Note: Most Internet Explorer 8 users encounter issues playing the presentation videos. Please update your browser or use a different one if available.

Seeing the Doctor without Fear: Systematic Desensitization for Medical Visits in ASD

Friday, 3 May 2013: 09:00-13:00
Banquet Hall (Kursaal Centre)
11:00
L. Boada1, M. Parellada1, C. Moreno2, B. Villamia3, V. Pensosi3, C. Llorente4, J. Romo5 and C. Arango1, (1)Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. IISGM. CIBERSAM, Madrid, Spain, (2)Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. IISGM. CIBERSAM, Child and Adolescent Psychiatry Department, Spain, MADRID, Spain, (3)Fundación Orange, Madrid, Spain, (4)Child and Adolescent Psychiatry Department, CIBERSAM, Insituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, Madrid, Spain, (5)Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. IISGM. CIBERSAM, Child and Adolescent Psychiatry Department, Spain, Madrid, Spain
Background:  People with autism spectrum disorder (ASD) not only have greater medical needs than the rest of the population (Gurney, McPheethers and Davis, 2006), but they also have particular characteristics that make it very difficult for them to get the medical services they need (need for anticipation, lack of flexibility, problems identifying and describing symptoms, hypersensitivity to certain stimuli, stress over waiting times, etc.). Going to a medical visit can be a traumatic experience for people with ASD and their families.

Objectives:

1) To design, implement, and evaluate a program based on new technologies that make the medical environment more familiar and less stressful to the patients with ASD before, during, and after a hospital visit.

2) To evaluate the effectiveness of this program for reducing patient stress and anxiety, improving the family’s quality care perception, and reducing medical visit time.

 Methods:

I.  Design “Doctor TEA” software built on a Web platform composed of a set of structured contents in film format of a real hospital, in 2D and 3D, showing the physical spaces, medical professionals, techniques, and instruments used for a medical examination, including many interactive games showing different aspects of a doctor’s visit, such as a blood test.                                                                                       

II. Evaluation: Participants: 80 participants with autism spectrum disorder, Asperger’s syndrome, or Pervasive Developmental Disorder-Not otherwise specified (PDD-NOS) (DSM-IV-TR and ADOS-G) recruited through the ASD Comprehensive Medical Care Program at Gregorio Marañón University Hospital in Madrid.

            Procedure: Forty patients will use the “Doctor TEA” software for twenty sessions of 30-minutes over a 6-week period (experimental period). The other 40 will not receive any intervention. Participants in these two groups will be matched for clinical diagnosis, mental retardation, age, and type of medical specialist visit/test they will require. Following the experimental period, they will have their actual medical visit/test. Next, an evaluation will be performed in both groups using three specific questionnaires completed by families, patients (when possible), and a health professional. The main dependent variables will be: patient comfort perceived by the doctor/nurse, patient self-rated anxiety, next-of-kin rated anxiety, hyperactivity during the visit, time needed by the patient, etc.).

 Results:   At the present time, we are finishing the software development fully funded by Orange Foundation. By May 2013, the software development will be nearly complete and we will have preliminary results on the effectiveness of the software based on the dependent variables of the study. 

Conclusions:   Daily clinical practice demonstrates that with preparation and specific training in desensitization to medical procedures, patient anxiety is considerably reduced.The reasoning behind this program, which will be freely available to the public in the future, is to try to demonstrate that TIC can help people with autism to anticipate and understand medical visits and tests that any hospital or health centre may perform.

Note: Orange has already developed several software which are publicly available to facilitate the integration of persons with ASD (www.fundacionorange.es) and Hospital Gregorio Marañón has a specific program for the attendance of the medical needs of patients with ASD (Parellada et al, 2011; http://ua.hggm.es/).

| More