Effect of Social Stories on Anesthesia Compliance in Children With Autism

Diskapi Yildirim Beyazit Training and Research Hospital

Status: Enrolling

Conditions: Autism Spectrum Disorder; Social Stories

Treatments: Behavioral: Routine Preoperative Preparation Group; Behavioral: Social Stories Group

Study type: Interventional

Funder types: Other

Identifiers

NCT07356895

AEŞH-EK-2025-311

Details and patient eligibility

About

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.

Enrollment: 40 estimated patients

Sex: All

Ages: 3 to 18 years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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40 participants in 2 patient groups

Social Stories Group

Active Comparator group

Description:

Participants in this arm will receive the Social Stories Technique as a behavioral preoperative preparation intervention. Following informed consent, families will be provided with age- and developmentally appropriate Social Stories materials describing the anesthesia and surgical process using simple language and visual supports. Parents will be instructed to review the Social Stories with their child once daily.

Treatment:

Behavioral: Social Stories Group

Routine Preoperative Preparation Group

Active Comparator group

Description:

Participants in this arm will receive standard preoperative information as routinely provided in clinical practice. This includes verbal explanation of the anesthesia and surgical process given to the child's caregivers during the preoperative anesthesia consultation. No Social Stories materials or additional behavioral preparation tools will be provided.

Treatment:

Behavioral: Routine Preoperative Preparation Group