Editor's note: This is the second of two parts. The first part addressed how to help foster a positive relationship with your child's doctor when your child has special needs. April is Autism Awareness Month.
Pediatrics often requires a level of patience and care that is uncharacteristic of other specialties. However, unique challenges arise when a patient with developmental disabilities enters an office. The anxiety of special needs children is not the same as other children. They need a step-by-step understanding of how the office works, and what will happen during their appointment in order to feel comfortable. Above all, doctors must gain trust so they can not only provide the highest level of medical care, but also become an ally and friend to the child and parents.
In finding treatment for children with special needs, here are four key things to look for in a doctor. These are things that I strive for when I work with families.
Taking time to listen: This may sound obvious, but it is invaluable. And it's not just about listening. Does the doctor schedule enough time to have a conversation and to conduct a thorough examination when needed? In addition, does the doctor ask questions to clarify what you and your child are seeing and experiencing, and carefully listen to the responses?
Asking questions: Does the doctor ask you and your child about experiences and daily routines such as education, caregivers, and aides to gauge your child's level of cognition and function to help address particular issues? While autism is a diagnosis, it's unlike other medical diagnoses, such as diabetes or asthma, where our focus is relatively narrow and standard. One family may have issues feeding their child, another may have problems with physicality, another with education, another with financial concerns – and the list goes on. It's important for your doctor to ask to fully understand.
Communicate and be transparent: Even from a young age, your doctor should address your child directly and in an age appropriate manner, using their name and avoiding use of "baby talk." If your child is hyperactive or stimming such as repeating physical movements or sounds, the doctor should act as if they are sitting quietly and appropriately. Doctors must remain calm, speak softly, and allow your child several minutes to warm up to them before attempting any sort of physical examination. During the exam, I like to speak with the patient the entire time, complimenting him or her on how well they are doing in the office, and narrating what I am doing, and why I am doing it. I almost always finish the exam by complimenting the patient and thanking them for letting me perform the exam. I also go over out loud what I saw or found with the patient and family. While not always successful the first time, an approach that focuses on communication and transparency, repeated consistently over time, should result in optimum comfort and success.
Be accommodating: Lastly, your doctor should be extremely accommodating to your child with special needs or on the autism spectrum. This runs the gamut from forms, appointment times, letters of medical necessity and phone calls to other specialists. Knowing these children are part of a great office with a caring medical professional means the world to patients and families–regardless of diagnosis–but is particularly important for patients on the spectrum.
Each child with special needs has a unique set of experiences and fears that shape who they are and how they will react to a checkup. As physicians who strive to provide the most comprehensive care to all patients, it is critical that we not only assess the needs of these patients in our first meeting, but continue to monitor new developments and behaviors during each visit. Doctors who keep an open mind and an open line of communication can provide the best care for your children and family.