如何带自闭症孩子去抽血

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A Parent’s Guide To Blood Draws for Children withAutism

如何应对抽血——给自闭症儿童家长的建议

INTRODUCTION TO AUTISM SPECTRUM DISORDERS

自闭症谱系障碍的介绍

The purpose of this pamphlet is to present ways for you and your childto cope with the stress and worry that may come with blood draws. It providesstrategies to make these appointments go more smoothly. Although completingblood draws with children with ASD is the main focus, the information andtechniques presented here also apply to other aspects of a clinic visit.

本文旨在为您与孩子提供建议，以缓解孩子抽血时的压力与困扰。此文提供的策略旨在使抽血过程更加顺利的。虽然完成对自闭症儿童的抽血是我们的主要目标，但我们将要介绍的信息与方法对于治疗过程的其他方面也会有所帮助。

These may be helpful for individuals of any age or with otherconditions. For more detail, examples, and printable tools, visitkc.vanderbilt.edu/asdbloodwork/

本文所述适用于任何年龄与多种情况。为了解更多细节，案例与可打印材料，请访问网站kc.vanderbilt.edu/asdbloodwork/

What Are Autism Spectrum Disorders (ASD)?

什么是自闭症

谱系障碍

（ASD）？

ASD are a group of developmental disabilities that affect the brain.They make communicating and interacting with other people difficult. BecauseASD affect people differently, they are referred to as “spectrum disorders.”They can range from mild to severe. Not everybody with ASD has the exact samesymptoms or the same skills. All people with ASD are likely to experiencechallenges in three main areas:

自闭症谱系障碍（ASD）是指一系列影响大脑的发展障碍，会严重影响患者与他人的沟通交流。由于个体ASD症状有所不同，ASD又被称作“谱系障碍”，严重程度不等。虽然患者症状与治疗方式有所区别，全体患者都可能面临三种障碍：

Communication. Individuals with ASD may have absent or limited speech.If they have speech, they may use it to recite or repeat words. They would havelimited ability to use words to convey their wants or needs and limited abilityto use them in conversation and social interaction.

沟通障碍。个体自闭症谱系障碍患者可能丧失全部或部分言语能力。即便患者具有言语能力，也可能只是背诵或是重复词语。他们在运用语言表达需求、进行交流与社交存在一定障碍。

社交障碍。自闭症谱系障碍患者往往存在严重的社交障碍。他们在理解诸如语调、面部表情等社交信号方面存在困难。在保持眼神交流上也会有障碍。

Play and Routines. Individuals with ASD are likely to engage inrepetitive behaviors. Routines are also important and may play a role in dailyactivities. Another characteristic of ASD is what some describe as “sensoryoverload.” For these individuals sounds seem louder, lights brighter, or smellsstronger.

玩耍与作息障碍。自闭症谱系障碍患者很可能会表现出重复的刻板行为。生活作息对自闭症患者十分重要，并深刻地影响其日常生活。自闭症的另一可能特征是感官超载。对于这类患者而言，他们会对声音、光线或是气味比常人更敏感。

TIPS TO HELP YOUR CHILD HAVE A SUCCESSFUL BLOOD DRAW

成功抽血的技巧

Before the Visit

抽血之前

• Discuss what will happen using words and pictures that your childcan understand.

运用文字与图案与孩子讨论即将进行的活动

• Try to avoid focusing on the most unpleasant/painful aspects beforethe visit if it will make your child more anxious.

如果抽血让孩子感到不安，则在行前尽量不去关注抽血中令人不愉快或是痛苦的方面。

• Talk with your child’s providers before the visit. Ask what they cando to make the blood draw go more smoothly, such as requesting a certain timeof the day, assuring no wait time, or scheduling with someone familiar withASD.

提前与为孩子抽血的工作人员沟通，询问为使抽血更加顺利的进行，他们能做些什么。例如申请特定时间段进行抽血，确保无等待时间，或专门与了解自闭症的工作人员预约。

• Plan to bring toys or visual supports that you use every day to helpyour child remain calm and happy.

携带玩具或日常使用的视觉辅助工具，使孩子保持平静与愉悦

During the Visit

就医期间

•Share your suggestions with medical staff.

将你的建议分享给医护人员。

保持镇定和安慰。控制好你的表达和情感将会帮助你的孩子也控制好他的情绪。

•Resist the “whitelie.”If your child asks, say it may hurt. It isbetter to prepare your child than to say it will not hurt if it could hurt. Youcould describe a needle for a blood draw as a “strongpinch.”

拒绝善意的谎言。如果你的孩子问，你就回答抽血会疼。因为在会疼的情况下，最好让你的孩子有所准备，而不是告诉他不会疼。你可以将抽血的针头描述为一个“大力的尖头”。

•Explain what is happening in simple, directlanguage.

用简单直白的语言描述正在发生的事情。

•Acknowledge feelings, but avoid longconversations and avoid using words like “scared”or“worried.”

承认抽血时难受的感觉，但避免进行长对话，避免使用“可怕”、“担忧”等词语。

•Help your child see medical staff as helpers.

帮助你的孩子将医护人员看作帮助者。

•Prioritize what you need to accomplish duringthe visit. Focus on what is most important to complete.

将你在就医期间需要完成的事情分好主次顺序。专注于最重要的事情。

•Whenpossible, provide choices to help your child feel more in control. For example,let your child pick where to sit, the color of a bandage, or a reward to followthe visit.

在可能的时候，提供更多的选择来帮助你的孩子获得更多掌控感。比如让你的孩子选择坐在哪里，绷带的颜色，或看完医生后的奖励。

•Praise your child’sability to complete the visit. Praise specific compliant behaviors.

表扬你的孩子完成这次看病的能力。要具体地表扬他哪些行为很听话。

RELAXATION AND DISTRACTION FOR CHILDREN WITH ASD

使患有孤独症谱系障碍孩子放松并转移注意力

Why Do Relaxation And Distraction Matter?

为什么放松和分散注意力很重要？

When children with ASD think about going to the doctor, many becomeworried about the visit. You can help by teaching your child simple relaxationtechniques.

很多患有孤独症谱系障碍的孩子一想到要去看医生，就会对这次见面感到很焦虑。你可以教给孩子简单的放松技巧，来帮助他们缓解焦虑。

Distraction may help by taking your child’smind off stressful events, thoughts, or emotions and putting attention onpositive thoughts or activities.

注意力转移可以通过让你的孩子暂时忘记紧张的事件、想法或情绪，并将注意力放在积极的想法或活动上。

Strategies For Relaxation And Distraction During Blood Draws

抽血时放松及转移注意力的策略

•Deep Breathing. Teach your child to take a deepbreath, hold the breath for a few seconds and then release it. For youngchildren, using a pinwheel or bubbles to practice can help them focus on theirbreathing and distract from their stress.

深呼吸。教你的孩子深吸一口气，憋住几秒钟，然后吐出来。对于年龄较小的孩子，用一个纸风车或泡泡来练习可以帮助他们将注意力集中于自己的呼吸，而无暇顾及紧张压力。

•Muscle Tensing/Relaxing. Have your child relaxby focusing on different muscles of the body and alternately tensing andrelaxing them one at a time.

肌肉收紧/放松。让你的孩子专注于身体不同的肌肉，每次对一块肌肉交替进行收缩与放松，以此使他放松。

•Visualization. Encourage your child to imaginesomething pleasant and to visualize that scene with eyes closed. Suggestthinking about smells, sounds, and touch of what is imagined. Using pictures orobjects to remind your child of favorite places or activities can help thisstrategy be more successful.

想像。鼓励你的孩子去想像一些愉快的事情，并闭上眼睛构想那个画面。建议去想想画面中的味道、声音和触感。用图片或物品帮助你的孩子想起最喜欢的地方或活动，可以更成功地实施这条策略。

•Favorite Toys/Activities. Involve your child indistracting activities before the procedure begins and, if possible, beforeyour child begins to become upset. Use a favorite toy, a particularly engagingtopic of conversation, or a game that does not require movement.

最喜欢的玩具/活动。在就医程序开始之前，并如果可能，在你的孩子变得不安之前，让他参与到转移注意力的活动中。用一个最喜欢的玩具，一个特别有吸引力的话题，或一个不需要运动的游戏。

•Music. Play your child’sfavorite music or sing a silly song.

音乐。播放你的孩子最喜欢的音乐，或唱一首简单快活的歌。

•Laughter. Find ways to make your child laugh.

笑。想办法让你的孩子笑。

Tipsfor Using Relaxation and Distraction

实行放松和干扰的建议

Parentsmay find that typical approaches to using relaxation are not always effectivefor children with ASD. Certain changes can be made in order to effectively usethese strategies with your child:

家长们可能认为一些让人放松的常规方法对孤独症儿童来说并不总是有效。此时在运用策略时应做出一些改变。

•Practice makes perfect. Try to teach relaxation strategiesat scheduled times in the day instead of when your child is already anxious.Reward your child immediately after practicing relaxation. This encouragescontinued practice and adds another positive connection with relaxation. Laterwhen you use these strategies because your child is worried, he or she willconnect it with something positive. Your child will trust that some- thing goodwill follow, just as it has during practice sessions.

熟能生巧。尝试每天在固定的时间教孩子放松策略，而不是在他焦虑时。在孩子练习完成后及时给予奖励，这能鼓励他继续练习并且使积极的因素与放松相联系。之后当你在孩子焦虑时运用这些策略的时候，他就能将其与积极的事物联系起来，孩子就会相信会有好的事情发生，就像训练时一样。

•Prevent instead of react. Try to use these strategies beforeyour child becomes worried, instead of only using them to calm your child downafter becoming upset. It is best to use these beforehand (for example, at homebefore going to the doctor’s office, in the car before going in to the office,in the waiting room) or when mild signs of anxiety are noticed.

预防而不是到发生时才想着应对。试着在孩子焦虑前运用这些策略，而不是在孩子沮丧时才使用它们来安慰孩子。最好提前使用（例如，在去诊所前在家里运用，在去诊所前在车里运用，在等候室运用）或者当出现焦虑前兆时运用。

•Use visual supports or concrete tools. It is important touse visual supports (for example, pictures) or other concrete cues whileputting relaxation strategies in place. Use them as a quick reminder to yourchild that it is time to use these strategies. This will be more helpful thantrying to explain through talking.

运用视觉辅助或具体的工具。在运用放松策略时，使用视觉辅助（例如，图片）或其他具体的线索非常重要。将它们作为及时的提醒物提醒孩子现在要运用这些策略了。这比

解释有用得多。

*If your child has lost consciousness during priorblood draws, check with your physician before using deep breathing or musclerelaxation.

如果孩子在抽血时失去意识，应该在深呼吸和肌肉放松前让医生来检查。

VISUALSUPPORTS FOR CHILDREN WITH ASD

孤独症儿童的视觉辅助

WhatAre Visual Supports?

什么是视觉辅助？

Avisual support refers to using a photograph, drawing, object, or list tocommunicate with a child who has difficulty understanding or using language.Visual supports can be especially helpful when your child has to participate inmedical procedures such as blood draws.

视觉辅助是指运用照片、绘画、物体或列表来和有理解和运用语言障碍的孩子交流。视觉辅助在孩子进行医学检查的过程例如抽血时非常有用。

Twokinds of visual supports that might help your child with ASD more successfullycomplete blood draws are First-Then Boards and visual schedules.

两种视觉辅助流程图和时间表能够帮助孤独症儿童完成抽血过程。

Whyare visual supports important?

视觉辅助为何重要？

Themain features of ASD involve challenges in interacting socially, in usinglanguage, and having limited interests or repetitive behaviors. Visual supportshelp in all three areas before, during, and after blood draws or other medicalprocedures.

孤独症的主要特点是社交和使用语言有障碍，以及缺乏兴趣和重复行为。在抽血或其他医疗过程中，视觉辅助在这三个方面都有帮助。

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对本文的特别申明:由于我们的医学专业知识和翻译水平有限，译文可能会有瑕疵，欢迎大家提出宝贵的意见和建议，以便帮助豆苗计划翻译小组更好地开展工作。

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