Patience comes in waves. As an adult with Autism, my patience varies. The bribery idea is actually a great one for children...but consistency is key...have one toy in particular that he only gets to play with when he is patient but he needs to know that if he starts to throw fits while he is holding that toy, it gets taken away until he can be patient again. This concept of being unrewarded for negative behavior is what you want to teach your child not rewards for good behavior. New toys and treats make it harder to teach this concept to someone with autism. The key is understanding the difference between a fit and a melt down. Melt downs come from fear/anxiety/and deep inside the autistic person and have nothing to do with patience, fits come from being a kid. Melt downs need more than bribes, they need patience and love to get through them. Patience teaches patience. If you can be patient when he is having a melt down and not panic, it will eventually rub off on him. Let him have his melt down and move through it no matter what people around in the store think. It is important that after the melt down happens, and the child is calm that you explain to them the situation in a logical manner and give them comfort. If people try to intervene or make snide comments, calmly explain to them that your child has Autism and that you understand what needs to be done to help him through his melt down. Ignore the snide comments, cause they are just ignorant people who will never understand.

Perhaps in a situation like that instead of telling him that appointment time is x, you could present it as the time you have to be at the doctors office (or wherever) so that you can start waiting for your turn. It might help manage the expectations better.

My aspie is very blunt and therefore sounds rude. I have tried and tried to explain being polite. All I can say is just keep telling him. But as for the nurse at the office I would have pulled her aside and reminded her that he is the patient and has autism and that she needs to be more professional. I am a nurse and would never treat a pt that way.

Temple Grandin had a great suggestion or insight to the Austistic way of think. A DVD about her thinking in pictures book and maybe some others. The selling it on the National Autism Resources. Keep in mind I very bad a parapharsing she said it so much better.

She said her brain was like two file folders---very rigid---right or wrong and nothing in between. You can agrue all day long and still it is one or the other. To make less rigid thinking---Create another file for them like rude. Demonstrate them things that go in the file. When they display rude Behaviour Label it RUDE don't go on and on. It take awhile to show all the possible looks of rude. But the more you put in the file--- the more they can anaylse what is rude.

This has helped my High function PDD daugther almost 7. We were at a BDay party when she was yelling loudly that she didn't want that Cake(wheat and sugarfree) she wanted normal cake.
I said it's Ok you don't have to eat it--- It rude to say you don't want it. Normally she would continue still we had to leave. (Note my 4-year old we did have to remove to Calm down) But that time my 7yr old accepted it. We had been labeling RUDE for 6 months. It doesn't always have that drastic results but I will take any improvement :)

Picture schedule would work with most things but the doctor's office. Since they are NEVER on time it makes it that much harder. You could try to talk with him about how his appointment is set for the one time but won't be seen by the doctor for another 45 minutes. Perhaps have that in the schedule?? (show appt time and seen by the doctor time)