Mini-Schedule and Behavior Story: Doctor Appointment
My friend’s daughter is 5 and was diagnosed with autism around age 2. She has trouble in public places. I am wondering if anything can help with her aggressive behavior at the doctor. A lot of the employees there have been pinched or bitten by her. Is there something that will help her feel more comfortable in public and with doctors?
Doctor appointments can be a stressful time for children. Since some children with Autism have difficulty communicating emotions, consequently we often see behavioral issues. Try using behavioral stories to prepare her for the doctor appointment, and a mini-schedule when at the doctor office. These suggestions may help with reducing anxiety and prevent behavioral issues associated with the doctor appointment.
A Behavior story is a simple description of a social situation, written from a child’s perspective. The situation is described in detail and focuses on the important social cues, events, expectations and ways for the child to react in the situation. Behavior stories are intended to be used with a child prior to an event. It is rehearsed with an adult so that when the event actually occurs, the child can use the story as a guide for behavior.
A Mini Schedule provides the child a visual support outlining steps of an event. It can be in picture, object, word or numeral format. A mini-schedule can give a sense of time and when an activity will end. Children often like to check off each item as it occurs. Knowing what and when things happen can help reduce anxiety and prevent many behavioral issues.
You can draw the pictures, write the words if the child reads, use pictures from the internet, Boardmaker visuals, or use objects. As you do each activity cross it off so the child can see what is next and when she is finished.
- Child's Age: 3-5, 6-10, 11-13, 14-17, 18+
- Planning Effort: Moderate
- Difficulty Level: Moderate
Child must be able to understand simple stories, words or what pictures represent.
- Create a simple story that includes the behavior(s) of concern, and how the behavior may make others feel. Include what the child can do instead of the concerning behavior(s). Incorporate the child’s special interest or favorite cartoon character. If possible add pictures of the child, pictures of the doctor’s office, exam room, and staff that will come in contact with the child.
- Below is an example of a behavior story for going to the doctor. Add to it and adapt to her needs.
- Read the Behavior Story with her frequently, prior to the appointment.
- Think about exactly what will take place at the doctor appointment.
- Create a few visuals outlining the appointment (sitting in waiting room, getting weighed and measured, talking with nurse, having temperature taken) If possible put something preferred at the end of the mini schedule such as going for ice-cream or getting a sticker.
- Have the child cross off or you can cross off each item when the item is completed.
- Be consistent with schedule.
- You may want to consider taking your child to the office once or twice to get a sticker/treat from receptionist/nurse prior to your visit. This will help your child see the environment in a more positive way. Most Dr. offices would be willing to cooperate with some advance notice.
Documents and Related Resources
Mini-Schedule for Public Settings
do2learn (website for picture cards)
Indiana University (website for using visual schedules)
Going to the Doctor Behavior Story (Word document)
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