Autistic children can be extremely difficult in new situations. One of the more difficult situations can be visiting a new doctor or dentist. As the mother of a now 16 year old autistic son, I have had lots of experience with this particular problem. My autistic son is also the one I call “medically intense” because he has multiple medical issues. We have had to take him to quite a few specialists over the years. So I have experienced the new doctor’s office many, many times.
Please note that I have an autistic adolescent, and have experienced most of these situations with my son as a child. I know that many of you may be dealing with autistic teens or adults. Just substitute person, adult, individual, or whatever word suits your situation wherever I use the word “child”.
Notifying your child
I learned very early not to mention the doctor’s office visit very much in advance. My son gets very upset and “perseverates” if he is given information about anything that breaks his routine without the proper amount of notice. See my article “Autistic Children and Routines” on associatedcontent.com. As you get more comfortable with your child’s behaviors, you will figure out what the “proper amount of notice” is. If you tell the child too early, you will hear about it for the entire time until you go to the visit. If you don’t give the child enough notice, your child will not be ready and will have difficulty behaving at the appointment.
My son is fairly high functioning. I can sit down and explain where we are going and what we are going to do. If your child does better with “practice”, you have several different choices. Some of this depends on the office that you are going to visit and some depends on your child.
What to ask the office
If you are unfamiliar with the particular type of doctor that you are going to see, you might ask to speak to someone who can explain what is going to happen at the visit. What is your child going to be asked to do? Are these things different than the usual things that he or she has done at regular visits? For example, at a dentist or orthodontist visit, a child may need to do impressions. This involves putting a tray full of goopy stuff in their mouth, biting down, and breathing through their nose for a minute or two until the “goop” starts to harden. Then the stuff is pulled off their teeth. The trays are disposable. My dentist gave me some for my child to play with and “practice” at home between visits, so the next visit was really quite easy.
Another problem might be the office equipment. When my son had to go get his eyes checked, I asked the ophthalmologist’s staff if we could make a visit to the office when it was closed to “practice” sitting on all the chairs, looking where we were supposed to look, covering the correct eye, etc. We did this about a week before the actual visit. My son was fascinated with the equipment and the tools, but got through that at our practice visit. Our doctor visit went off with minimal problems.
We have even practiced getting on and off the scales without touching the walls. We also practice taking deep breaths for the lung doctor without making lots of extra noise. Anything you have had problems with at one visit is a good thing to practice between visits. Proper greetings for the staff, inside voices, staying with Mom or Dad….and the list goes on.
Making the visit easier
I always notify the office that my son is autistic. I have actually had offices refuse to see him because of this. I would rather know that before we got there than after we had registered, etc. Other offices have no problem with this. I also ask for a time of day that isn’t really busy, so we probably won’t have to wait with a room full of people. My son doesn’t do well in crowds and doesn’t wait well. You might find that after lunch or after nap time works better for you. Go with what works.
Make sure to bring something with you to keep your child busy. You will probably have to wait at various points during the visit. My son likes books. Does your child have a favorite toy, blanket or storybook that calms him or her? Try not to bring food or drink into most offices unless you have cleared it in advance. If you do, make sure it is something that isn’t really messy. Clean up is your responsibility. Most offices hate crumbs or cereal everywhere.
If this is a long distance or consultant visit, you might want to “double team”, or take someone with you to help with your child so you can have a chance to talk to the consultant after he or she has finished the examination. You could take a relative, your spouse, or even your regular babysitter or respite provider. It is important that you get whatever information you need from this consultant. I actually lost my son once while talking to a consultant. He got on an elevator in an eight story building when he ran away from me. Fortunately, the security guard and the people in the elevator were very observant and returned him in less than 3 minutes. It was the longest three minutes of my life.
When your child gets bored
If you know that it is going to be a long day or a long appointment, try to break it up a bit. Take a walk in between. Go to lunch. If you can, bring something new or special to get out in the middle of the appointment. A new book or small toy will keep most children occupied for a while. Many doctors offices will blow up a glove or find other office devices that can entertain a child for a while depending on the age of your child. Sing a silly song. Play a familiar game. Make faces at each other. I even like to ask my child questions as I am filling out paperwork. He thinks it’s funny if I ask him if he’s married, for example. Or how many children he has. I’ll do anything to keep him occupied and giggling. I try to keep it fun and each time gets a little easier.