When treating an individual with autism, having an in-depth talk with the client or client’s caregiver prior to the appointment is crucial to having a successful appointment. Autistic individuals often have sensory issues so knowing what they are is so important as to not overwhelm the client during the appointment.
Questions such as: Is the client sensitive to noise? If they are you may want to try to keep the use of the ultrasonic, suction and hand piece to a minimum or eliminate them all together. They may not be able to tolerate the noise at all and you will quickly see a reaction from the client if they find these sounds overwhelming. Also keeping the music in the room low or turning it off all together if possible.
Another great question is: Does the client get overwhelmed with too many people in the room? If they do, it would be a good idea to let the other staff know not to enter your room while you are seeing this client.
Asking about their dislikes. They may not be able to tolerate the air/water syringe, the prophy paste or any number of things during a hygiene appointment.
Another question of value is: Is there something that the client is really fond of such as a particular TV show? My daughter loves Paw Patrol. So things like these can be helpful motivators for the client to focus. For example: I could put Paw Patrol on TV during the appointment for her.
When seeing an individual with autism it is important to ensure that you have booked sufficient time for the appointment. Another tip is to make sure the time of day that the appointment is booked coincides with the time of day the client finds easiest to manage. The client may not be able to tolerate items in their mouth for very long so you may have to make several quick trips into and out of their mouth taking longer than a typical client. Otherwise, if they become overwhelmed they can break down and start to cry, or express their frustration by slapping your hand away. This is important to know in order to maintain safety when you have instruments in their mouth.
Always pay attention to the client’s mood and as soon as you see them becoming frustrated, stop whatever it is that you are doing. It is important not to overwhelm the client to the point of a breakdown. They may also not be able to keep their mouth open for long periods or be able to focus and stay still so this is another factor that will lengthen your appointment. Consider bringing them back for multiple appointments if you are unable to get through it in one. If the client is able to tolerate a fluoride varnish or a bite block these can also be helpful.
A lot of patience, compassion and questions are expected when treating a client with autism. One of the best ways of achieving positive appointments is really just getting to know the client over time. Autistic individuals love familiarity and routine. So even if your first appointment doesn’t go so well, don’t give up.
Caring for those with autism is a lifelong commitment where you build on small achievements over time. You have the privilege to be just one of many support staff that they hopefully are able to access to support them in their daily life. The best part is when you get a hug, a smile or a high five!
About the Author
Jennifer Grzebien is an independent RDH who specializes in severe dental phobias and special needs. With over 8 years of experience and over half of that working independently she provides a very unique personalized experience for her clients working closely with them in order to overcome their fears, anxieties and barriers to care in order to achieve their oral heath goals.
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