Online environmental scan and content analysis of social stories about needle procedures.

Needle procedures are often difficult for autistic children. Preparatory education is an evidence-based strategy that is especially important for autistic children given they commonly struggle with unpredictability. Carol Gray developed Social Stories to walk autistic children through new/challenging situations step-by-step. Although needle-related Social Stories exist online, no research has investigated whether their content aligns with best practices for needle pain and fear management and Gray's guidelines for Social Story development.

Objective: This study aimed to characterize the content of online Social Stories about vaccination and venipuncture. Specifically, the degree to which Social Stories (a) depict evidence-based/helpful and unhelpful coping strategies, (b) follow Gray's guidelines, and (c) depict accurate procedural steps, was examined in an exploratory manner.

Methods: An online environmental scan (systematic method of collecting and synthesizing information) characterized the content of Social Stories. A Google search was conducted, including free, English-language stories. After screening, two coders conducted deductive content analysis (>80 codes) with the sample of 82 eligible Social Stories; frequency statistics and quotes were derived.

Results: Most Social Stories focused on vaccination (89%). Social Stories commonly conveyed evidence-based strategies (e.g., 70% depicted distraction), accurate procedural information (e.g., >80% depicted step of needle insertion), and followed Gray's guidelines (e.g., 90% had meaningful titles). Several areas for improvement exist, including allowing for user customization and depicting less commonly shown evidence-based strategies like topical anesthetics.

Conclusion: Social Stories may have utility for supporting autistic children and their caregivers through needle procedures. Examining effectiveness/outcomes of usage is a future research avenue.