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A Pilot Study to Improve Venipuncture Compliance in Children and Adolescents with Autism Spectrum Disorders

Davit, Caroline J. BS*; Hundley, Rachel J. PhD; Bacic, Janine D. MS; Hanson, Ellen M. PhD

Journal of Developmental & Behavioral Pediatrics: September 2011 - Volume 32 - Issue 7 - p 521-525
doi: 10.1097/DBP.0b013e3182245b09
Original Article

Objective: Medical procedures, particularly venipuncture (the puncture of a vein especially for the withdrawal of blood), can cause serious distress and behavior disturbance for many children. Noncompliance to blood draws can have significant ramifications in both research and clinical settings. The negative reactions may be exacerbated in individuals with autism spectrum disorders. Even so, there has been little research into the prevalence of the problem or effective intervention procedures. In response to these concerns, we developed and evaluated the Blood Draw Intervention Program. The program was designed to be easy to use, require little provider or family time, effectively reduce negative behaviors, and increase blood draw compliance.

Method: In a quasi-randomized trial over the course of ∼18 months, 58 of 210 families with children with autism spectrum disorders participating in a larger study of phenotypic and genotypic factors reported significant concerns about blood draws and elected to use the Blood Draw Intervention Program.

Results: Completion of the program increased blood draw compliance rates from 85.4% to 96.6% (odds ratio = 4.80; 95% confidence interval = 1.12, 20.59; p = .03).

Conclusion: Results indicate the efficacy of the program in a research setting and suggest a potential clinical application. The current intervention, unlike many others for the same or similar difficulties proposed in the past, was successful without requiring extensive time, training, or effort on the part of providers and parents or their children, nor did it require large-scale institutional changes.

From the *Neurodevelopmental Disorders Phenotyping Program, Divisions of Developmental Medicine and Genetics, Children's Hospital Boston, Boston, MA; †Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN; ‡Children's Hospital Boston, Boston, MA; §Program in Genomics, Children's Hospital Boston and Harvard Medical School, Boston, MA.

Received January 2011; accepted March 2011.

This research was supported by grants from the Simons Foundation and the Autism Consortium and a grant (77233-01) from the National Institute of Health.

Disclosure: The authors declare no conflict of interest.

Address for reprints: Ellen Hanson, PhD, Neurodevelopmental Disorders Phenotyping Program, Divisions of Developmental Medicine and Genetics, Program in Genomics, Children's Hospital Boston, Harvard Medical School, 1 Autumn Street, Boston, MA 02115; e-mail:

Presented at the International Meeting for Autism Research in May 2009 at Chicago, IL, and the Society for Developmental Behavioral Pediatrics October 2009 annual conference at Portland, OR.

© 2011 Lippincott Williams & Wilkins, Inc.