some children may just need to be told that they will get a special treat if they do a good job at the doctor's appointment. Others will need constant reinforcement throughout the entire exam. For this reason, try not to use edible reinforcers, especially for dental appointments. Portable DVD players work well if the child has preferred movies that they enjoy watching. Consult with the child's behavior specialist on the best way to provide reinforcement during the visit.
Dentist and doctors’ appointments can be challenging for children with ASD and other developmental disabilities. With planning, preparation, and practice, however, the experience can be much easier for children and parents.
Erica Kearney, M.A., LABA, BCBA, is Executive Director of the May Center School for Children with Autism and Developmental Disabilities in Chicopee, Mass. She can be contacted at ekearney@mayinstitute.org.
May Institute is a nonprofit organization that is a national leader in the field of applied behavior analysis, serving individuals with autism spectrum disorder (ASD) and other developmental disabilities, brain injury and neurobehavioral disorders, and other special needs. Founded more than 65 years ago, we provide a wide range of exceptional educational and rehabilitative services across the lifespan. May Institute operates five schools for children with ASD and other developmental disabilities, including our newest school in Chicopee, Mass. For more information, call 800.778.7601 or visit www.mayinstitute.org.
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