Before applying a splint to an 8-year-old child with autism who has a lower leg fracture, which approach best respects the child’s needs?

• A. Ask her father to hold her down while you and your partner apply the splint.
• B. Ask her father to distract her by turning the lights off and on while you apply the splint.
• C. Tell her splint will immobilize her leg so she doesn't feel any more pain.
• D. Tell her the splint will be tight to keep her from moving.

Answer: (D)

When working with a child who has autism, giving a simple, honest explanation about what will happen helps her predict and cope with the procedure. Saying the splint will be tight to keep her from moving provides a straightforward reason for immobilization and describes the actual sensation she will feel. It helps reduce anxiety by linking the tightness to a clear purpose—preventing movement to protect the injured leg—so she understands why the splint is necessary.

This approach respects her need for predictability and autonomy, and it avoids implying hidden motives or overstating pain relief. Other options either rely on force, which can be traumatic; use distraction without addressing the immobilization, which may be ineffective for some sensory profiles; or make promises about pain that aren’t accurate or helpful for her understanding.