Effect of Social Stories on Anesthesia Compliance in Children With Autism

The Effect of the Social Stories Technique on Anesthesia Compliance in Children With Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) frequently experience heightened anxiety and reduced cooperation during the perioperative period, which can complicate anesthesia induction and negatively affect procedural safety and efficiency. Non-pharmacological behavioral preparation methods that enhance predictability and understanding of medical procedures may improve anesthesia-related cooperation in this vulnerable population. The Social Stories Technique is a structured, visual-based behavioral intervention designed to support children with ASD by explaining upcoming experiences in a clear and developmentally appropriate manner.

This prospective controlled study aims to evaluate the effect of the Social Stories Technique on anesthesia compliance and preoperative anxiety in children with Autism Spectrum Disorder undergoing elective surgery. Children in the intervention group will receive Social Stories materials to be reviewed with their families prior to surgery, while the control group will receive standard preoperative information only. Primary and secondary outcomes will include anesthesia induction compliance, preoperative anxiety levels. The findings of this study are expected to contribute evidence regarding the effectiveness of a low-risk, non-pharmacological behavioral intervention to improve perioperative care in children with ASD.

Inclusion Criteria:

• Children diagnosed with Autism Spectrum Disorder
• Patients scheduled for elective surgical procedures
• Children aged 3 to 18 years
• American Society of Anesthesiologists (ASA) physical status class I-II
• Written informed consent obtained from a parent or legal guardian
• Caregivers willing and able to read the Social Stories materials at home as instructed
• Caregivers able to understand the Social Stories materials prepared in the Turkish language

Exclusion Criteria:

• Children with ASA physical status class III or higher systemic disease
• Patients requiring emergency surgery
• Children with severe intellectual disability or significant visual or hearing impairment
• History of severe behavioral problems during previous general anesthesia
• Families unable or unwilling to comply with the Social Stories intervention during the study period
• Inability to obtain written informed consent from a parent or legal guardian
• Children receiving pharmacological treatment for a comorbid psychiatric disorder