Should autism parenting be an Olympic event? A trip to the dentist

An autism mom/warrior shares the "lived experience" of taking her daughter diagnosed with autism to the dentist. Details include the preparation, car ride, and actual examination. Questions follow regarding how we can support similarly situated patients, nurses, and their families. Resources related to dental health care for people with disabilities are also included. Nurses General Nursing Article

Plans for my 28 year old daughter's "routine" dental visit begin two months ahead of time. I make the appointment and schedule time off from work. Then, I call her psychiatrist to request medication for the appointment.

Anxiety starts to permeate our family as the day of the dental appointment slowly approaches.

Breathe Donna, breathe.

The day of the appointment is finally here. I dress "appropriately" for the event, call her day program and explain the early pick-up and cancel her transportation home from the day program.

We pick up Lauren at her day program around 11:00. She eats lunch and takes her medication in the car. Tom and I skip lunch and eat a few carrots and some string cheese. It is a two hour long drive to the special needs dental clinic in Miami.

A traffic jam on Interstate 95 brings us to a complete stop. From the back seat, Lauren begins to act out- banging on the car windows, kicking the front seat and pulling Tom's hair. Finally, traffic starts to move and calm is restored.

We arrive in Miami at last. We have to walk into the building through a certain door to avoid the soda and snack machines. After a trip to the bathroom, we check in at the desk. Then, we wait.....today not so long.....about 30 minutes.

Tom is getting more and more anxious as the minutes tick away. He is pacing. I sit showing Lauren pictures on my phone.

Breathe Donna, breathe.

They finally call Lauren's name and she refuses to get off her seat. It takes 3 people to cajole her into moving into the clinic area. There awaits a papoose positioned on the exam table. Lauren begins to act out...she pulls my hair and rips my shirt (thankfully I dressed appropriately for the event). She throws her glasses on the floor (thankfully the expensive, unbreakable kind).

A female dentist is wearing a head scarf. Lauren wants to take the head scarf off her. In the midst of a behavioral outburst, how do you explain to a person with autism that some women wear head scarfs?

Four people lift Lauren onto the table and the papoose is secured. Lauren immediately calms down. I think she is comforted by being inside the papoose. She screams occasionally but "within normal limits". She manages to wiggle out one leg and her sneakers are tossed on the floor. She is stronger than all of us. In order to get x-rays and a cleaning done, it took two dentists, one assistant and two parents.

Breathe Donna, breathe.

High fives, hugs and a promised Diet Coke conclude this visit. No cavities...see you in 6 months.

We got back in the car and drove the two-hour ride home in 5:00 p.m. traffic.

Breathe Donna, breathe.

Parents are raising significantly disabled children, often with little or no support. Many parents continue to work and juggle job-related responsibilities along with the care of their child. All of the other life issues impact these families as well (siblings, illness, aging parents, divorce, school, therapy and medical appointments, meetings with service providers, baseball games, battles with insurance companies, grocery shopping, cooking, cleaning, holidays, vacations and financial challenges).

As we see more and more children and adults diagnosed on the autism spectrum, what can we do to help families more? Are nurses accommodated for having to meet the needs of their disabled children? Do colleagues reach out and offer to help these nurses?

Have we lost nurses due to the challenges of raising children with autism spectrum disorders and other disabilities? If so, would some of them return to practice if workplaces were more supportive?

Meeting the needs of people with autism and their families is a large scale Olympic event. We need everyone to raise a flag.

Love to hear your thoughts, suggestions or experiences.

Below you will find some resources related to dental care for people with autism and related disabilities.

American Academy of Developmental Medicine and Dentistry

American Academy of Developmental Medicine and Dentistry

National Institute of Dental and Craniofacial Research

Practical Oral Care for People With Autism

Just wanted to add that if autism parenting is made an Olympic event, it should be classified as a million mile marathon because it requires stamina and a lot of perseverance to keep working toward the finish line.

For many of our 'kids' the parenting never really stops. They move on to adulthood and we proceed with guardianship and a new set of challenges.

I used to work in a psychiatric hospital on a floor for those who have autism.

I once had to take one of my patients to the dentist.

Thankfully I was accompanied by 2 safety officers and the young man's parents. He was 20 and his mother didn't take him since he was a child because it was always almost impossible for her to manage. He also refused to brush his teeth, so that rarely got done. He had to get every single tooth pulled.

I really commend parents that do this day in and day out. It's not easy.

Specializes in Geriatrics, Dialysis.

My nephew is classified as "high functioning" and I suppose he is. He is not next to impossible in public situations, his outbursts tend to be at home thankfully. Also thankfully he rarely becomes physical toward people and when he does it's been limited to grabbing, not striking/hitting/biting. He tends to throw things when he's upset.

The most obvious external behavior is his very foul language, the kid drops f bombs anywhere and everywhere. At 17 I am pretty sure most people that don't know him chalk this up to poor parenting and that is fine with me as I don't give a rodent's donkey what perfect strangers think of us.

Our biggest issue is dealing with the school. Unfortunately he hates it with a capital h and it has become impossible to get him there. IEP's are a nightmare, especially as he doesn't act up as much in public so the school just doesn't seem to get why it's so difficult for him. He becomes physically ill to the point of vomiting at the prospect of school and as a result has already caused a fine for truancy to be issued last year. Way to be supportive school district!

At this point we are just trying to get him through until he is 18 [about 6 more months] so he can legally drop out without generating more and larger truancy fines. If anybody with experience with this has some pointers on dealing with a less than cooperative school district I am all ears!

When a few of you mentioned how hard it can be since our autistic kids look "normal" it adds an extra layer of challenge to situations. Thanks OP for the article.

Specializes in Pediatrics, developmental disabilities.

You have no idea how much this post helped me....Lauren has no cavities...regular visits, no sugary foods, daily brushing.... my efforts have paid off...

So sorry for the young man you took to the dentist:(

Specializes in Pediatrics, developmental disabilities.

I feel your pain!

Specializes in Pediatrics, developmental disabilities.

Your post speaks to how diverse folks on the spectrum can be in term of abilities ....but the challenges remain the same!

I got a message from a "friend" who is a teacher tell me that, even though my son was diagnosed by a team of experts using DAYC and ADOS and a pediatric psychologist it doesn't matter because it wasn't a neurologist it doesn't count. Also that 3 is too young for an actual diagnosis and that *she* doesn't think he is autistic which is rich considering she hasn't seen him since before his first birthday.

Way to be supportive. :banghead:

Specializes in Complex pedi to LTC/SA & now a manager.
I got a message from a "friend" who is a teacher tell me that, even though my son was diagnosed by a team of experts using DAYC and ADOS and a pediatric psychologist it doesn't matter because it wasn't a neurologist it doesn't count. Also that 3 is too young for an actual diagnosis and that *she* doesn't think he is autistic which is rich considering she hasn't seen him since before his first birthday.

Way to be supportive. :banghead:

"she" is wrong. Message me if you need help. My son was not diagnosed until age 7 so we had w crap ton of roadblocks

Specializes in Pediatrics, developmental disabilities.

Ummmm not sure what to say! But I do know that 3 is not too young for diagosis!

I got a message from a "friend" who is a teacher tell me that, even though my son was diagnosed by a team of experts using DAYC and ADOS and a pediatric psychologist it doesn't matter because it wasn't a neurologist it doesn't count. Also that 3 is too young for an actual diagnosis and that *she* doesn't think he is autistic which is rich considering she hasn't seen him since before his first birthday.

Way to be supportive. :banghead:

Also feel free to message me. This is absolutely not true. It doesn't matter what she thinks. A neurologist does not have to give the diagnosis. In fact, in some institutions, it is not neurology who diagnoses autism.

In my state, you can carry the educational label of autism, but not have a medical diagnosis of autism.

My nephew is classified as "high functioning" and I suppose he is. He is not next to impossible in public situations, his outbursts tend to be at home thankfully. Also thankfully he rarely becomes physical toward people and when he does it's been limited to grabbing, not striking/hitting/biting. He tends to throw things when he's upset.

The most obvious external behavior is his very foul language, the kid drops f bombs anywhere and everywhere. At 17 I am pretty sure most people that don't know him chalk this up to poor parenting and that is fine with me as I don't give a rodent's donkey what perfect strangers think of us.

Our biggest issue is dealing with the school. Unfortunately he hates it with a capital h and it has become impossible to get him there. IEP's are a nightmare, especially as he doesn't act up as much in public so the school just doesn't seem to get why it's so difficult for him. He becomes physically ill to the point of vomiting at the prospect of school and as a result has already caused a fine for truancy to be issued last year. Way to be supportive school district!

At this point we are just trying to get him through until he is 18 [about 6 more months] so he can legally drop out without generating more and larger truancy fines. If anybody with experience with this has some pointers on dealing with a less than cooperative school district I am all ears!

When a few of you mentioned how hard it can be since our autistic kids look "normal" it adds an extra layer of challenge to situations. Thanks OP for the article.

Is there an ability to home school through a computer program? Many states have them, and they are no cost programs. (connections academy is one I can think of off the top of my head)

Another thought process is a vocational school, as opposed to a "traditional" high school.

If there is a truancy officer, now would be the time to discuss diagnosis. The obligation is on the school to provide the education--and take it to the superintendent if you have to.

It really is so hard--sounds much like my son. We are not quite at the vomiting stage YET, but he is almost 13...and really dislikes school. Loves the routine, but sensory overload with kids that he doesn't "get" who don't "get" him.

Specializes in Geriatrics, Dialysis.
Is there an ability to home school through a computer program? Many states have them, and they are no cost programs. (connections academy is one I can think of off the top of my head)

Another thought process is a vocational school, as opposed to a "traditional" high school.

If there is a truancy officer, now would be the time to discuss diagnosis. The obligation is on the school to provide the education--and take it to the superintendent if you have to.

It really is so hard--sounds much like my son. We are not quite at the vomiting stage YET, but he is almost 13...and really dislikes school. Loves the routine, but sensory overload with kids that he doesn't "get" who don't "get" him.

Been there , done that as far as checking into home schooling. Crazy thing is he has missed so much that according to the school district he doesn't qualify. The compromise was to finish last year as a "homebound student" which is geared toward kids with a long-term illness that keeps them out of class. The school is very, very reluctant to allow him to start this year under the same program. At this point they are insisting on his physical presence in school and we know that isn't going to work out well.

Our next step is gettting yet another letter from his therapist clarifying the very real anxiety issues he has related to school and hope that they decide the hombound program can continue this school year. If not we have pretty much decided that if the school won't bend on this we'll just suck it up and pay any fines he accrues until his 18th birthday.

To say that we are disappointed and angry at the lack of support in getting my nephew the best education he is able to get is a huge understatement.

Sorry to hear you have similar school issues with your son and I sure hope it gets better [or at least doesn't get worse]. And you really hit the nail on the head on why the dislike for school is there. My nephews level of functioning is high enough for him to appear "normal" in most things but his academic level is so far below the other kids in the classes they insist on mainstreaming him into that it is just too frustrating for him. He also just can't tolerate that level of constant activity in a bigger class.