Patients with ASD struggle to comfortably and safely navigate encounters with medical staff in doctors' offices and hospitals. This article guides us through an effective treatment approach for patients with ASD.

Patients with Autism Spectrum Disorder (ASD) face a number of challenges in the doctor’s office. Communication barriers, lack of physician knowledge of ASD, and the stigma attached to the disorder cause patients on the spectrum to receive less than optimal care in medical settings intended to facilitate healing, as noted in an article published by Pediatric Research.

Some patients who exhibit severe behaviour like self-injury, aggression and destruction of property are physically restrained by medical staff, which can hurt the patient and damage their trust in HCPs.

Doctors can provide more effective, safer care to these patients by familiarising themselves with their communication preferences and sensory issues, as well as by using alternative methods to address severe behaviour.

Learn your patient’s communication style

If you’re a doctor who works with patients on the spectrum, a primary way to improve their care is to understand how your patient can (or prefers to) communicate.

According to the Academic Autistic Spectrum Partnership in Research and Education (AASPIRE), individuals with ASD tend to communicate atypically. While some may be able to express that they successfully received your verbal information, others may not.

The same is true of different modes of communication. Some patients may struggle to verbally communicate, while others have more difficulty processing what you say without a visual aid. Steer clear of making assumptions about what your patient understands. Instead, consult them or their caretakers for information about how they communicate, and what they need from you.

Once you have this information, you can then use patient-specific strategies to obtain as much information about their health issue as possible.

Limit sensory input

You can also address how your patient responds to sensory stimulation. Patients on the spectrum often demonstrate increased or decreased sensitivities to their environment. Certain sounds, lights, touch, tastes, and smells could hinder physician-patient interactions, leading to ineffective healthcare.

You can foster an environment that works best for your patient. Talk to them or their caretaker about what’s needed from you to create a sense of calm. For example, AASPIRE recommends using natural light instead of fluorescents and meeting with the patient in a quiet room. Speak only when the room is otherwise noise-free so your patient can focus on your voice.

Allow them to use noise-cancelling headphones, sunglasses, and sensory toys to increase their comfort. Avoid any unnecessary physical touch. If you must touch your patient, clearly explain what you’ll do before initiating contact.

Use alternative strategies to address severe behaviour

Let’s say you’ve done everything right. You took the time to get to know your patient and how they communicate, and you went above and beyond to provide a comfortable space for them.

But upon examination, your patient exhibits severe behaviour. Maybe they start thrashing, becoming aggressive toward you or themselves, or beating on the table. Do you physically restrain them?

Physical restraints can cause skin breakdown, muscle mass loss, and infection, among other injuries. The patient’s risk of developing mental illnesses such as anxiety, depression, and PTSD also rises as a result of being physically restrained.

Instead of a method that damages the long-term doctor-patient relationship, try these alternative strategies to address severe behaviour:

1. Adapt the room to suit the patient’s needs - Reduce the number of HCPs in the room, and mitigate any underlying background noise.
2. Change your medical approach- Can you use a quieter tone of voice? Is there a medical assessment you can navigate differently, or save for a future visit? Can you provide a simpler explanation of a medical issue?
3. Make items in the room accessible to patients- If your patient needs a sensory toy, perhaps your stethoscope could do the trick. Pillows may be helpful. In the wake of severe behaviour, allowing your patient time to play with these items, even if it distracts from the task at hand, could help reduce severe behaviours without physical restraints.

Disclaimer: This article was originally published on October 15, 2022. This story is contributed by Jules Murthah and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.