PERIOPERATIVE PSYCHOSOCIAL INTERVENTIONS FOR AUTISTIC-CHILDREN UNDERGOING ENT SURGERY

Tonsillectomy/adenoidectomy is one of the most frequently performed op erations in the United States. It is therefore likely that pediatric E NT surgeons will encounter autistic and developmentally delayed childr en in routine practice. Autistic children differ from normal children in that they exhibit severe deficits in language and social functionin g; abnormal reaction to stimuli such as light, sound, touch, and pain; attachments to particular unusual objects and rigidly stereotyped rou tines. They are often mentally retarded. With the increasing importanc e of managed care and continuous quality improvement, knowledge of how to manage the operative course of such children is crucial for the pr actising surgeon. Based on research and clinical knowledge of these ch ildren, certain psychosocial and medical interventions are presented w hich may improve the operative course of this population. Using the pa rent as a consultant; decreasing separation from familiar caretakers, objects, and routines; pre-operative role-playing; tailoring anestheti c induction; and using post-operative distracters are suggested techni ques. (C) 1997 Elsevier Science Ireland Ltd.