At the Doctor’s
U:11
L:1
Do you know these places?
•
Unpredictability
– Unfamiliar place & people
– Unsure of routine
•
Toys present sharing
• Unexpected/sudden noises 
coughing, sneezing
•
Long wait
• Multiple transitions required
– (car waiting room  exam
room to car)
• Change in normal routine (unnerving)
• Florescent lighting may cause
discomfort
•
Presence of others
– Noise level
– Other children or babies crying
• Hospital
• Clinic
• Dispensary
Advices
What Can You Do
» Preparation – Child and Parent
» Feasible Environmental Modifications
» Positive Associations, pairing
» Social Stories
» Power Cards
» Priming
» Pretend Play/De-sensitization
» Visual Supports and Schedules
» General Guidelines
Preparing for the Visit
• Schedule appointment times carefully.
Consider:
• Times of day (fatigue, irritability)
• Time of the month (menses)
• Disruption to child’s routine
– After school appointment vs. leaving school early.
– Research the upcoming environment.
• Duration of visit
– Know your child’s tolerance level
– Multiple visits of shorter duration if needed
• Sensory sensitivities (if any)
Do your homework
Advanced preparation is an asset!
– Familiarize yourself with the staff
• How experienced /knowledgeable they are about ASDs
• Are they open to education?
• Tell them about your child.
– Call ahead of time to learn the routine
• Typical wait time?
• Can accommodations be made?
• Let them know about your concerns ahead of time.
Things to consider prior to visit:
• Bring along additional support
– Preferably adults
• Spouse, relative, friend
• Program staff/home therapy staff
• Try to determine possible
obstacles/problematic situations you may
encounter
– Develop some contingency (backup) plans
• Of course we cannot plan for everything, but the
more advanced prep you can do, the better!
• Look for precursors/rumbling behaviors
(warning signs of distress)
Come Armed!!
• Bring material/items to address sensory issues
– Head phones; fidget items; weighted blankets
• Keep bag o’ tricks as distracters
Social Stories
Increases child’s familiarity with various
situations they may encounter; how they
may feel; what may happen during the visit

Provides them with possible things they
can try to do if encounter difficult
situations

Its providing them with advanced
preparation for themselves!

Power Cards
• Power cards can also be made
• Depicting favorite character/hero describing the
situation
• Provide list of suggestions/things to remember
when at the doctor
– E.g., child can carry it around as reminder
Priming
• Practice with your child-in a
relaxed setting (no demands)
• Go through what they might
experience during the visit.
Pretend Play
• Play pretend doctor/dentist
visits
– Doctor or dentist toy kits
• Familiarizes child with some items
they may encounter at doctor’s
office
– Reduces uncertainty; helps make it
less frightening
– Enhancing predictability; making it
less overwhelming
Read Some
Books!!!
– Read books about going to doctor/dentist
– Watch videos that deal with doctor visits
An Array of Visual Supports
Schedules and Checklists
• Use visual supports whenever
possible & appropriate!
• Enhances predictability
• Reduces uncertainty & anxiety
• Helps child prepare for what is going to
happen & when the visit is finished
• Fosters independence
• Minimizes the need for problem
behavior!
Activity Schedules
• Displays activities before & after doctor’s
appointment
– Prepares child for the visit, and shows them what they
will be doing following the appointment
• Variety of formats:
–
–
–
–
Wallet schedules
Object schedules
Small photo albums
Key ring schedules
Use
“looking forward to…”approach
Access
to highly preferred reinforcer or activity
following visit to doctor’s office
Example: see the doctor play favorite computer game!
Sample Task Analysis: Going to the Dentist
Task analysis of dentist
appointment
Pictures/written symbols of
various steps involved in visit
Describes what will
happen next
Helps child visualize
what is remaining &
what parts they have
completed
More Visual Supports!
• Use weekly/monthly calendar to signify when
appointment is scheduled for
• *Be cautious  some children may NOT find this helpful;
Know what will work for your child!
• Advanced warnings/use timers
– Indicate upcoming transition or end of disliked portion
of exam
Tell them what to do vs. what not to
do!
• Use clear, concise, specific instructions
• Ensure expectations are clearly understood
• Reduce ambiguity/uncertainty
Coping Skills
•
Prior to the event, during teachable moments
– Relaxation techniques
– Access preferred/calming materials
– Communication skills
– Teach coping skills
Praise and Reinforcement:
Let them know when they are on
the right track!
• Catch them being good approach
• Provide frequent behavior-specific praise
whenever they are displaying appropriate
behavior!
• Provide physical & verbal reassurance
• Rub their back & explain how well they are doing!
Monitor your small and large
successes
• Keep track of what works and what doesn’t
work.
• Certain strategies might be successful in other settings as
well.
• Eventually you will develop a pool of resources that you
can teach your child to access as part of their own coping
strategies.
• Remember to reward yourself too!