Feature
UNSPOKEN RULES
Strategies for treating patients with verbal challenges due to autism or developmental delays
W
NEED TO KNOW:
f Several pediatric conditions,
including certain intellectual or developmental delays and some forms of autism, may present both mobility and communication challenges.
f To prepare for patients who may
be nonverbal or minimally verbal, O&P clinicians should undergo training and work with experts— such as child life specialists or applied behavior analysis therapists—and garner tips and ideas to tailor care appropriately.
f Experts urge clinicians to
“presume competence” when treating nonverbal patients, and avoid making assumptions
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O&P Almanac April 2024
about a person’s understanding based on their disability or communication style.
f Prepare patients for the evaluation, fitting, and delivery phases of the O&P treatment process via videos or step-by-step visual guides.
f Collaborate, when warranted,
for optimal patient care—partner with facility staff members, other healthcare providers, or family members and caregivers to ensure appointments go smoothly.
hen language is a challenge, how do orthotists and prosthetists ensure they treat patients appropriately? Many children who have autism spectrum disorder (ASD) or intellectual or developmental disabilities may also present with mobility challenges that necessitate O&P intervention—and some of these patients may be nonverbal or minimally verbal. Several pediatric conditions, including ASD, may present both mobility and Shannon O’Shea, CPO communication challenges, according to Shannon O’Shea, CPO, an area clinic manager for Hanger Clinic in Kansas City, and national clinical specialist in pediatrics for Hanger’s Clinical and Scientific Affairs team. Knowing how to approach patients with autism or developmental delays is challenging because every patient is unique. “Like all aspects of autism, the spectrum of mobility is diverse, and mobility challenges will vary from person to person and over time,” explains Allie Tasche, vice president, national programs, at the Autism Society of America. “Muscle, sensory, and neurological differences impact a wide range of mobility challenges and associated needs—from coordination and balance, including toe-walking and other differences