Children with special needs

It is well-known, that children with special needs, such as for example children with ASD, tend to be more anxious than typically developed children (Johnson & Rodriguez, 2013).

• In addition those children may have difficulties, which may be a challenge when seen for a procedure in the Radiology Department.
• Difficulties may be regarding communication, both to express themselfs and also to understand verbal information.
• Also, it may be difficulties in the social interaction, maybe not being able to ”read” and understand the situation.
• Often children within the autism spectrum are inflexible in, that they are depending on routines and highly sensitive to changes in the environment.
• In addition, they may be sensitive to stimuli souch as touch, where a light touch may cause pain.
• Also visual stimuli may be overwhelming and ”too much”…
• Children with special needs are frequent users of a variety of health care systems, also including procedures and treatment in the Radiology Department.
• Also, as they often experience more anxiety than typically developed children, it is more important that the interaction between the child and the radiographer is a successful one. 

Parents find, that health care professionals do not understand the complexity of interacting with children with special needs (Davignon et al., 2014).

Adapted information to the child’s level of understanding is necessary to meet each child in a person-centered way and to achieve participation and a successful outcome of the health care procedure (Björkman et al., 2014).

Adapted information should be provided regarding benefits and risks of the procedure (WHO 2016).

Inclusion of different parts must be considered as an advantage, since children in different ages and developmental stages have different needs. Furthermore, if parents are involved, it is shown to have an effect on improved communication and social functioning (Gårdling, 2017).

One way to achieve a person-centred encounter and to support the communication may be to use illustrations as part of Augmentative and Alternative Communication (AAC); (Beukelman et al., 2013).

It is rather common that children within the autism spectrum, tend to have difficulties in communication, both in understanding verbal interaction and to express themselfs in verbal. 

Tools to facilitate the interaction

Fig. 1: Møller Christensen et al 2019

Illustrations can be used in the interaction with children during radiographic procedures (Møller Christensen et al 2019).

Guidelines can be used as a help when planning for a procedure and in this regard a check-list can be used to prepare for a person-centered meeting with the child and family.

It is important that the health care professionals are aware of how the child communicates – if for example the child use to communicate through pictures or maybe uses other alternative communication aids (Gimbler-Berglund et al 2017).

Also, it may be a help for the health care professional to have information regarding what the child likes or dislikes, what works or maybe doesn’t work in order to achieve participation. What worries and what calms the child and how the child shows anxiety.

Regarding the child’s sensitivity to stimuli, it is important to know how the child reacts to sound, light, touch, or if there are other contextural needs that should be taken into consideration in the environment in order to prepare the procedure and the interaction in the best way possible (Gimbler-Berglund et al 2017).