A little work and preparation can go a long way for practices dealing with neurodivergent children and their caregivers, says Ms Faioa Wolterman.
There is a growing awareness and acknowledgment of invisible disabilities, especially within neurodivergent communities. Neurodivergent children often navigate highly stimulating environments that can exceed their capacity to self-regulate, leading to meltdowns or shutdowns. These are important signals that support is needed.
Optometry practices are in a unique position to positively impact the lives of these children and their families. A visit to the optometrist is more than just an eye check; it’s a chance to build rapport, trust, and to offer a calm, supportive experience from the moment the appointment is booked through to aftercare services.
Understanding invisible disabilities
Neurodivergence includes a range of neurotypes such as Autism, ADHD, Sensory Processing Disorder, and PDA (pathological demand avoidance), among others. Often, individuals have more than one diagnosis.
Each child presents differently, and their needs, triggers, and coping mechanisms vary widely.
The saying, “If you’ve met one Autistic person, you’ve met one Autistic person” reinforces the importance of personalised care. By learning a bit more about each child, optometrists and optical dispensers can build meaningful relationships that support both the child and their family.
The impact of a poor experience
In a busy practice with short consultations, a neurodivergent child may not have the time or space needed to feel comfortable. This could lead to incomplete assessments or the need for unplanned repeat visits, which adds to the family’s stress.
A meltdown during or after the appointment can be distressing for the child and their caregivers, potentially leading to avoidance of further vision care.
The consequences of delaying or avoiding care can be serious: conditions like myopia, hyperopia, astigmatism, amblyopia (lazy eye), and strabismus (eye turn) may go undetected and untreated.
These issues can impact the child’s learning and development and may even cause long-term damage if not addressed early.
How optometry practices can be more inclusive
A proactive, inclusive approach can make a significant difference.
One useful concept is Spoon Theory, which uses “spoons” to represent the daily energy available to manage tasks.
A neurodivergent child might already use most of their spoons navigating a typical school day and home routine.
Attending an unfamiliar and possibly overstimulating appointment could exceed their capacity, leading to distress.
By understanding and planning for this, optometry staff can help prevent overload. Start by gathering helpful information before the appointment, either via a form or phone conversation such as:
• What are your child’s special interests?
• Have they had negative healthcare experiences in the past?
• What are their sensory sensitivities and what strategies work?
• Do they benefit from movement breaks or specific seating aids?
• How does your child communicate best?
This information allows the optometrist to modify the appointment to the child’s needs.
For instance, a “look-see” visit can help the child become familiar with the environment. Social stories, visual schedules, or personal items like headphones, fidget toys, or blankets can also help regulate sensory input.
Sometimes it may be appropriate to split the consultation over two visits: one focused on relationship building and one for clinical testing.
Practical adjustments that make a big difference
Some simple but effective strategies can enhance the experience for neurodivergent children:
• Use clear, literal language: “Say what you’re going to do, then do it.”
• Speak in a calm, even tone and keep instructions brief and specific.
• Provide a quiet space with sensory supports like a beanbag or tent where the child can decompress.
• Allow for flexibility: if a child becomes distressed, let the parent take them to the car and complete payment there using a wireless EFTPOS terminal.
These small adjustments help the child feel more secure and can reduce the likelihood of post-visit meltdowns. More importantly, they signal to families that their unique needs are respected and understood.
Building long-term trust
Creating a safe, welcoming space doesn’t just benefit the child during the appointment, it can have a ripple effect on their overall wellbeing.
When a family feels seen and supported, they are more likely to return and to recommend your services to others.
In turn, your practice not only helps improve access to essential vision care but also supports the emotional wellbeing of families navigating the complexities of invisible disabilities.
About the author: Faioa Wolterman is a senior optical dispenser and staff trainer at Bullseye Optometry and Sensory Clinic in Western Australia. She specialises in complex visual needs, including paediatric dispensing and support for patients with neurological and sensory sensitivities. She draws from her lived experience of having three neurodivergent teenager and pre-teens (13, 12 and 12) with differing complex needs.
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