Warning

Pre- Admission

Give as clear a picture as possible of what the person can expect to happen.

  • Information (in appropriate formats) should include an explanation of processes and medical terminology. It should also, where possible, include routes to buildings/clinics from point of arrival at the hospital.
  • If there is sufficient advance notice of the admission, offer the opportunity for a pre visit or additional information to reduce anxiety levels about the experience. This will also aid staff understanding of what is required to improve a patient’s journey.
  • If it is an outpatient appointment, try to give an Autistic person appointments at less busy times of day. This may help reduce stress levels caused by busy environments.

Admission

  • Is the reception desk in a noisy or brightly lit area? Is there a lot of information for the Autistic person to process? Consider using a quieter, less brightly lit space for admission and allow time for the person to ask questions and process what they are being told.
  • If there has been no opportunity to chat or answer questions prior to admission, staff should take extra time to ensure the Autistic person (and where relevant their family/carer/partner) has understood what is happening. Speak clearly, giving the Autistic person time to process the information. If someone is non-verbal do not assume that they do not understand what is being said.

During Stay

  • If the waiting area is brightly lit or noisy consider the use of a quieter, less brightly lit space. Also take into account any smells; is it possible to minimise this?
  • Explain any examinations or processes to be undertaken during the stay. If an Autistic Person has a carer, enlist their support but do not talk over the Autistic Person.
  • Any changes which need to be made should be clearly explained to the person as soon as possible. This will give time to enable an Autistic person to process the changes and feel more comfortable.
  • Consider where the Autistic person will be during their stay in terms of lights, sounds and smells. If necessary try to allocate a quieter less brightly lit space away from strong smells.
  • If it is not possible to find an alternative space, consider what can be done to lessen the environment and sensory influences. A single room can be easier in terms of lessening light, sound and smell. Encourage use of noise cancelling earphones or ear buds. - Many Autistic people will have these but may not be sure of using them in the environment; consider providing such equipment. Some Autistic people also wear dark glasses to lessen the impact of bright light.
  • Ensure that the Autistic Person is aware of the position of other relevant facilities such as toilets (Accessible toilets if necessary).
  • Over-stimulation of an Autistic Person’s senses may lead to “stimming”. Stimming is a self-regulatory behaviour intended to soothe or steady an Autistic Person. This can take many forms including humming, rocking and hand-wringing or flapping but will vary from Autistic person to Autistic person. It may also involve the use of stimming tools (sometimes called stim toys) such as fidget spinners or rings and squishy toys or just something the person finds comforting. Not all Autistic people visibly stim and it may go unnoticed by others if it takes a less visible form.
  • Be aware that a previously vocal person can also shut down when under stress, becoming less able to communicate.

Good Practice Example - RAH Day Surgery

Autistic patients can enter the unit via an alternative entrance which enables a less stressful start to their appointment/stay.

Within their six bedded wards, staff at can pull their dark curtains around individual beds to create more privacy and lessen sensory input. They can also reduce lighting in the individual areas.

Discharge/Follow up

When the appointment or hospital stay is over, be clear about what will happen next, including any timescales and the need for follow up.

Take time to go through any information that an Autistic person may need and ensure that it is in a format which is suitable for them. Go through the information with the person if necessary, ensuring you check their understanding. Take special care to ensure any medical terminology is explained.

Editorial Information

Last reviewed: 31/05/2024

Next review date: 29/11/2024

Author(s): Jacqueline Fairweather.

Version: 1

Author email(s): jacqueline.fairweather@ggc.scot.nhs.uk.

Co-Author(s): Susan Thompson, Jac Ross.

Approved By: GGC Public Health Senior Management Team

Reviewer name(s): Susan Thompson, Jac Ross, Jacqueline Fairweather.