HELP get my son to health appointments

[robobot]

I have a 13 year old with diagnosis of ASD/ADHD/ARFID/Anxiety.
This year he has refused to go to the dentist, opticians, doctors and to have any vaccinations.
These are all things he has done routinely every year and I’m not sure what has changed to make him anxious/refuse to go (maybe his age/hormones). But I really need some advice on how to support him to attend. He is becoming very agitated and verbally and physically aggressive or hiding/bolting if we try to force the issue. Have tried motivating rewards which has not worked.
Really grateful for any advice.
Thanks

Is DS receiving support for his anxiety?

Can DS communicate what makes appointments stressful? Would things like having the first appointment of the day, not waiting in the waiting room, having a photograph of who he is seeing help?

For dental, optician, vaccinations and GP appointments, would home visits be easier? Home visits are even possible for some other medical appointments, such as CAMHS, dietician, or physio.

For vaccinations, would using numbing cream or spray help?

For hospital appointments that can’t be home or telephone/virtual appointments, have you spoken to the hospital's learning disability liaison nurse? They support autistic patients even if they don’t have a learning disability.

Thanks. There is some really helpful advice there. He is able to communicate verbally but can’t express what he is afraid of re: attending appointments. Will definitely try some photos and contacting local learning disability team.

I have wondered about home visits but in the past when we’ve had a visitor that he hasn’t wanted to see he refuses to leave his room.

I have also thought maybe to take him to the opticians or dentist or GP buildings but without seeing anyone but I can’t get him to do that.

He has a lot of support in school for anxiety but won’t engage with any other support outside of school.

I may see if school would facilitate an appointment but that might upset how he sees school as a safe space.

So hard.

Does DS have an EHCP? If so, you could look at pursuing further MH support (including therapies) in school. Maybe a therapy tapping into DS’s interests. Does he game? Also SALT to look at communication.

Is it possible to rationalise with DS? For some, explaining not having vaccinations could lead to needing even more intervention in the longer term. Similar for dental appointments. It wouldn’t work for all, though.

We aren’t in England but yes he has the equivalent of an EHCP. He’s a big gamer. I will speak to school when he goes back next week and see what they can do. He is already having a lot of MH support from them.

we’ve written out the pros and cons and even though he rationally really thinks the pros outweigh the cons it’s not enough to get him to these appointments.

If DS is a gamer, look at Mindjam. Depending on where you live, your version of the EHCP, may be able to fund it.