Table 1

 Selected studies/case reports summarised by study characteristics, methods and outcomes

First author (year)Participants
CountryStudy design/assessment typeOutcomes and recommendations for perioperative interventions
Thompson (2014)8432–16USAABABetter communication of individual needs enhances staff comfort, parent satisfaction and patient experience
Christiansen (2005)91 (case report)13AustraliaCase reportEmphasise parental involvement, review of anaesthesia techniques with focus on ‘combative’ and ‘uncooperative’ child
Seid (1997)102 (case reports)USABest practices/case report(1) Parent/caregiver to be used as expert/consultant on child's idiosyncrasies; (2) pre-teaching adjusted to cognitive capacity of patient; (3) separation from carer minimised; (4) disruption of patient's routine minimised; (5) distractors/treasured objects used to decrease anxiety
Lindberg (2012)1112 ParentsSweden, FinlandCase report—parent report of child's induction in the presence and absence of dialogueContinuity in the perioperative dialogue with parents, increased familiarity with staff (photo of nurse). Eloquent illustration of historical tone of attributing despair to procedure-related child/parent anxiety vs suffering caused by care
Ambardekar (2013)12USACase report of incorporating service animal in perioperative care of 12 year old with ASDExtension of family-centred care to include service dogs makes experience less stressful for patients/families. Author proposed ‘induction room’ so that the dog would not compromise the sterility of the surgical procedure
van der Walt (2001)1359 Patients, 87 procedures26 months–17 yearsAustraliaReview/audit of 59 patients with ASD in a total of 87 procedures requiring anaesthesiaAdvanced notification, involvement of parents in planning periprocedural elements and from induction to early in the recovery phase were all emphasised. Flexible admission (decreased waiting time) and quiet room
Souders (2002)14623–8USABest practices review of nursing care for participants in study of secretin effects on 62 children with ASD by Levy et al and Coplan et al (2001)Focused preparation with family before hospital. Children with high-functioning ASD: modelling, choices, distraction and conversation and token systems. Children with mild–moderate ASD: imitation, shaping, choices and distraction. Children with severe ASD: combination of high-probability requests/low-probability requests, distraction with singing, counting and holding
Scarpinato (2010)159 CasesUSAClinical case studies and literature reviewComprehensive initial assessment informing strategies for intervention at Children's Hospital of Philadelphia. Focused preplanning with family and individualisation. Instructive neurosurgical case
Nelson (2009)16USAPerioperative guidelinesReview of key strategies for perioperative nursing care, organised by phase
Davignon (2014)1720 Mothers
20 Providers
Semistructured interviewsAdvanced preparation and communication with families informing individualised modifications in patient flow and clinical environment improve care
Vlassakova (2016)18ReviewFamiliarity with patient's specific behavioural characteristics and efforts to alleviate stress are keys to smooth perioperative course
  • ASD, autism spectrum disorder.