The Children's Corner:
Perspectives on Supportive Care
Jessika Boles, PhD, CCLS
Empowering Children with Autism
Spectrum Disorder and Their Families
Within the Healthcare Environment
Danna Stokes
A
child’s understanding of a healthcare experience
is greatly impacted by his or her cognitive devel-
opment and baseline knowledge, as well as the
amount of information the child is given about
the experience (Rushforth, 1999). For typically developing
children, healthcare providers may be able to predict how
an individual will respond to a medical procedure or event
based on these characteristics. In regard to patients with
autism spectrum disorder (ASD), research indicates that
healthcare providers report an overall lack of confidence
and skills training in effectively interacting with children
with ASD and their families (Bultas & McMillin, 2016). In
addition, caregivers of patients with ASD have reported dis-
satisfaction with healthcare experiences due to the lack of
healthcare provider confidence, knowledge, and skills in
managing the challenging behaviors associated with ASD
(Bultas & McMillin, 2016). Therefore, as healthcare profes-
sionals, there is a need for continuous education regarding
ASD to increase healthcare provider confidence in working
with this population, as well as improve overall healthcare
experiences for patients with ASD and their families.
Autism Spectrum Disorder
The American Psychiatric Association (2013) classifies
ASD as a neurodevelopmental disorder characterized by
marked impairments in social and emotional functioning
and communication, as well as restricted interests and
repetitive behaviors (Bultas & McMillin, 2016). Whereas
some social and emotional diagnoses are referred to as
delays in development, Souders, DePaul, Freeman, and
Levy (2002) point out that ASD is categorized as a “dramatic
deviation from normal development” (p. 556). Therefore,
social, emotional, cognitive, and linguistic development
may look different for an individual with ASD than that of
a typically developing child.
Danna Stokes, MS, CTRS, CCLS, is a Certified Child Life Specialist,
Children’s Healthcare of Atlanta, Atlanta, GA.
The Children's Corner: Perspectives on Supportive Care focuses on exploring ways to support children undergoing health-
care experiences. Drawing on the documented thoughts and perspectives of children in the research literature, The Children's
Corner aims to provide practitioners with high-quality evidence-based care practices that also promote the coping and develop-
ment of children of all ages and their families.
If you are interested in submitting material for this column, please contact: Jessika Boles, PhD, CCLS; Pediatric Nursing; East Holly
Avenue/Box 56; Pitman, NJ 08071-0056; pnjrnl@ajj.com
254 PEDIATRIC NURSING/September-October 2016/Vol. 42/No. 5
As of 2012, the Centers for Disease Control and Preven-
tion (CDC) reported a 600% increase in the prevalence of
ASD over the last 20 years (Jolly, 2015). Due to common
medical comorbidities that often exist alongside a diagnosis
of ASD, it is common for these children to experience
repeated or lengthy hospital admissions throughout their
lifetime (Jolly, 2015). As a result, children with ASD are
more likely to use healthcare services than typically devel-
oping children, increasing the frequency of interactions
between healthcare providers and patients with ASD (Jolly,
2015). Given the deviation in normal development and
increased rate of hospitalization among children with ASD,
healthcare providers must continue to establish more effec-
tive techniques to meet the unique needs of this popula-
tion.
Healthcare Experiences for Patients
With Autism Spectrum Disorder
Due to the broad range of features that exist alongside
a diagnosis of ASD, children may exhibit a variety of social,
emotional, and behavioral characteristics. Souders et al.
(2002) indicate that some of the most common character-
istics of ASD include difficulty adjusting to new environ-
ments and somatosensory disturbances, such as hypersen-
sitivity. For most children, including typically developing
children, healthcare experiences involve numerous stress-
ful components, such as uncomfortable procedures or
interactions with unfamiliar individuals. During a health-
care visit, children may be exposed to unusual sounds,
smells, sights, and tastes. In regard to a child with ASD,
these experiences could be especially stressful due to hyper-
sensitivity or difficulty adjusting to abnormal situations. In
addition, Brown and Elder (2014) state “impairments in
communication are a hallmark of ASD” (p. 219). As a result,
these children may have a difficult time expressing their
concerns as well as processing information during health-
care experiences.