Medical / Dental

Making Treatment Less Traumatic

Persons with FASD function best  with a great deal of structure and routine in the environment. Unfortunately, even when they are scheduled far in advance, visits to doctors and dentists are usually breaks in the normal routine, and therefore they may be upsetting to the individual. This is especially true if he or she is in pain or has a sudden illness.

Make the Visit Concrete, Less Abstract

In order to avoid the anxiety around an unanticipated visit to the dentist or the doctor, parents can try to obtain take photos of the office and staff beforehand. Many health care offices have websites that have pictures you can use for this purpose. Use these to remind your child of previous visits, or to show her pictures of who she will be meeting. Review the photographs each day for about two weeks before a scheduled appointment.

Reduce Fear of the Unknown

If possible, make the appointment at the quietest time of the day or even after regular hours. For a routine examination, ask the practitioner for a “practice visit.” During this time, have the staff member walk the FASD-affected person through the procedures and use the exact treatment rooms and instruments that will be used during examination and treatment later.

Patients with FASD often need to “unwind” or calm themselves down before treatment begins. This may include walking around the room or fidgeting with their hands. Let you child bring a rubber ball or any other soothing object to squeeze or hold during the visit. Unless the practitioner is examining the person’s eyes, allow him or her to wear dark glasses if they help to reduce discomfort from the glare from overhead lights (such as at the dentist’s office).

Advocate for the FASD-Affected Consumer

Most health care recipients who are affected by FASD should be accompanied to the doctor’s or dentist’s office by a trusted adult who can act as his or her advocate. Usually the advocate is a parent or caregiver, but if the patient is an adult the advocate could be a sibling, spouse, roommate, friend, or coworker.

The advocate should be ready to do the following:

• Review the FASD-affected person’s medication history with the practitioner carefully. It is not unusual for persons with FASD to have extreme reactions to medications. Dentists and specialists should always consult with the person’s parents (guardian or conservator, if applicable) and pediatrician (or primary physician) when administering anesthetics.
• Make sure that the practitioner understands that the patient with FASD is very literal, and will likely become confused if anyone on the staff uses terms such as “(name of instrument or procedure) like this”, and then that instrument or procedure is not used.
• Stress that the practitioner should talk about and show the person the actual instruments and materials that will be used during treatment in order to avoid confusion and misunderstanding.
• Encourage the staff and practitioner to warn the patient about noise and new phases of the procedure. This will reduce tension. Make sure that the practitioner and other staff members understand that they should speak directly to a patient with FASD. Stress that the individual is very visual and often cannot understand if you turn away when you speak. Hand gestures, signing, and visual aids will help them to understand you more clearly.