Treatment of fear of medical procedures in children with intellectual disabilities and autism

Abstract

The prevalence of phobias among people with autism spectrum disorder (ASD) is estimated to be as high as 40%. Fear of medical procedures is higher for this population when compared to neurotypical populations, therefore it is necessary to find interventions to help eliminate fears within this population. In this research, an intervention was designed for four participants who feared medical procedures and examinations. The participants were students with ASD and intellectual disabilities between 9 and 13 years old in a school for children with various disabilities in Iceland. Three participants feared getting their temperature measured with a tympanic thermometer, and one feared getting their blood drawn for blood tests. The intervention used differential reinforcement of alternative behaviour (DRA) and shaping without extinction as well as an enhanced choice model to eliminate the students' fears. Negative reinforcement was used to help students go through the steps of a desensitization hierarchy. After the intervention, all four students' fears were reduced, while two out of four students could get their temperature measured without any fear by multiple people and in various locations. The results showed that the intervention used can reduce or eliminate the fear of medical procedures and examinations in children with intellectual disabilities and autism.