1. It is advisable to minimize waiting time, so seeing the patient early or late in day is preferable. This would likely also likely minimize contact with others in the waiting room that could result in anxiety. Restlessness can be managed by allowing a walk or the use of a Walkman or other auditory distracter.

2. Once in the exam room, autistic individuals will be more comfortable when they feel in control of their environment and do not feel pressured to relate. Toward this end try to keep interpersonal interactions to a minimum, use a calm voice that is not overly engaging, as well as not imposing direct eye contact if they appear to want to avoid interactions. Physical contact itself may be aversive to the patient, so try to keep this to a minimum.

3. In view of the fact that patient likely has significant difficulties in both receptive and expressive language, any discussion whether in gathering history or explaining procedures should be in simple language. The use of pictures or the use of inanimate objects may be a preferred means of communcation in trying to explain something to the individual. A discussion with the caregiver to clarify the most effective mode of communication prior to the visit or before you actually engage with the patient can both be enlightening and helpful.

4. In gathering history, when performing your examination or explaining your treatment use simple and concrete language. Explaining what you are going to do each step along the way will give them time to ready themselves. You should keep in mind that although they may not be talking to you or look interested in what you are saying does not mean they are not hearing and reacting to what is being said to them or around them. Their appearing aloof or distracted can be a protective mechanism.

5. Autistic individuals tend to be hypersensitive in one or more sensory modalities. Therefore try to limit any loud noises, bright lights, or excessive tactile stimulation. What might be a calm reassuring touch to a non-autistic individual can feel threatening to an autistic individual.

6. In order to alleviate some of the stress that is inherent in the appointment it may be necessary to allow the patient to bring puzzles, magazines, story books, or even inanimate objects into the examining room which they can use throughout the appointment to self sooth in what is at least an unfamiliar, and even possibly aversive setting for them.

7. If the patient becomes agitated, direct intervention may lead to further escalation of the individual’s maladaptive behaviors. Consequently it is advisable to allow the patient to deescalate on his or her own or via intervention(s) by the caregiver before one continues with the examination.