Why appointments are hard for autistic children and teenagers

Many autistic children have social and communication difficulties, a preference for set routines, and sensory sensitivities. This means that appointments with unfamiliar people in unfamiliar, busy or noisy places are often difficult for them.

Also, appointments can be confusing for autistic children. They might not understand why they’re there or what’s happening. You child might feel very anxious and have trouble understanding and expressing their anxiety.

Changes in routine can also be difficult for autistic children. For example, your child might feel upset if if you take them to an appointment when they should be at school.

Strategies for before appointments

Here are some strategies you can use to prepare your child for an experience that’s unfamiliar or confusing.

Prepare the professional
It’s a good idea to 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 often helps if only one person speaks at a time, slowly and clearly, using simple language in a soft, calm voice’.

Visit before the appointment
Ask the professional if you can visit briefly before the appointment so your child can see where they’re going and meet the professional.

Another option might be to look at pictures of the venue online or drive past it a couple of times before the appointment to remind your child. You could say, ‘There’s the hairdresser. You’re going there on Wednesday’.

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.

Use social stories
A social story can help your child understand what’s going to happen.

For example, here’s 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.

Lots of 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 you. 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 could also build in possible changes in plans – for example, ‘I might have to wait until the hairdresser is ready to cut my hair’. This also gives your child an idea of what to expect.

You could read the story with your child every day for a few days before the appointment and again immediately before.

Use pictures or other visual supports
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 also help. 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.

You could also use a picture symbol on a calendar, so your child knows what day they’re going to the appointment.

Read about where you’re going
There are many storybooks and DVDs 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. 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.

Arrange a home visit
A mobile hairdresser who comes to your home might be a good idea. Your child can get their hair cut in a familiar place, without the sensory overload of a salon.

Use a sedative
For some children who get very distressed during appointments, dentists can prescribe a mild sedative to help them cope with the treatment. Some children who might get very distressed (and hurt themselves or others accidentally) might have work done under a general anaesthetic.

Get professional help
Psychologists, experienced Applied Behaviour Analysis (ABA) practitioners and other professionals with experience in behaviour therapies and supports can work with your child to help them feel comfortable about going to an appointment.