Procedural Support for Neurodivergent Children During Medical Procedures: A Scoping Review

Neurodivergent children face unique challenges during medical procedures due to distinct sensory processing patterns and communication difficulties. Evidence-based interventions for procedural pain/distress may inadequately address their specific needs, leading to undertreated distress and negative healthcare experiences.Following Joanna Briggs Institute methodology, we conducted comprehensive searches across six databases on January 10, 2025, for studies published 2014-2025 focusing on neurodivergent children (0-21 years) undergoing medical procedures. Two independent reviewers screened studies and extracted data, with results presented as a narrative synthesis with evidence mapping.From 14,393 initial records, 144 studies met the inclusion criteria. Most studies (n = 121, 84.0%) focused on autism spectrum disorder, with limited representation of other neurodivergent diagnoses. Hospital outpatient settings (n = 93, 64.6%) and dental specialty (n = 50, 34.7%) were most commonly studied. The most frequently used support strategies were visit preparation and support (n = 61, 42.4%), pharmacological agents (n = 48, 33.3%), and patient care plans/pathways (n = 43, 29.9%). Few studies used validated pain and distress assessment tools, with only 4.2% (n = 6) reporting child-reported pain measures. While 74.3% (n = 107) of studies reported distress outcomes, these were primarily observational rather than validated measures.Findings highlight significant gaps in procedural support strategies for neurodivergent children, particularly for conditions beyond autism. There is a critical need for research using validated pain and distress measures, especially those capturing the child's perspective. Future studies should prioritise diverse neurodivergent populations, incorporate structured assessment tools, and evaluate tailored interventions across wider clinical settings.