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Procedural Support for Neurodivergent Children During Medical Procedures: A Scoping Review
Mari Takashima1,2,3,4, Harriet Robertson5, Karin Plummer6
1School of Nursing, Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia. m.takashima@uq.edu.au.
Insights
Medical procedures pose challenges for neurodivergent children. Current support strategies often fall short, highlighting a need for better, child-centered pain and distress interventions for diverse neurodevelopmental conditions.
Area of Science:
- Pediatric Healthcare
- Neurodevelopmental Disorders
- Medical Procedure Support
Background:
- Neurodivergent children experience unique challenges during medical procedures due to sensory and communication differences.
- Existing interventions for procedural pain and distress may not adequately meet the specific needs of neurodivergent youth.
- This can lead to undertreated distress and negative healthcare experiences for this population.
Purpose of the Study:
- To systematically review and map evidence-based interventions for procedural pain and distress in neurodivergent children (0-21 years).
- To identify gaps in current research regarding support strategies and assessment tools for this population.
- To inform the development of more effective and tailored interventions.
Main Methods:
- A comprehensive literature search was conducted across six databases (January 2025) for studies published between 2014-2025.
- Joanna Briggs Institute methodology guided the systematic review process.
- Two independent reviewers screened 14,393 initial records, extracting data for narrative synthesis and evidence mapping.
Main Results:
- 144 studies met inclusion criteria; 84% focused on autism spectrum disorder, with limited data on other neurodivergent conditions.
- Commonly studied settings were hospital outpatient (64.6%) and dental (34.7%).
- Top interventions included visit preparation (42.4%), pharmacological agents (33.3%), and care plans (29.9%).
- Few studies utilized validated pain/distress measures, especially child-reported outcomes (4.2%).
Conclusions:
- Significant gaps exist in procedural support strategies for neurodivergent children, particularly beyond autism spectrum disorder.
- There is a critical need for research employing validated pain and distress measures, prioritizing the child's perspective.
- Future research should focus on diverse neurodivergent populations, structured assessments, and tailored interventions across various clinical settings.
Abstract:
Neurodivergent children face unique challenges during medical procedures due to distinct sensory processing patterns and communication difficulties. Evidence-based interventions for procedural pain/distress may inadequately address their specific needs, leading to undertreated distress and negative healthcare experiences.Following Joanna Briggs Institute methodology, we conducted comprehensive searches across six databases on January 10, 2025, for studies published 2014-2025 focusing on neurodivergent children (0-21 years) undergoing medical procedures. Two independent reviewers screened studies and extracted data, with results presented as a narrative synthesis with evidence mapping.From 14,393 initial records, 144 studies met the inclusion criteria. Most studies (n = 121, 84.0%) focused on autism spectrum disorder, with limited representation of other neurodivergent diagnoses. Hospital outpatient settings (n = 93, 64.6%) and dental specialty (n = 50, 34.7%) were most commonly studied. The most frequently used support strategies were visit preparation and support (n = 61, 42.4%), pharmacological agents (n = 48, 33.3%), and patient care plans/pathways (n = 43, 29.9%). Few studies used validated pain and distress assessment tools, with only 4.2% (n = 6) reporting child-reported pain measures. While 74.3% (n = 107) of studies reported distress outcomes, these were primarily observational rather than validated measures.Findings highlight significant gaps in procedural support strategies for neurodivergent children, particularly for conditions beyond autism. There is a critical need for research using validated pain and distress measures, especially those capturing the child's perspective. Future studies should prioritise diverse neurodivergent populations, incorporate structured assessment tools, and evaluate tailored interventions across wider clinical settings.
