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Preparing Your Child For a Blood Draw


If your child on the autism spectrum needs to have a blood draw due to an upcoming medical procedure or for testing, both you and your child may be anxious about it. In preparing for the blood draw procedure, consider whether your child will respond best if he or she knows what will happen, or if your child will do better without expecting the needle prick. The information below may help ease the concerns of both you and your child.

Before the Blood Draw:

  • If your child likes to know what will happen, talk about what to expect, use pictures, and practice. If it is better for your child not to know, just work on the next step (relaxation practice), and don't talk about a blood draw.
  • Help your child practice relaxing and being calm long before the blood draw. Use visual cues (like pictures or hand signals) to start the techniques. Reward your child for practicing! Examples of relaxation techniques are:
    • Deep breathing (pinwheels and bubbles are great helps)
    • Muscle tensing/relaxing
    • Visualization
    • Favorite toys/activities
    • Music and laughter
  • Don't talk much about the pain or discomfort. Focus on what to do instead.
  • Talk to the medical staff before you go.
    • Schedule the appointment at a good time of day for your child.
    • Ask to have someone there who has experience with special needs (such as ASD).
    • Ask that your child be taken straight back without waiting.
  • Bring comfort items and communication tools with you. Bring things with you to use as rewards.

During the Blood Draw:

  • Tell the medical staff how best to get your child to comply with what needs to be done.
  • Stay calm yourself at all times, even if you are worried or angry.
  • Begin to distract your child before the blood draw begins. Use the calming and relaxing techniques you practiced. Give your child items for distraction and comfort before the blood draw procedure begins.
  • If your child asks, don't lie about the "sting" or "pinch," but don't focus on it.
  • Use simple language to explain what is happening.
  • Avoid long conversations about fears or worries, but tell your child that it is okay to feel that way.
  • Refer to the medical staff as helpers.
  • Set priorities with the medical staff for the most important things to get done during the visit. If less important things are not done, that's okay.
  • Give your child choices along the way, like which chair, what color band aid, which treat to get afterwards, etc. This helps your child feel like he or she has some control.
  • Tell your child he or she is doing a great job, and be specific about every little thing he or she does that is helpful (sitting in the chair, holding his or her arm out, holding still, looking at Mom, listening to the "helpers," etc.).

Tools to Help Prepare Your Child for a New Experience

Many of the tools that you may use to help your child in the community, for example visual schedules, Social Stories™, and "First/Then" boards, can be used to help your child at a blood draw.

  • Your child may be very familiar with using a visual schedule at home or school. A visual schedule can also help with a blood draw. Visual schedules can be a checklist going down the page, a sequence of pictures going across the page, or a series of pictures in a binder. Call the facility which will be doing the blood draw to get specific information to include and/or ask if you can visit them ahead of time to take photos to include in your visual schedule.
    • Make a checklist or chart of what will happen, in order, using pictures or drawings.
    • Think of the steps to get the job done. For example: Driving to the hospital, riding in the elevator, checking in, getting weighed, sitting in the chair, holding my arm out, feeling a little pinch, Mom saying "Good Job," the nurse putting on a Band-Aid™, getting a reward or treat, going home. Put a picture or drawing on the schedule for each step.
    • Be sure to put pictures of "wait," "play," "reward," or "break," as well as things that have to be done.
    • Mark each step or take it off the schedule when it is finished.
  • Social Stories™ describe an event or situation with the intent of explaining the circumstances, perspectives, and expected behaviors that occur during the event or situation. They can be particularly helpful when preparing for an out of the ordinary situation, such as a blood draw. To be effective, the social story you create should be highly individualized and written in the first-person, from the point of view of your child. You can use pictures or drawings to help your child visualize the experience. Make sure to be specific about what will happen, what your child needs to do, and what will happen (rewards) when your child has done what is asked. (See the ideas under visual schedule, above.) Once created, the story can be read or viewed over and over again to make the process familiar to your child.
  • A First/Then board visually reinforces for a child that if he or she does an unpreferred task, such as a blood draw, he or she will get a reward. Use pictures and simple words to help your child understand that "First," he or she needs to do this thing (give a little bit of blood), "Then," he or she can have or do the thing he or she really wants. You can break the task down into small steps that each have a reward, such as "First: sit in the chair," "Then: cookie/hug/iPad," by changing the pictures on the board for each step.



(Put a picture or drawing of the thing that needs to be done here) (Put a picture or drawing of an immediate reward your chld can get or do when finished with the "First" task.)

Additional Resources:

The Center for Autism Research and The Children's Hospital of Philadelphia do not endorse or recommend any specific person or organization or form of treatment. The information included within the CAR Autism Roadmap™ and CAR Resource Directory™ should not be considered medical advice and should serve only as a guide to resources publicly and privately available. Choosing a treatment, course of action, and/or a resource is a personal decision, which should take into account each individual's and family's particular circumstances.