Recently our GP recommended that we get our 6 year old son a blood test to rule out some ideas of what could be behind his stomach pains. We have mentioned his stomach pains in the past and been fobbed off with ‘it’s part of his autism’, but finally a doctor is looking for a medical reason before we go down other avenues. However, when she mentioned blood test it did make my heart jump. As an adult I find blood tests uncomfortable and at times painful (although it’s usually pretty quick) but in my head I flashed through several issues that could effect J.
- Change in routine for the day
- Sitting still enough to do the test
- If he sees the needle how will he react?
- Dealing with the sensory aspect as well as any pain.
- Dealing with the after sensations (the plaster coming off etc)
- What happens if he refuses.
- The overload or come down afterwards.
First thing I did was ring the appointments centre and ensure that it was on the notes that we need paediatric services AND that J is autistic. It’s not a case of wanting to throw his diagnosis around. It’s because it gives the staff taking the blood chance to prepare. They are usually pretty experienced and so they’ll know the ‘tricks of the trade’ to use, allow us extra time and more understanding. I then phoned the paediatric outpatients to ask for their advice and to get a run down of what to expect. They were really helpful and we discussed numbing cream vs spray, time to apply it, where to apply it etc.
Next, I arranged childcare for my youngest child (thank you Auntie S) and asked my Mum to accompany us in case we needed an extra pair of hands. I spoke to the SENCO to discuss whether I should bring J back to school after lunch if all goes well. We agreed that a full day off would be better otherwise it would be adding more transitions and yet more change in routine for him. So the day was planned.
I chose not to give J advanced notice as I usually would because I knew he’d dwell on it. I simply told him that he would be going to the hospital for some tests which means he wouldn’t be going to school…that sold it for him! I waited until the morning, I then explained in simple terms that they needed a little bit of blood from his arm to test using special machines. I said he wouldn’t feel the scratch as he would have special cream that would make it numb. I kept it quite basic and told him what we would be doing afterwards.
I thought I’d share what we did in case it is helpful for others:
- Have symbol cards/visual timetable ready (I just used a general hospital sign rather than a blood test symbol).
- Take support with you (they may not be allowed in if you are reading this during corona days but its handy for the before and after).
- Allow them to stim (if safe) and take sensory aids for the lead up. There may be a short wait.
- Discuss numbing options BEFORE the day. We had to get the numbing cream prescribed by GP and not every pharmacy stocks it. We choose the cream over the spray as it last longer and I felt that the spray would simply draw attention to the procedure when there.
- Confirm with the paediatric team at the hospital where the blood will be taken from and whether 1 or both arms (so you know where to put the numbing cream if you choose this option).
- Take distractions (we took the ipad and fidget toys).
- Don’t let them see (either stand in the way or use hand to create barrier).
- Communicate with the staff. You know your child and you need to advocate on their behalf.
- Go by the child’s emotional and physical state for the rest of the day. They may need a physical outlet, chance to shutdown, something to focus on, get back to days normal routine, or need the routine amended.
Our experience was surprisingly positive. J was stimming so I was talking about all the displays and the signs to keep him focused when it wasn’t safe to stim (he verbally and physically stims). We had a little wait which was hard as it was in the corridor in a queue which is something J doesn’t find easy. If it had been any longer I would have asked for a quiet space for him. Once in he sat in the chair and we had a quick chat with the staff. One help J’s arm in place, whilst the other did the blood test. I focused on distracting J. He didn’t feel it at all. He said all he could feel was a tickly feeling. After a couple of minutes he was getting fidgetty which is a bit challenging when the needle is already in but once we got him talking about his obsession/special interest he was focused again.
Once we left he was very proud of himself. They gave him a sticker, a colouring book and pencils. I then treated him to a magazine and some treats. The rest of the day J had the verbals and was constantly on the go. It was like he had just released everything .The worst part for him was taking the plaster off. It was great to have a positive experience and I truly believe it was down to the planning I did. End of the day, you know your child and what will help them. Just prepare for the worst case scenerio and be thankful for the best case.
If you have any hints or tips to add to this please feel free to comment or check out my post on Instagram and comment there. If you have any questions I’m always more than happy to answer them.