“Doctor Tea” Helps Children with ASD Going to the Hospital without Fear

Background:

People with autism spectrum disorder (ASD) have greater medical needs than the rest of the population (Gurney, McPheethers and Davis, 2006), and they also have particular characteristics that make it very difficult for them to access the medical services (need for anticipation, lack of flexibility, problems identifying and describing symptoms, hypersensitivity to certain stimuli, stress over waiting times, etc.). A specific program for medical specialty care of ASD subjects was started in 2009 at the Hospital Gregorio Marañón (Parellada, 2013). Subsequently, a web-based tool was developed to help decrease the anxiety and stress associated with medical visits and procedures in attendees to the clinical program.

Objectives: To evaluate the effectiveness of this web program for reducing patient stress and anxiety, improving the family's quality care perception, and reducing medical visit time.

Methods:

1. "Doctor TEA" software is built on a Web platform and is composed of a set of structured contents (in film format of a real hospital, in 2D, in 3D, with cartoons and pictograms) showing the physical spaces, medical professionals, techniques, and instruments used for a selected medical examination–magnetic resonance, electroencephalogram, orthopantomography, blood test and stomatology or ophthalmology visits-. (Please, see http://www.doctortea.org/entra/pruebas/). The website also includes interactive games showing different aspects of a medical visit.
2. Evaluation: Pilot study. Participants: 40 patients with autism spectrum disorder recruited through the ASD Comprehensive Medical Care Program at Gregorio Marañón University Hospital in Madrid (Parellada, 2013).
3. Procedure: 20 patients will use the "Doctor TEA" software for 2 weeks and 6 sessions of 15 minutes. The other 20 will not receive any intervention. Participants in these two groups will be matched for clinical diagnosis, mental retardation, age, and type of medical 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).

Results: At the present time the software is complete and we are collecting data for its effectiveness evaluation.

Conclusions: Daily clinical practice suggests that anticipation and specific desensitization for medical procedures training, patient anxiety towards medical procedures is considerably reduced. The reasoning behind this program, which are freely available to the public, is to try to demonstrate that TICs can help people with autism to anticipate and understand medical visits and tests that any hospital or health centre may perform.

Interactive demonstration will be presented in the technical session.

Financial support: Orange Foundation has already developed several software tools which are publicly available to facilitate the integration of persons with ASD (www.fundacionorange.es).