Autism, Dentists, and Shots: How to Avoid a Fail

Leo is on spring break. This means the two of us are hiking a lot, and scheduling Leo's medical appointments during what would otherwise be school hours.

Yesterday was Dentist Day, which occurs every six months. We have spent years, literally years, getting Leo used to his wonderful dentist, the exam chair, opening his mouth for prodding and viewing, etc. This is neither the easiest nor quickest solution, and it took a lot of work, but now our former screamer-and-bolter is used to the dentist and her staff and routine. He will, and did, (mostly) comply with the visual exams and cursory teeth cleanings.

Fortunately, according to the dentist, he has the teeth we want all of our children to have -- the strong, plaque-repelling ones. But he's still not had x-rays or a proper, deep teeth cleaning, so we agreed that he would undergo sedation for his next visit. I'm not thrilled, but it's necessary, as we need to know if he has any cavities between his teeth or issues with incoming adult teeth. (Bonus: if we need to draw blood for any other, non-dental medical needs, we can do it then, too.)

We also confirmed that his "It hurts, my mouf, I want Tylenol pleeease" talk that had been making me nervous this past week is due to a loose front tooth. Seymour and I can't wait to see what he looks like with gappy teeth, so expect lots of pictures when it falls out.

Today was more complicated: Injection Day. Leo is behind in his vaccinations due to years of hesitance and vaccine/autism mulling. Since I no longer believe vaccines had anything to do with who Leo is, I decided it would be easier to for him to have four shots at once instead of spacing them out.

Leo hates shots. Hates them. And he is big and strong and non-compliant. But as our local medical office has historically shown skill and compassion with my kids, I felt confident that Leo would actually receive his shots.

Even more important to me, though, was his not being terrified during the procedure and heartbroken afterwards. I wanted him to know what was coming, and to understand that it would pass quickly and that there would be a treat for him afterwards (compliant boy or not). So I set up his portable visual schedule with a hastily created "Doctor" icon followed by the usual ones for "Car" and "Snack."

We discussed his schedule several times before leaving the house, and again in the car. He really got it, and announced, "Doctor Time!" when we arrived at the office. I checked us in, confirming the "extra nurses" accomodation I'd requested while making his appointment. They called us into the exam room and sat Leo on the table. I reminded him for the last time that the doctor would be coming in to give him shots, and mimed injecting him in the arm.

Three nurses came in to help with the four injections -- all people who understood that Leo needed cheerfulness, minimal talk, strength, and speed. (This is unfortunately not always the case -- nurses often try to talk Leo through the procedure beforehand, which freaks him out, and then they try to talk him down, which makes him even more upset.)

They delivered three injections before he knew what what happening. By being calm, kind, and firm, they were even able to do a sub-cutaneous TB test injection without him entirely losing his shit.

(At least, not in the exam room. There is still no laxative more effective for our boy than a trip to a doctor's office. He left large deposits -- in the proper receptacles -- before leaving both the doctor's and the dentist's offices.)

Everything happened so quickly that Leo didn't have time to get truly upset. As soon as the bandaids were slapped over the injection sites, he was completely recovered, and ready to go get his snack. Which means I didn't crave a strong drink. Win-win!


  1. Well done! It is hard finding and implementing stratagies that work for these kiddos. I keep telling the nurses, don't ASK him if wants his blood pressure taken, he will say no! Just tell him you are going to do it, and then do it. So glad things worked out.

  2. Woo hoo! Hurray for win-win situations. What *is* it with nurses that feel compelled to talk through everything? I've actually yelled at nurses while in the hospital to "stop talking to him NOW!" after they didn't honor polite requests to just let Nik deal however he was going to deal while they did their thing. OY.

    So, in all, sounds like a really good experience —well, except for L actually having to get the shots...

  3. Anonymous10:04 AM

    Oh, man, you could have been writing this about my son :)

  4. Yay! congratulations!

  5. Yay! Great success!


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