Hospital Desensitisation Guidelines

Creating a desensitization plan for someone with learning disabilities to prepare them for a hospital visit involves breaking the experience down into manageable steps, using gradual exposure, and providing plenty of support throughout.

By gradually introducing the hospital environment and addressing concerns, you help the child/young person become more comfortable with the experience. Patience, clear communication, and positive reinforcement are key throughout the process.

Here’s a sample plan to help with this process:

Introduction and Building Trust	• Giving simple and clear information about the hospital visit in a way that the child/young person can understand (e.g., using visuals, stories, or social stories). • Encourage questions and address any concerns the child/young person may have and provide comfort and reassurance. • Speak about any specific fears the child/young person might have (e.g., needles, loud noises, unfamiliar people) and make note of these.
Familiarization with the Hospital Environment	• Show photos or videos of the hospital, including key places the child/young person may visit (e.g., the waiting room, exam room, etc.). • Visit the hospital before the actual appointment if possible. Walk through the entrance, waiting areas, and other non-threatening spaces. Introduce the child/young person to friendly staff or volunteers who can help make the place feel more welcoming. • Use a social story to explain the hospital visit. This helps the child/young person understand what will happen step-by-step and reduces anxiety by creating familiarity.
Gradual Exposure to Similar Experiences	• If possible, start with low-stress medical activities like a visit to a GP or a routine check-up, could start with observing another individual. This helps the child/young person get used to medical settings. • Engage in role-playing games where you take turns being the doctor or nurse. Use toys, props, or even real medical equipment (e.g., a thermometer) to simulate what might happen during the visit. • If the child/young person is worried about specific equipment (e.g., blood pressure cuffs or thermometers), show them these items before the actual visit. Let them touch and get used to seeing and hearing the equipment in a relaxed setting.
Practice Coping Strategies	• Teach calming methods such as deep breathing, listening to calming music, or squeezing a stress ball. Practice these techniques regularly. – Brain in Hand App has useful strategies. • Reward each step of the process (e.g., after watching a video, or completing a role play) with positive reinforcement, such as praise or a small treat. •  Let the child/young person bring a comfort item to the hospital (e.g., a favourite blanket, stuffed animal, toy, sensory toys). This will provide the child/young person with security during the visit.
Simulation of the Actual Visit	•  Before the hospital, try visiting a place that is also unfamiliar but less intimidating (e.g., a doctor’s office or a dentist’s office). • Work through the entire hospital visit experience: getting dressed, leaving the house, entering the hospital, waiting in the waiting room, going to the doctor’s office, and going home. Use a visual schedule for clarity. Reward each step of the process with positive reinforcement, such as praise or a small treat.
On the Day of the Appointment	• Provide a clear visual schedule of the visit, showing the steps and any breaks or rewards afterward. This will help the child/young person understand what to expect and feel in control. • Remain calm during the actual visit. It’s important for the child/young person to see that you are confident and relaxed. •  If the child/young person is sensitive to loud noises or bright lights, bring earphones/ear defenders or sunglasses to help mitigate the discomfort. Consider a sensory-friendly approach to the environment, if possible. Some departments have access to VR devices. • Request a less stimulating environment such as quiet waiting area or side room. First or last or last appointments of the day will be quieter.
Post-Visit Reinforcement	• After the hospital visit, provide praise and reward the child/young person bravery. Reflect on the positive aspects of the visit to reinforce that it wasn’t as bad as expected. • Talk about what went well and what can be improved for next time. Gradually incorporate any feedback into future visits.
Ongoing Support	• Regular Desensitization: If further hospital visits are needed, repeat the desensitization process, gradually increasing the complexity of the visits. • Incorporate Routine: Try to incorporate these visits into a regular routine, especially if frequent hospital appointments are expected. Routine builds familiarity and decreases anxiety.

Example:

Step	Activity
Visit Hospital	Visit the hospital for a non-medical purpose (e.g, walk around the main entrance or visit a non-medical area).
Medical Role Play	Meet a nurse or doctor (without any procedures).
Watch Videos	Engage in role-play with medical toys (e.g, using a stethoscope on a teddy bear).
Watch Videos	Show videos about going to the doctor or hospital
Simulate an appointment	Act out full appointment (e.g sitting in the waiting room, checking in, etc.).
Real Medical Appointment	Attend an actual appointment with support.

Adapted by: CFHD Specialist Children’s Learning Disability Service.

Reference:

• PAV Publications – “Successful Health Screening Through Desensitisation for People with Learning Disabilities.”
• The Challenging Behaviour Foundation – “Supporting People with Learning Disabilities in Healthcare Settings.”
• Royal College of Nursing – “Supporting People with Learning Disabilities in Hospital Settings.”
• NHS England – “Reasonable Adjustments for People with Learning Disabilities.”
• SCIE – “Supporting People with Learning Disabilities Through Healthcare Services.”
• The Autism Education Trust – “Preparing for Healthcare Visits
• Sheffield-Children39s-Learning-Disability-and-Autism-Strategy-2024-2029
• Nursing Times- Children’s fear in hospital can be eased with small actions even at bust times- 06/10/2022