Increasing Adherence to Medical Procedures for People with ASD and Intellectual Disabilities

Abstract

While adherence with medical procedures and compliance during medical exams are important skills to learn, approximately one third of individuals with Autism Spectrum Disorder (ASD) and/or intellectual Disabilities (ID) have been found to exhibit noncompliance during basic medical procedures (Gillis et al. 2009). A skill deficit in this area may result in higher risk of injury and in the need of more intrusive procedures or physical and mechanical restraint. This talk will start from a review of Applied Behaviour Analysis (A.B.A.) based literature related to the application of non-aversive procedures to increase adherence to medical procedures, such as blood draw, dental care, routine exams, ECG etc. Procedures such as differential reinforcement, stimulus fading, gradual exposure, shaping will be discussed. Clinical applications of such procedures on adolescents and adults with ASD will be discussed, as well, with a focus on teaching students to report pain, preventing emotional negative responses and assure the assent of the participants during the procedures. Results of these interventions will be contextualized in a Quality of Life (QOL, Schalock et al. 2002) frame evaluating the impact of the results on the physical wellbeing domain.