Orchid Pediatrics

Overview

Since 2021, pediatrician Joy Eberhardt, MD, FAAP (she/they) from Orchid Pediatrics has endeavored to create an office space that is welcoming and supportive for children who are neurodiverse. The evidence base surrounding provision of neurodiverse-friendly care, particularly for autistic individuals*, has been emerging in recent years and sheds light on a practical path forward for pediatricians who provide care for children who are neurodiverse.

Neurodiverse individuals may experience lower levels of healthcare satisfaction, and many healthcare spaces are not neurodiverse-friendly. For children, provision of a neurodiverse-friendly office space can reduce anxiety, overstimulation, and lead to a more satisfactory visit for the child and family/caregiver.

Recommendations

Recommendations for entities interested in implementing a similar model to improve the systems of care through the medical home lens:

• Critically evaluate the physical space where children receive healthcare services.
  • Children who are neurodiverse may have sensory needs that differ from non-neurodiverse children.
    • Example: Reduce overall stimulation (overhead lights, noisy doors, etc.) and provide toys/items to increase specific stimulation (washable crash pad, sensory corners with an enclosed space, textured wall hangings, etc.).
• Reduce burden on families.
  • Families do a lot to support their children and need help to manage limited time and energy.
    • Example: Assume a parent and child are trying their best (practice curiosity; consider the double-empathy problem when communicating with autistic individuals) and use technology to ease communication (provide recommendations in written form and offer virtual patient portals for scheduling and communication).

Additional opportunities to Create a Neurodiverse-friendly Clinic Space

• Offer a virtual office tour.
  • The virtual office tour allows families and children to experience coming into the office and seeing how it is set up.
  • By allowing children and their families to visualize the clinic, it can help reduce anxiety and increase engagement by children during their visit.
• Engage in continuous quality improvement to meet the needs of children who are neurodiverse and ensure the clinic space is inclusive of all children seen by the practice.
  • Ask children and families to provide feedback to keep the space family-centric and neurodiverse affirming.