Principles of examining patients with autism
- You should ask the patient, or their carer if appropriate, whether they would like to visit the practice before their appointment, to help them become used to the surroundings and the equipment. If this is not possible, you could provide photographs of the instruments you will use, or allow time at the beginning of the examination for the patient to familiarise themselves with the practice and the room setup. You could also provide a list of the questions you are likely to ask, such as history and symptoms. There is a checklist available to help you see how autism-friendly your practice environment is (refer to COVID-19 guidance).57
- If relevant, try to speak to the patient’s carer before the appointment to find out what the patient may like or dislike or respond well to.58
- Reduce the number of staff involved in the patient’s journey. This is because it takes time for a person with autism to become comfortable with a new person.
- Knowing when something will happen is important to a person with autism so, If possible, try and offer the patient an appointment at a quiet time of day and when they are least likely to be kept waiting, for example the first appointment of the day or immediately after lunch. . Tell the patient if you are running late, and be realistic about when they are likely to be seen, so that they can wait outside or come back later.
- Ask direct questions rather than waiting for the patient to volunteer information. Explain why each test is being conducted and what is going to happen before each test, using clear language. Give direct instructions, such as ‘please put your chin on the chin rest’ rather than asking ‘can you put your chin on the chin rest?’.
- Allow extra time, and allow the pace of the examination to be partially dictated by the patient.
57 Simpson, S. (2015). Checklist for autism-friendly environments [Accessed 18 Nov 2020]
58 National Autistic Society. A guide for eyecare professionals - working with autistic children [Accessed 18 Nov 2020]