Sunday, January 8, 2012

Autism and Medical Check-ups

Author: Jeremy Robb
Published: December 06, 2011 at 7:52 pm

Family can help calm a child with Autism. So often we may find ourselves focused so much on one particular disorder or illness, and forget that people can still get common colds and cavities. And that's the same for my son. I often find myself so caught up on trying to teach him behaviors, focus on speaking and spelling (he's becoming a wizz on the iPod Touch virtual keyboard), that I forget that he has other needs too. And, unfortunately for him, he inherited my baby teeth and now has at least one massive cavity.

Because my son has Autism and is non-verbal, he can't tell us that his jaw hurts when he tries to eat. So we need to rely on body language to help guide us. It's not easy, because any behavior caused by continuous pain could also be caused by his need for constant deep pressure. It's difficult to tell what the problem is, and how to best address it. It wasn't until I started looking into his mouth that I noticed a large cavity forming.

Now knowing that my son has a cavity, a new anxiety can take hold: the dentist. People generally don't like going to the dentist, and people with Autism like it even less. There is the lighting necessary to see within the mouth, and those who are light sensitive can have problems with that. There is the physical sensation of someone placing their fingers and objects within their mouths, and those with sensory issues may not like that. And then there is the need to sit back in a chair for long periods of time, or sit in a waiting room for long periods of time, and that's just not fun at all. So a visit to the dentist is something I have been dreading.

Luckily, within our area there is a dentist that specializes in treating children with Autism. They are sensitive to their special needs, and can cater to them accordingly. I'm not sure how, though our first appointment is this week so I will find out soon enough. It was a relief to my mind to even find a dentist willing to make the effort to work with a child with such sensory needs.

But what about other check-ups? The dentist isn't the only place where children with Autism can have a hard time. What about the doctor's office? You have the same problem: long waits in the waiting room, and then again in the exam room. Then getting poked and prodded by the doctor, injections by the medical assistants (when necessary), and bright lights getting shined in places where bright lights generally don't go (ears, eyes, and mouth among others). It's a sensory nightmare, and getting an impatient pediatrician can make it all the more frustrating.

Again, luckily for us we have a pediatrician that understands our child's needs, and can cater to them. Part of it is because he delivered our son, and part of it is because he works with my wife. But also, he is a very patient man who is willing to make the effort to make sure our son is comfortable.

But that doesn't mean every visit has been event-free. One time we took our son into the Urgent Care for a quick check-up, and he was not handling the experience very well. He didn't feel well, and wanted to run around and get his energy out. Another person, someone bringing in their grandchild for something, became disgusted with my son's seemingly undisiplined behavior. She voiced as much, under her breath, perhaps in hopes what we wouldn't hear, or perhaps wanting us to hear. I, of course, heard, and just when I was about to explain to her our situation, we were called in. So, unfortunately, I was unable to educate this person to the trials of visiting such a structured environment with a child on the Spectrum, and what kind of effect it has on his behavior.

So what is it about the office that makes it so difficult for a child with Autism? Well, children with Autism generally (not always) have more neurons in their brain than most neurotypical children. These neurons remain active, and often do not prune at age 2 like most neurotypical children. As such, when they get a sensory message along those neurons, all those extra neurons fire at once. Imagine, for a second, someone turned on a strobe light in the room you are in, turned up the stereo and television to a very loud setting, and ran them both at the same time. Then add some sandpaper for the walls, gravel floors and seats, and painted everything in bright, swirling colors (imagine the 60's, but brighter). The strobe lighting represents the minute flickering of the florecent lights. The stereo and television reflect a sensitivity to hearing, and hearing multiple conversations at once. The sandpaper walls, gravel floors and such represent the sensitivity to touch. What is perfectly normal to a neurotypical child is amplified x number of times over for a child with Autism. And add to that a long, unpredictible wait (healthcare professionals can and often do get behind in their schedules), and it becomes almost intolerable.

So what can you as a parent do to help relieve the situation for your child? Well, often times finding a provider who is aware of your child's condition can be the best step. They will do their best to schedule you when it's most convenient, and results in the shortest wait time. Next, if your child has a sensitivity to light, often sunglasses or dimming the room's lighting can relieve the tension. If sound is a problem, giving them something to focus on, such as music with headphones, can help calm them down significantly. Some children need something to chew on (gum, a hose, plastic toys, something), while others just need someone to give them bear hugs (deep pressure on the skin and muscles). It may be any one of these, or a combination, which is why as a parent we are the best judges as to what works and doesn't work for our children. That being said, if you work with occupational therapists, they may have ideas you can try.

So if you perhaps see a parent with a child that seems to be behaving with no regard to that parent, it's quite possible that child has Autism. Offer to help if they are obviously in stress, otherwise just a smile and a nod to let them know you understand works wonders. Parents are often more comforted by the nod than by anything else that you can do.

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