If your children fear the physician, dentist or even hairstylist, you’re not alone. And for children with autism and other intellectual disabilities, fear can lead to major meltdowns. One local Advance Practice Nurse who treats this population provides insight for parents
Contributor: Lisa Alberts APRN-BC, PMHNP-BC, APN Leader, Acute Behavioral Health at The Bancroft School and Marcroft Medical Associates
If your child or adolescent fears the physician’s office, you’re not alone. And if you have a child with autism or another intellectual or developmental disability, a doctor’s visit can be more than nerve-wracking – it can become nearly impossible! In fact, for a child with a sensory sensitivity or communication barrier who may not be able to effectively communicate his or her fears, a simple mention of a doctor’s visit – or even driving through the neighborhood of the medical practice – can incite fear, anxiety and challenging behaviors.
As an Advanced Practice Nurse at Voorhees-based Marcroft Medical Associates, an affiliated medical practice of Bancroft, who treats individuals with autism and other disabilities, I’ve seen what strategies work best for parents of children who fear the doctor. Fortunately, many of these apply to all children and families!
Before your child’s next physical or medical intervention, remember these tips:
For a child who normally comes home right after school, a 4 p.m. appointment can make the day feel endless. Discuss the long day with your child the night before, so he knows what to expect, and try to get to sleep a little earlier than normal. The extra shut eye will help keep energy levels up late into the next day.
If your child is fearful of his appointment, becoming “hangry” will only elevate his stress. Pack a cooler with his favorite snacks and drinks – even a treat or two – to keep after-school hunger and anxiety at bay. He may even begin to look forward to a special snack – something he doesn’t normally enjoy on school days – when he knows he’s visiting the doctor.
For sensory-sensitive kids, comfort items such as stress balls, stuffed toys, Play-Doh or pre-programmed headphones with favorite music can help, too.
Bring a Helper!
For parents of very little ones, or with more than one child, bringing a helper to appointments makes a world of difference. Quiet games and electronics can help too, but nothing beats one-on-one attention from a preferred adult. If your child fears the doctor, bringing a favorite grandparent or older cousin or friend along to help occupy him during his wait can improve his mood considerably and reduce stress for you, too
Do Your Homework (and ask for copies)!
I’ve seen tough medical appointments become even more stressful when a parent is trying to calm and comfort a child while simultaneously trying to complete complex paperwork, take notes and ask the right questions. I advise parents to prepare paperwork in advance (many medical offices will provide this electronically well before your appointment date), write all questions down beforehand, and even request a copy of the appointment notes. It’s easier to focus on an upset child knowing you can comb through your notes afterward.
With flu season just around the corner, area families will surely be paying their fair share of visits to the doctor’s office, so keep these in mind for medical services, dentist visits and even haircuts!
A little advanced planning and communication with your child regarding expectations can go a long way to easing fears and anxieties regarding all types of appointments – for the patients, the parents and the physicians and nurses who treat them.
Marcroft is a specialized medical practice of psychiatric, behavioral health and neurological experts who practice an interdisciplinary approach to treating people with neurological conditions as well as those with autism, intellectual and developmental disabilities throughout their lives. Specializing in psychiatry, behavioral health and neurology, our expert team of physicians and clinicians provide world-class care.
Marcroft is conveniently located in Voorhees, N.J., and is the affiliated medical practice of Cherry Hill-based Bancroft. If you or a loved one could benefit from Marcroft’s specialized services, visit MarcroftMedical.com or call 856-524-7243
Concussions can result from any impact to the head that jars the brain. They do not necessarily include the loss of consciousness. The developing brain is particularly susceptible to concussion, and children and adolescents who participate in sports are at even greater risk. A child who suffers from one concussion is more likely to experience another, and recovery takes longer in children than it does in adults.
Concussions disrupt the brain’s ability to process information. They impact reaction time, memory, and cognitive processing speed. Physical and mental rest are critical to recovering from a concussion, and while most concussions resolve within a few weeks, sometimes symptoms linger. In these cases, students are at risk of additional academic and social difficulties that can persist long beyond the abatement of their concussive symptoms.
It Takes a Village: Concussion Recovery is a Team Effort
The management of a student’s recovery should be a team effort, and students should receive consistent messaging from their doctors, parents, and teachers about the importance of rest during the healing process. In instances where students continue to struggle with social and emotional problems, educators should maintain communication with parents and guidance counselors in order to give the student the best opportunity for recovery. When students return to school after a concussion, it’s essential to find a balance between academic progress and cognitive healing.
For teachers…the question is usually asked, what can I do to assist in a positive transition back to class?
Accommodations for students recovering from a concussion
Primarily, a student recovering from a concussion requires mental and physical rest. Educators should excuse absences or accommodate half-day attendance for the first several days following a student’s injury. Schoolwork requires focus, memory, and concentration — decreasing these demands will allow the brain to heal faster. As symptoms decrease in number and severity, students can gradually return to school.
When children return to the classroom after a concussion, physical and cognitive symptoms may persist. These can include headache, dizziness, fatigue, and sensitivity to noise and light, as well as difficulty concentrating or remembering. These symptoms can impact a student’s ability to focus on learning, and make it difficult to for them keep track of their schoolwork. Educators should understand that students recovering from a concussion may not be able to complete their schoolwork or participate in class until their symptoms have completely cleared. The following table details accommodations for concussed students that can aid in their recovery:
|Excused absence from school||
Several days of rest, progressing to half-days and limited attendance is likely needed.
|Rest periods during school||
When symptoms flare, brief periods of rest may allow to student return to the classroom.
|Extended coursework deadlines||
Cognitive speed and ability is impeded and will take time to repair.
Mental effort and pressure required to prepare for an exam may trigger symptoms.
|Excused from assignments or exams||
Nervousness and emotional pressure can compound symptoms and delay healing.
|Reduction of light and noise||
High-simulation environments can cause symptoms to flare.
|Provide preferential seating or
small space testing
Reduces stimulation and distraction.
Assists student in organizing and prioritizing their thoughts and assignments.
Students who present ongoing behavioral issues or persistent symptoms should work with a guidance counselor or school psychologist to ensure their process is being tracked. Students with prolonged symptoms, may need to develop an individualized education plan (IEP) or 504 plan.
Warning signs a child might not be ready for class yet
Some children are at more risk for post-concussion problems than others. Even with accommodations, some students will have difficulty acclimating back to the classroom.
Concussions are invisible injuries, and lengthy healing times can be frustrating and difficult to understand. The pressure to recover quickly can be very emotionally taxing on students. The following signs may indicate a student didn’t recover completely:
- Disproportionately emotional responses
- Inability to cope with emotions and other problems
It’s a team effort and teachers play an important role in the child’s recovery and should always work in conjunction with the child’s physician and parents for the right road towards recovery.