Natasha is a 14 year-old girl, diagnosed with severe autism who has speech consisting of single words and set phrases. She is able to communicate basic needs through words and symbols. Natasha has a close relationship with her mother who suffers from migraine headaches. Natasha has developed a pattern of telling carers, ‘I have a headache’, whenever she is unwell. The receptionist reports that the residential school where Natasha lives has made an appointment for her to be examined. You know that the school is often short-staffed and it may not be Natasha’s keyworker who accompanies her.

Strategies

• Ask the receptionist to call the school and ask Natasha’s keyworker to provide a written summary of: exactly what her symptoms have been and how long these have been evident; details of any checks they have made, (e.g. temperature, diet, toileting patterns, change in behaviour).
• During the appointment, communicate with Natasha using single words, short sentences and visual information, wherever possible (e.g. drawings).
• Explain in advance all procedures you are going to carry out with Natasha.
• Use gesture before starting your examination so that Natasha is prepared for any physical contact.