This cohort observation, randomized controlled trial is intended to provide data that icons and non-verbal communication improve communication and cooperation with children with Autism/communication delay and aid in the transition to an unfamiliar environment. It would lay the foundation for future studies and practices of using icons and pictures for the whole office visit to enhance communication between the patient and physician/nurse/medical staff and cooperation of the patient.

1. Use icons during triage/check in process to decrease time and increase patient compliance. Compare typical children to those with Autism/communication delay.
2. Use icons during blood draw to improve communication with patients, to help with patient understanding, and increase patient cooperation and decrease noise and length of procedure.

Inclusion Criteria:

• established patients with a documented diagnosis
• 4-18 years old
• present to the NeuroDevelopmental Center during the study period
• Lab study: given prescription for lab work that will be following the visit or the next day in the Locust outpatient lab

Exclusion Criteria:

• <4 years old or >18 years old
• new patient
• diagnosis not documented
• Lab study: lab work will be drawn at another lab or more than 1 day later

Children who are established patients, 4-18 years old, and present to the NeuroDevelopmental Science Center for a follow-up office visit during the study period, since a diagnosis will be available at the time of the study (patients in the lab study may be new patients if they have a diagnosis at the time their lab work is prescribed). The NeuroDevelopmental Science Center at Akron Children's Hospital provides nearly 25,000 visits annually to children and youth affected by neurological, developmental, and behavioral disorders. This includes children with autism, intellectual disabilities, physical disabilities, learning disabilities, epilepsy and other neurological conditions.