Why appointments are difficult for autistic children and teenagers
Many autistic children and teenagers have social and communication difficulties, a preference for routines and sensory sensitivities. This means that appointments with unfamiliar people in unfamiliar, busy or noisy places are often challenging for them.
Appointments can be confusing for autistic children. For example, your autistic child might not understand why they’re attending the appointment or what’s happening. Your child might feel very anxious and have trouble understanding and expressing their anxiety. And your child might express their anxiety by getting upset or frustrated, crying, hiding or trying to avoid the appointment.
Appointments also often mean changes in routine, which can be difficult for autistic children to cope with. For example, your child might feel upset if you take them to an appointment when they should be at school.
Before appointments with autistic children and teenagers
If you prepare your child for appointments, it can help your child to feel safe in unfamiliar or confusing situations. Here are strategies you can use.
Develop skills
Make sure your child has the skills for a positive and successful appointment. For example, can they sit in a chair that reclines? Can they follow simple instructions like ‘Open your mouth’ or ‘Look at the light’? You can help your child learn or practise any skills they need before the appointment.
Prepare the professional
Talk to your GP, dentist or hairdresser about your child’s needs before the appointment. Older children might like to speak to the professional themselves.
When you talk to the professional, you can explain your child’s sensory sensitivities, preferences and interests. If your child has trouble understanding what people say, you can mention this too. For example, you might say, ‘It helps if only one person speaks at a time. Please speak slowly, clearly, softly and calmly, and use simple language’.
Gradually introduce your child to the clinic or salon
Consider showing your child pictures of the clinic or salon before the appointment. Your child might be interested in seeing where it is on a map or driving past a few times before the appointment. You could say, ‘There’s the hairdresser. You’re going there on Wednesday’.
If possible, ask the professional whether you can visit briefly before the appointment to see the clinic or salon and meet the professional.
Choose an appointment time
If your child finds waiting or busy spaces difficult, try to book the first appointment of the day. If your child needs time to settle before the appointment starts, you could ask for a longer appointment. You could also ask for an appointment on a quieter day or time in the week.
If your child copes better knowing about things in advance, mark the appointment in a calendar so they can see when the appointment will happen. If your child can’t read, use visual cues or pictures.
Use social stories
A social story can help your child understand what’s going to happen. You could read the story with your child every day for a few days before the appointment.
At the bottom of this article there’s an example of a social story for going to the hairdresser.
Use pictures, visual supports and video-modelling
You might use photos, videos, symbols, pictures, words or other visual supports to show your child what’s going to happen at the appointment.
For example, you could make a visual support with photos to show your child what will happen at the dentist. You might take photos of the dentist’s front door, waiting area, treatment room and a dental examination. Before you go, you can show this to your child.
You can also use this strategy during the appointment to show your child what will happen next. Ask the professional to put a sticker on the schedule at the end of each step and praise your child.
Video-modelling can help too. You could try looking at YouTube videos of people going to the dentist or hairdresser. Just remember to watch them yourself first to check they’re suitable for your child.
Read about where you’re going
There are many storybooks that can help you talk about going to the GP, dentist and other places. You should be able to find some at your local library or bookshop. For older children, you could look at the hairdresser’s or dentist’s website.
Watch someone else
You can help your child understand what’s going to happen by letting them watch someone else first. For example, they could watch a sibling or friend have a haircut. You might need to do this several times before your child feels comfortable to stay in the room or get into the hairdresser’s chair.
Visit an autistic-friendly provider or arrange a home visit
Consider choosing a hairdresser or other professional who regularly works with autistic children.
A mobile hairdresser who comes to your home might also be a good idea. Your child can get their hair cut in a familiar place, without the sensory overload of a salon.
Consider using a sedative
Sometimes dentists can prescribe a mild sedative for children who get distressed during dental appointments. Children who might get very distressed and hurt themselves or others accidentally might be able to have work done under a general anaesthetic.
Get professional help
Psychologists and other professionals with experience in positive behaviour strategies and supports can work with your child to help them feel comfortable about going to an appointment.
While you’re waiting with autistic children and teenagers
Waiting to see a doctor, dentist, hairdresser or other professional can be boring and frustrating. It can help to take a bag of things to do – for example, a couple of favourite small toys, a book or audiobook, favourite music, or apps on a phone or tablet. A snack and a drink are good ideas too.
You can also use these strategies during the appointment to distract your child and help them feel more comfortable.
During appointments with autistic children and teenagers
Remain calm
Try to stay calm, if you can. This will help to reassure your child that everything is OK.
Be creative
Think about strategies that might help your child feel more comfortable during the appointment. For example, they might be able to sit on the floor or on your lap, wear headphones or sunglasses, sing their favourite song or talk about their special interest. Depending on the situation, you or the professional might be able to play a game like ‘I spy’ to distract or calm your child.
Manage stress
If you notice that your child is becoming overwhelmed, take a step back and think about the environment.
Are there any sensory triggers like overwhelming smells or sounds or too much talking? In this situation, let your child have a break while you think of a strategy with the professional.
A sensory item or toy like a soft teddy or a Rubik’s Cube might calm your child. It can also help to let them know how long the appointment will take.
If your child gets too distressed during an appointment, it’s OK to stop and try again another day.
A social story for going to the hairdresser
Here’s an example of a social story for going to the hairdresser.
Everyone’s hair grows and needs cutting every few weeks. Usually, they go to a hairdresser to get their hair cut.
Many people I know get their hair cut, like Sam. Sam goes to the hairdresser every month.
At the hairdresser’s, people get their hair washed while sitting in a special chair, not in the bath like at home. Then the hairdresser asks them to sit in another chair and starts cutting their hair with scissors.
Sometimes the hairdresser uses clippers to cut people’s hair. These make a funny buzzing sound and can tickle. This is OK. The clippers don’t hurt.
The hairdresser will talk to me while they’re cutting my hair, and I can look at my reflection in the mirror.
When my haircut is finished, I will look fantastic.
You can personalise the story for your child and use language your child will understand. You can also build in possible changes in plans. For example, ‘I might have to wait until the hairdresser is ready to cut my hair’. This gives your child an idea of what to expect.