Bridging health care and behavioral science for neurodivergent children

Bridging health care and behavioral science for neurodivergent children | Image Credit: © Studio Romantic - stock.adobe.com.

Dear Editor,

As both a pediatric phlebotomist and registered behavior technician, I witness daily how health care and behavioral therapy intersect—yet rarely collaborate. For neurodivergent children, this gap has real consequences.

Every pediatrician has experienced it: the child who freezes at the sight of a needle, the parent apologizing while restraining their distressed child, the appointment running overtime. For children with autism, ADHD, or sensory sensitivities, a routine blood draw or vaccination can become genuinely overwhelming. Yet most health care providers receive minimal training in behavioral strategies that could transform these encounters.

The result? Mounting medical anxiety, cancelled appointments, and children developing fear-based associations with health care that persist into adulthood. Research shows that untreated needle phobia affects up to 25% of adults—often rooted in childhood medical experiences. We can prevent this.

Applied Behavior Analysis offers practical, evidence-based tools that integrate seamlessly into medical care. Task analysis breaks procedures into manageable steps. Positive reinforcement pairs cooperation with meaningful acknowledgment. Visual supports reduce uncertainty. Most importantly, offering choice and assent—even in small ways—gives children agency in their care. A child who learns "not yet" is still progressing and has learned self-advocacy.

These aren't therapy techniques requiring certification—they're trauma-informed approaches any provider can implement. Through my work developing behavioral protocols for medical settings, I've seen how a 5-minute preparation using a visual storyboard can replace a 45-minute struggle. I've watched children who couldn't even walk into a room, do so when they knew they were going to feel the tourniquet, or read a storyboard—meeting them where they are instead of demanding compliance.

When health care and ABA collaborate, everyone benefits. Providers gain practical strategies that reduce appointment stress. Parents receive tools that extend beyond the clinic. ABA professionals ensure behavior plans align with medical needs. Most importantly, children transform from "difficult patients" into confident partners in their own care.

This collaboration is why I founded PokePals—to provide medical teams and families with trauma-informed preparation tools that make procedures calmer and kinder. But the larger opportunity extends far beyond any single program. If we integrate behavioral insight into standard medical training, we don't just improve individual appointments—we reshape how an entire generation experiences health care.

The path forward requires pediatricians, behavioral specialists, and families working together. When we do, anxious appointments become growth opportunities, and medical visits become experiences children can navigate with confidence rather than fear.

Sincerely,

Franchesca Kelly