FRCPC), we trialed a "Special Accommodations Program" for children
with ASD at our institution. It very quickly became the most rewarding
aspect of my practice.
ASD cases are very challenging, often taking providers out of their
comfort zone. However, with some small changes, things can be easi-
er for patients, families and staff. You must change the perioperative
environment. There are very powerful reasons why:
• Although only about 1.5% of all patients are on the spectrum,
autism is the fastest rising developmental disability in North America.
• Although the population is small, autistic people tend to visit surgi-
cal facilities much more frequently than neurotypical patients because
they require sedation or anesthesia for dental care and routine proce-
dures like eye exams, blood work, scans and even vaccinations.
• Caring for non-verbal autistic patients can take much longer than
normal and can be extremely stressful and disruptive, not only for the
patients but for the families and the providers as well.
• Without understanding or a plan, you may succeed in getting
patients anesthetized, but you will have traumatized the patients and
made them more averse to health care.
• Importantly, you can use many of the same procedures you use for
patients with autism to help make a better experience for patients
with generalized or procedure-specific anxiety.
Our program focuses on improving the experience for autistic patients
at our children's hospital. The results have been overwhelming. Our
inductions are now much more successful and peaceful, our families and
our providers are thrilled, and most importantly, our patients avoid a lot
of the trauma they've experienced in the past. Here's our process.
1. Change the paradigm
Traditionally, healthcare facilities have viewed autistic children as
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