4. Visual or data-based communication and resources are helpful… VERY helpful.

People with ASD often rely on visuals and data for learning and processing information.  This includes processing sexuality education and the various procedures that take place on an OB/GYN’s office.  Provide your patient with brochures, links, and other resources you may have in your fingertips of the procedure or exam your patient would be coming in for.  Do this during their initial introduction visit, prior to the first scheduled office visit.

When discussing birth control options with your patient, provide brochures and descriptions with precise drawings, photos, diagrams and comparison charts for your patient to take home and process to make their decision making easier.  For instance, with pap tests, you can present material that falls something along the lines of this example or this example.

Here are a few other examples to help you get a better idea of what you can present to your patient:

Birth Control Tool (contains a customizable comparison table) | Association of Reproductive Health Professionals

STD Brochures – The Facts (contains downloadible PDF files) | Centers for Disease Control

Pelvic ultrasounds | Web MD (see page 3 of that article for drawing diagrams of the various ultrasound procedures)

5. Maintaining a professional persona will ensure less anxiety. Keep your personal emotions to yourself.

Over the years, I have visited several OB/GYN offices… most which were not pleasant, but still well-handled.  But one particular visit with an OB/GYN turned out to be an especially distressing experience.  This particular doctor (and the clinic) broke a number of accommodation rules.  Her tone of voice lacked a sense of calm, and she raised her voice when expressing surprise or disagreement.  She interrupted me several times during our consultation. Her facial expressions were hauntingly dramatic.  And the worse part of that experience is when she pulled out the ‘God Card’ – stating that “you cannot trust a man (even when you’re in a solid committed relationship) to go out and cheat on you and possibly give you an STD… but once you’re legally married, a condom is no longer necessary and it’s up to him and God.”

Oh, really?  And a partner is not as likely to cheat when you’re married as when you’re not married?  Bullshit.  (I wish I had responded all that to my doctor had I processed my thoughts fast enough.)

Obviously, I have no plans to return to that particular clinic.  One’s personal views and religious beliefs are to be fully respected.  But it is beyond inappropriate to bring that into any professional relationship, including a doctor’s office visit.

So please keep in mind…

• Facial expressions can still be defined (happiness, concern, etc.) but try not to be too dramatic in your facial expressions.  The complexity of dynamic facial expressions often distracts a person with ASD, and may prove intimidating to your patient.

• Be aware of your tone of voice. People with ASD respond best with a tone of voice which is calm, professional, and not overly fluctuating.

• Take caution on using humor or “small talk” with your patient,  as this often will bring more discomfort and escalate their anxiety level. When in doubt, it’s best to avoid it altogether.

• If a patient shares information which brings you concern (i.e. your patient is sexually active and does not use protection, your patient has experienced sexual trauma, or you patient is not following all the steps for efficient prenatal care), handle it professionally.  It is perfectly appropriate to address your concerns and safety recommendations based on facts (i.e. unprotected sex increases the risk of contracting STDs, STIs and unwanted pregnancy).  But avoid imposing these concerns based on your personal beliefs.

Keep your personal emotions to yourself, and the interaction between you and your patient will flow more smoothly.

6. Treat your patient with ASD like you would your other patients. Treat fairly.

For additional insight on this topic, I highly recommend checking these out:

Sex & the Spectrum: Autism and Gynaecological Health by Nominatissima

Interactive site for clinicians serving women with disabilities (contains a recorded slideshow program:“Reproductive Health for Women with Disabilities”,  which focuses on both physical and developmental)

Gynecologic Care of Women with Developmental Disabilities and Other Special Needs

Fellow self-advocates:  please feel free to share thoughts in the comments on
what you would like OB/GYNs to know about caring for patients on the autism spectrum.

Image credits: The Doctr, Jeffrey Beall, Vagabond Shutterbug, Raychel Mendez, Ann64