Sharing the following tips and ideas with your doctor may help to make medical appointments less stressful:
- Autism is a spectrum condition and can present very differently, particularly in girls and women
- Please research autistic masking so that you don’t make assumptions based on more “classic” autism presentations
- The stress of a medical appointment may affect things like blood pressure and can lead to situational “muteness”
- The more stressed a person becomes, the less he/she will be able to engage with a doctor or other medical professional. If an individual brings someone with for support, please ask which person you should speak to. Alternatively, writing or another form of communication may be more appropriate
- Individuals on the spectrum may not like to be touched—always ask permission first, and if possible touch through clothes
- Autistic people may not feel comfortable with eye contact—please don’t attribute this to anything but being a different neurotype
- Some people may be hypersensitive or hyposensitive to pain. If they are new or irregular patients and you don’t know, please keep an open mind to alternative signs of pain
- Please avoid any negative language around autism such as deficit, impairment and even disorder—despite the official classification of ASD, may people in the autistic community reject the term disorder and prefer either the use of ASC (C being Condition) or just autism
- In surveys, the majority of the autistic community have also said they vastly prefer identity-first language (autistic person) over person-first language (person with autism). Of course, individual preferences may differ
- Autistic people have been known to react to medication differently than neurotypical people. Ensure you are aware of any known sensitivities and intolerances
- Most individuals on the spectrum tend to use language in a more literal way than neurotypical people. It’s best to use precise and clear language which can’t be misinterpreted
- Ask mostly “yes” or “no” questions (where possible). Remind the patient that it’s completely OK to not know the answer to the questions
- Autistic people may find it difficult to identify and describe pain—what it feels like and where it’s coming from. To learn more about this, please research interoception and proprioception
- Strive to maintain a low sensory-arousal environment
- Eliminate fluorescent lighting and anything which emits noise as much as possible. Waiting rooms, with ringing telephones, people talking and loud TVs, are often a torturous sensory environment for those who have exceptionally sensitive hearing
- Autistic people may use different facial expressions than neurotypical people and may have difficulty judging facial expressions
- Please don’t use the autistic patient’s facial expression as part of a diagnosis, as you may not be interpreting it correctly
- Autistic people tend to value direct communication, and may reply in the same fashion
- Some autistic people find using the telephone to try to make an appointment quite stressful. It would be much more inclusive to offer other ways to book appointments, such as online. Likewise, offering virtual appointments in place of in-person ones may be more inclusive (if this is possible and appropriate)
- Autistic people tend to dislike change and things happening without their knowledge
- Please explain what is likely to happen and how long it’s likely to take
- It can be stressful to keep having to meet unfamiliar healthcare providers. If it’s not possible to see the same doctor, keep notes which can be read by other practitioners before each appointment
- Avoid small talk, and don’t stand too close unless necessary
- Allow time to process before expecting a reply or a decision
- If you are sending the patient away with detailed instructions, please write them down
- Encourage your patients to build an “autism passport” which they can give to healthcare providers in the event of a hospitalization or emergency. Such a document can detail what will make the patient more comfortable and he/she struggles with
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These statements are generalizations since autism is a spectrum disorder there are many differences between autistic individuals. As such, many will experience medical appointments differently. When treating patients, be aware that the condition often presents differently in girls and women. Research the term “masking”, and ensure that a strict adherence to diagnosing according to the classic presentation of autism does not lead to false presumptions. Research autism, from lived experts in the autistic community. Be an ally.
This article was featured in Issue 121 – Autism Awareness Month
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