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Planning a Successful Medical Visit: Tips for Parents of Children with Autism

MAY 4, 2023

A doctor’s appointment can feel like an impossible task when your child with autism has behaviour challenges. At Surrey Place, we know how difficult but crucial these appointments are, so we created a list of tips for parents and caregivers to prepare for a successful medical visit. Some families experiencing challenging behaviours may also benefit from our Urgent Response Services.

Before the visit

  • Prepare your provider: Speak with your child’s provider before the appointment. Tell them what you need. For example, if your child finds waiting difficult, ask to book the first appointment of the day or bypass the waiting room by heading straight into the examination. If there is something specific that could upset your child (e.g., music, bright lights), let your provider know ahead of time. Don’t hesitate to reach out to your provider’s office and advocate for your child’s needs.
  • Read a social story: A social story uses a picture book format to explain what will happen at the appointment. Social stories are a great way to help prepare your child and teach appropriate behaviours. Children love them because they are visual, and they follow a narrative. Read the social story to your child many times leading up to the appointment. If you decide to create your own social story, write it from your child’s perspective using “I” statements and their name. This will help your child envision themselves at the center of the story.
  • Use rewards:  Consider rewarding your child after the appointment by getting a treat together or allowing your child to watch a video on an iPad on the way home. It is important to let your child know about the reward beforehand so they can anticipate it. If you use a social story, include the reward as part of the narrative. Your child may manage the discomforts of the visit better if they remember that something fun is waiting for them.
  • Use a calendar: Mark the appointment on a physical calendar in a common area (e.g., a kitchen calendar or whiteboard). This will help your child remember and prepare for the upcoming visit. Remind your child about the reward each time they look at the appointment on the calendar. By reinforcing the reward, you’re positioning the appointment as something positive. Who knows – your child might even start to look forward to the visit since they will get something special when the appointment is over.
  • Use a visual schedule: A visual schedule is an illustrated representation of the day’s activities. The idea is to give your child a sense of predictability about what they can expect during the day. Include the medical visit as one activity on the visual schedule. Don’t forget to also show the reward on the schedule, so your child sees that after the appointment, they get a fun activity or something else they enjoy.
  • Have an exit strategy: Even if you follow all these steps, things may not go as planned. Let your provider know you may need to leave early so they’re prepared for this possibility and can check in with you.

During the visit

  • Bring another adult: If you’re able to bring another adult to the appointment, one person can focus on the child while the other focuses on the doctor.
  • Use distraction: Bring distractions to keep your child busy while you speak with the physician. Some ideas include music, a video on an iPad, snacks or a colouring book.
  • Use smaller rewards: For visits where your child needs to get a needle (or deal with something difficult or uncomfortable), consider bringing a smaller reward to the visit. This can help your child get through challenging parts of the appointment (e.g., preferred foods or favourite toys). Remind your child about the bigger reward they will receive when the appointment is over.
  • Don’t push through: If you notice signs that your child is getting upset, end the appointment. Medical triggers will only get work if you push through because your child will remember the appointment as a negative experience. Focus on remaining calm and leaving the doctor’s office safely. You can always follow up later with the doctor’s office to book another appointment. Ending early, before challenging behaviours arise, is still a success.

Resources for Parents and Caregivers

If you’re a parent or caregiver whose child has new or escalating high-risk behaviours like self-injury, aggression, or property destruction, you may be eligible for Urgent Response Services for children and teens registered with the Ontario Autism Program (OAP). Urgent Response Services offers brief, rapid support from a multidisciplinary team to quickly address new behaviours that have been emerging in the last 14 days or less.

New environments and public spaces are one of many potential behaviour triggers, along with social, psychological and physical factors.

About Urgent Response Services

This resource was written with support from staff in Urgent Response Services. Urgent Response Services are part of the Ontario Autism Program. They were created to support children or youth with an emerging urgent need. Surrey Place leads Urgent Response Services for Toronto Region in partnership with 2-Spirited People of the 1st Nations, Community Living Toronto, Family Service Toronto, Geneva Centre, Holland Bloorview, Kerry’s Place, Lumenus, SAAAC, SMILE Canada and Strides Toronto.

Resources

If you enjoyed this article, check out these other great autism resources:

Challenging behaviours:

Mental health resources:

Transition resources:

Safety resources:

Eating habits and hydration resources:

Additional helpful resources:

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By 2 months

Has your baby had their hearing screened? YES NO

By 6 months

Does the child?

Startle in response to loud noises? YES NO
Turn to where a sound is coming from? YES NO
Make different cries for different needs (hungry, tired)? YES NO
Watch your face as you talk? YES NO
Smile/laugh in response to your smiles and laughs? YES NO
Imitate coughs or other sounds such as ah, eh, buh YES NO

By 9 months

Does the child?

Respond to their name? YES NO
Respond to the telephone ringing or a knock at the door? YES NO
Understand being told no? YES NO
Get what they want through using gestures (reaching to be picked up)? YES NO
Play social games with you (Peek-a-Boo)? YES NO
Enjoy being around people? YES NO
Babble and repeat sounds such as babababa or duhduhduh? YES NO

By 12 months

Does the child?

Follow simple one-step directions (sit down)? YES NO
Look across the room to a toy when adult points at it? YES NO
Consistently use three to five words? YES NO
Use gestures to communicate (waves hi/bye, shakes head for no)? YES NO
Get your attention using sounds, gestures and pointing while looking at your eyes? YES NO
Bring you toys to show you? YES NO
Perform for social attention and praise? YES NO
Combine lots of sounds together as though talking (abada baduh abee)? YES NO
Show an interest in simple picture books? YES NO

By 18 months

Does the child?

Understand the meaning of in and out, off and on? YES NO
Point to more than 2 body parts when asked? YES NO
Use at least 20 words consistently? YES NO
Respond with words or gestures to simple questions (Where's teddy? What's that?)? YES NO
Demonstrate some pretend play with toys (gives teddy bear a drink, pretends a bowl is a hat)? YES NO
Make at least four different consonant sounds (p ,b, m, n, d, g, w, h)? YES NO
Enjoy being read to and sharing simple books with you? YES NO
Point to pictures using one finger? YES NO

By 2 years

Does the child?

Follow two-step directions (Go find your teddy bear and show it to Grandma.)? YES NO
Use 100 to 150 words? YES NO
Use at least two pronouns (you, me, mine)? YES NO
Consistently combine two to four words in short phrases (Daddy hat. Truck go down.)? YES NO
Enjoy being around other children? YES NO
Begin to offer toys to other children and imitate other children's actions and words? YES NO
Use words that are understood by others 50 to 60 per cent of the time? YES NO
Form words or sounds easily and without effort? YES NO
Hold books the right way up and turn the pages? YES NO
Read to stuffed animals or toys? YES NO
Scribble with crayons? YES NO

By 30 months

Does the child?

Understand the concepts of size (big/little) and quantity (a little/a lot, more)? YES NO
Use some adult grammar (two cookies, bird flying, I jumped)? YES NO
Use over 350 words? YES NO
Use action words such as run, spill, fall? YES NO
Participate in some turn-taking activities with peers, using both words and toys? YES NO
Demonstrate concern when another child is hurt or sad? YES NO
Combine several actions in play (puts blocks in the train and drives the train, drops the blocks off.)? YES NO
Put sounds at the beginning of most words? YES NO
Use words with two or more syllables or beats (ba-na-na, com-pu-ter, a-pple)? YES NO
Recognize familiar logos and signs involving print (Stop sign)? YES NO
Remember and understand familiar stories? YES NO

By 3 years

Does the child?

Understand who, what, where and why questions? YES NO
Create long sentences using five to eight words? YES NO
Talk about past events (trip to grandparents house, day at child care)? YES NO
Tell simple stories? YES NO
Show affection for favourite playmates? YES NO
Engage in multi-step pretend play (pretending to cook a meal, repair a car)? YES NO
Talk in a way that most people outside of the family understand what she/he is saying most of the time? YES NO
Have an understanding of the function of print (menus, lists, signs)? YES NO
Show interest in, and awareness of, rhyming words? YES NO
Read to stuffed animals or toys? YES NO
Scribble with crayons? YES NO

By 4 years

Does the child?

Follow directions involving three or more steps (First get some paper, then draw a picture and give it to Mommy)? YES NO
Use adult type grammar? YES NO
Tell stories with a beginning, middle and end? YES NO
Talk to try and solve problems with adults and with other children? YES NO
Show increasingly complex imaginary play? YES NO
Talk in a way that is understood by strangers almost all the time? YES NO
Generate simple rhymes (cat-bat)? YES NO
Match some letters with their sounds (letter b says buh, letter t says tuh)? YES NO