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NCT Number: NCT07356895

Effect of Social Stories on Anesthesia Compliance in Children With Autism

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.

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Key information

Conditions

Autism Spectrum Disorder Child Development Disorders, Pervasive Mental Disorders Neurodevelopmental Disorders Social Stories

Age range

3 year–18 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Social Stories Group

Behavioral

The Social Stories Technique is a non-pharmacological behavioral intervention designed to prepare children with Autism Spectrum Disorder for anesthesia. Social Stories materials will be provided to families and will be read to the child by caregivers once daily for 7-14 days prior to surgery. The effect of the intervention on reducing preoperative anxiety and on cooperation during anesthesia induction-specifically compliance with intravenous cannulation and/or face mask application-will be evaluated.

Routine Preoperative Preparation Group

Behavioral

Routine preoperative care consists of standard verbal information provided to caregivers regarding the anesthesia and surgical process during the preoperative anesthesia consultation. No Social Stories materials or additional behavioral preparation interventions will be used. Preoperative anxiety and cooperation during anesthesia induction, including compliance with intravenous cannulation and/or face mask application, will be evaluated.

Primary outcomes

  1. Anesthesia Induction Compliance

    Time frame: During anesthesia induction on the day of surgery.

    Behavioral cooperation during anesthesia induction in children with Autism Spectrum Disorder will be assessed by compliance with face mask application and/or intravenous cannulation using the Induction Compliance Checklist (ICC).

Secondary outcomes

  1. Preoperative Anxiety Level

    Time frame: Preoperative period on the day of surgery.

    Preoperative anxiety will be assessed using the Modified Yale Preoperative Anxiety Scale (mYPAS).

    The mYPAS is a validated observational scale evaluating preoperative anxiety across five behavioral domains (activity, vocalization, emotional expressivity, interaction with parents, and movement).

    Total scores range from 0 to 100, with higher scores indicating greater levels of preoperative anxiety.

    Clinically significant anxiety is generally considered at mYPAS scores ≥30-40.

  2. Postoperative Agitation / Emergence Delirium

    Time frame: Immediate postoperative period in the post-anesthesia care unit.

    Postoperative agitation and emergence delirium will be assessed using the Pediatric Anesthesia Emergence Delirium (PAED) Scale.

    The PAED scale consists of five items scored from 0 to 4, yielding a total score ranging from 0 to 20.

    Higher PAED scores indicate more severe emergence delirium, and a total score of ≥10 is generally accepted as clinically significant emergence delirium.

  3. Parental Satisfaction

    Time frame: On the day of surgery.

    Parental satisfaction with the perioperative process will be assessed using a 5-point Likert-type satisfaction scale, ranging from 1 (not satisfied at all) to 5 (very satisfied).

    Higher scores indicate greater parental satisfaction.

Study contacts

Contact information is provided by the study sponsor or research team.

Aslı Dönmez

CONTACT

[email protected]

00905322256473

Elif Şule Özdemir Sezgi

CONTACT

[email protected]

00905059209638

Sponsors and collaborators

Lead sponsor

Diskapi Yildirim Beyazit Education and Research Hospital

Other Gov

Registry information

Official study title

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

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jan 21, 2026
Registry last updated
Feb 2, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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