Abstract

Premier HealthCare, a member of the YAI Network, specializes in outpatient healthcare services (such as primary care, dentistry, psychiatry, rehabilitation, psychotherapy, psychological testing, and nutrition) for people with intellectual and developmental disabilities in New York City. This is one of the most in need, yet underserved, groups of medical and dental patients. Many people with autism spectrum disorder (ASD) have difficulty understanding the significance of healthcare procedures and become overwhelmed by the unfamiliar environment and sensory input of medical and dental practices. They may also have difficulty with communication and socialization, which can exacerbate anxiety and challenging behaviors such as self-stimulation, self-injury, aggression, and tantrums. Additionally, this heightened level of stress can potentially translate into disruptive behaviors or physical reactions to avoid treatment. These challenges combined with a lack of healthcare professionals trained and experienced in working with people with ASD can result in ineffective preventative care and high-cost procedures. At Premier HealthCare, a desensitization program was initiated to increase functional participation in medical and dental exams and decrease use of physical restraints or general anesthesia for people with ASD. An interdisciplinary team of occupational therapists, behavior analysts, doctors, nurses, and dentists collaborate to address how to make medical and dental procedures more tolerable for patients with special needs using a protocol comprising of four main stages: evaluation, treatment, generalization, and maintenance. They work with caregivers to provide person-centered individualized care, ultimately leading to decreased anxiety, fear, and aggressive behaviors; increased participation; and better health outcomes for people with autism.

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