Making needle procedures comfortable for autistic children: Caregiver perspectives

Background: Autistic children are at greater risk for having difficulty undergoing needle procedures and poor management of their needle pain and fear. While there are general clinical practice guidelines (CPGs) available for managing pediatric needle pain and fear, it is unclear whether these strategies are appropriate for autistic children and their caregivers. Method: The objective of this study was to explore caregiver perspectives on what is needed for needle procedures to be comfortable and CPGs to be appropriate for them and their autistic child. Twenty Canadian caregivers of autistic children were interviewed, including open-ended questions and ratings of how helpful CPG strategies would be for autistic children. Results: Using reflexive thematic analysis, four themes were identified: 1) autistic children's sense of autonomy is important; 2) external factors impact autistic children's comfort (e.g., environment, familiarity, healthcare providers); 3) caregivers play a key role by preparing themselves and others before needle procedures and 4) it is essential to tailor CPG strategies to children's needs. Conclusions: Findings indicate that a child and family-centered approach is imperative to making needle procedures comfortable for autistic children. Practical recommendations for healthcare providers and caregivers are provided.