Pediatria pre prax 2/2024

The use of behavioral interventions in the training of the medical examinations in children with autism

Background: According to the literature, medical comorbidities are more common in individuals with autism spectrum disorder (ASD) than in the neurotypical population. These also predispose an increased number of outpatient and inpatient care visits for these patients, during which the occurrence of problem behaviors can make it difficult to conduct a thorough professional examination and set up effective treatment. However, several studies have shown that the use of behavioral interventions prior to the actual clinical examination is effective in children with autism. Aim: To describe and validate in practice the effectiveness of a multicomponent desensitization method in pediatric examination training. Design: A single-case experimental design with multiple probes across behaviors was used. Subjects and Methods: A boy diagnosed with autism spectrum disorder at the age of 4 years who presented problem behaviors during clinical examinations with a pediatrician was included in the study. The direct intervention method and the graphical processing and analysis of the collected data were used to experimentally validate the independent variable. Results: The multicomponent desensitization method had a positive effect on increasing acceptance of each behavior during the pediatrician‘ s visit. Compared to baseline, when the participant tolerated only 1 of the 9 steps, the participant performed all the steps after application of the intervention without the occurrence of problem behaviors. It was also significant that the learned skills generalized to the pediatrician‘s office setting. Conclusion: The presented results indicate the effectiveness of behavioral methods in our setting and also the need for such an intervention for the health care of a group of children with ASD.

Keywords: autism spectrum disorder, medical examination, behavioral interventions, desensitization