The Autism Society Event and Education Recordings Archive

Children with ASD have the potential to go into crisis in a health- care setting. Triggers include: past unpleasant experiences, the lack of understanding of what is to happen, unfamiliar environments, the anxiety of those around them, pain, fatigue, hunger, and sensitivities to bright lights, loud sounds, certain textures, odors, and voices. Through the use of video clips and simulation, this interactive presentation will address how to dispel their fear and anxiety, and prevent behavioral challenges. Purpose: The purpose of this interactive presentation is twofold. First, we will address how health care providers can dispel the fear and anxiety of children and youth with ASD, as well as their families, and in the process, prevent the challenging behaviors. Second, we will focus on how parents of children with ASD can partner with healthcare providers. 

Background: Health care providers may lack the necessary knowledge and skills to communicate with children with ASD that could prevent some of the challenging behaviors. While providing care is challenging, there are known strategies using the principles of applied behavior analysis techniques that are effective in the health care setting. Finding the time to teach staff the communication, preparation and play strategies is difficult because of the busy clinical environment. We do know however, that the staff like a blended education approach (part on-line and part classroom). We developed a curriculum to teach staff at our hospital. This presentation will include the films from that currriculum. The films show modeling of interaction between staff and patients that demonstrates the actual communication techniques.  

The course objectives include:

1. Outline the rationale for addressing challenging behavior.

2. Identify the causes of challenging behavior.

3. Identify how parents and staff can prepare the child for hospital visits.

4. Practice techniques to use during different stages of escalating behavior.

Content Outline:

Part 1:

Background knowledge: We will spend the first 10-15 minutes of the session presenting an overview of ASD. In this overview, we will focus on the social, communication and repetitive behaviors that a person with ASD may display. We will introduce the concepts of anxiety, self-stimulatory behavior and acclimation to a new environment. Next, we will present the strategies that a parent can use to prepare a child for a hospital visit (social story) and how staff can prepare in advance as well. We will then focus on the role of the child life specialist in procedure preparation, distraction and in play consultation. We will talk about appropriate toy selection as well.

Part 2:

Interactive: We will spend the remainder of the class learning about and practicing 4 communication strategies. The first strategy is not interupting self stimulatory behavior. The second strategy is using  "one-voice" when interacting with patients and families. The third strategy is the 8-step initial contact model and the fourth strategy is the compliance directive cycle. We use a mixture of live and video demonstration in this presentation. We have 9 video clips of children with ASD in health care settings. Examples of the video clips include: a child getting an intravenous line for sutures; a child having vital signs done, a child engaging in therapeutic play with a child life specialist, and a physician interviewing the parent of a child. The video clips model therapeutic communication techniques for health care providers. The film of the child life specialist demonstrates the use of appropriate body language and verbal communication. We also have interview footage of a dentist who discusses her philosophy of care. Select statements include:  "communication is the forefront of care"....."We are not afraid to ask parents what works for them at home" .... " we ask how does your child do in a medical setting?" ..... "We recognize that children will need to access health care for the rest of their lives. We know that when we tell a child what we are going to do, then show them, then do it, we are wildly successful".

After showing each video clip we will have time for discussion with the participants.

Part 3:

Distraction kit items, social stories, teaching sheets, community resources: In the final part of the session, we will show the participants the kit we developed for staff to access when working with children who have ASD.

Learning Objectives: