How to handle vision/hearing refusal

[100kids, BSN, RN]

I have a young student with autism who just entered my school a few months ago. I have tried on 2 occassions to have him do the hearing and vision screening but he will not allow it. I documented that he refused but how do you handle these types of situations?

[LisaLPN7]

Let the parent/guardian know he's refusing and move on.

[Flare, ASN, BSN]

if i've given the attempt at screening a valiant effort and the child can't or won't comply, I write "unable to test" on their health card send a simple notice home and move on. If time permits and the child and staff are agreeable to it, we may work towards teaching the child how to comply. Usually as the autistic students get older, depending on their verbal skills or abilities, can get the hang of the screenings.

[Sudsy]

How old is the student?

I have had a few refusals in my whopping two years of being a school nurse, so I don't have tons of experience here, but I found that all the refusals were from the very young kids (my state starts screening at age 4). For those kids, I asked the preschool director to take over for one of the classroom teachers while the teacher accompanied the child to me. For some kids, it's just too much, the newness of being in my office *and* doing something new, and they shut down. Sometimes they can get through it if their teacher is with them.

I had one kid who is known to have a LOT of anxiety and extreme trouble adjusting to new situations. He couldn't even do the test with his grandmother with him (she works at the school). We did give it one last try after I spoke with his parents on the phone. He also couldn't complete vision screening at his doctor's office, either, so it seemed more important to try here. We tried with him sitting on his Dad's lap, and he still just refused.

I told the Dad that, imo, the work that we had done getting him more used to being in my office and used to what symbols he would see on the vision screening chart would hopefully pay off next year, when he is able to complete the screening!

Good luck.

[100kids, BSN, RN]

Thanks everyone. I will send home a note to mom. This child is 7 but only just entered school. He knows me well and feels comfortable with me and has come each time with his 1 on 1 aide or his Special Ed teacher. I will keep trying and hopefully one of these days he will let me but I appreciate the help and ideas.