Tuesday, 7 November 2017

3 Top Tips in Managing Autism with the National Autistic Society

At our most recent staff meeting within our community dental services we received a talk from the National Autistic Society. This post is based on that talk...




What is Autism?

  • Autism is diagnosed by observing behaviour
  • The condition is a spectrum disorder i.e. it affects people in varying degrees
  • Asperger's Syndrome is on the spectrum of autism, but it may not be recognised as a separate diagnosis  soon
  • Prevalence is 1 in 100
  • The cause of autism is unknown; there is thought to be a genetic and environmental component
  • 5:1 ratio of male to female
  • 30% of autistic people also have an associated learning disability

The diagnosis of autism is based of a triad of symptoms: 
  1. Social interaction difficulty
  2. Repetitive behaviours
  3. Communication difficulties

Considerations when interacting with Autistic patients


1. Non-verbal Communication

Autistic patients will often take the literal meanings of words or phrases and have difficulties with non-verbal communication e.g. they do not create eye contact. 

Give increased processing time for these patients, don't give them too much information at once and give instructions in stages/allow them to prepare e.g. Ben, sit in the dental chair then open your mouth then I will use this mirror to look at your teeth. 


2. Structure/Routine

Try structure the environment so they are familiar with their surroundings e.g. see them in the same surgery with same nurse etc. Try to arrange an appointment time that disrupts their day as little as possible and stick to a structured appointment. 

Encourage the parents to create a routine surrounding their oral hygiene regime and create a reward system following the routine e.g. brush teeth, add a sticker to a tooth brushing chart. 


3. Hypersensitivities

Autistic people can be very sensitive to sound, light, touch and so it's something to be aware of in a dental surgery full of foreign experiences! Be aware of use of the dental light - many autistic patients do no like it as well as loud noises like the suction or dental drill. They may also be sensitive to the taste of your dental gloves, toothpaste, fluoride varnish etc. 

For light consider the use of sunglasses. Autistic patients often have ear defenders to block out sound. If patients do not like the sound of vibration of an electric toothbrush, use of a Dr Barman's toothbrush can be useful. 


A usual acronym with interacting with people with Autism is SPELL:

Structure

Positive approach (language use, visual)

Empathy and seeing things from another point of view

Low arousal, low stress

Links and consistency


To see other tips in managing Autistic patients see my previous post. Many thanks to NAS for the informative talk!



Do you treat autistic patients? Let me know how you manage these patients in the comments section.

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