Phone calls are hard: other routes and a call card

Phone calls can be hard for autistic adults, and some adults with ADHD describe the same. There are other routes than calling. People describe an email, an online form or a text, a few lines written down for the calls that cannot be avoided, and a call card filled in beforehand. In an online survey, autistic adults generally preferred email when contacting unfamiliar people or organisations ^[1]. This page covers other routes, why calls can feel so hard, lines to say, and a call card.

What can you do instead of calling?

You can ask a service for another way to make contact. People describe a few:

Email or an online form. For contacting services and unknown organisations, autistic adults in the survey generally preferred email ^[1][2].
Booking by text, or emailing ahead. In a survey of 507 autistic adults, 41% chose booking a GP appointment by text, and 62% chose emailing the doctor in advance with a description of the issue ^[3].
Asking how you would like to be contacted. A UK health trust page lists several things staff can do, among them asking how a person wants to be contacted, sending a list of likely questions beforehand, and sending a written follow-up after a call ^[5]. You can ask a service for any of these.
Someone who helps. In the online survey, many people had a person who helped with contact with others ^[2]. Asking that person to make the call, or to sit nearby during it, is one way to use that help.
A video call. An ADHD guidance page from ADDitude suggests switching to video chat when the other person is comfortable with that ^[8]. Some people find video harder than voice, so it is one option among several.

Why can phone calls feel so hard?

In the same online survey, people described calls as fast, with fewer cues, often unexpected, and linked with officials and institutions ^[2]. Writing, they said, gives time to think, a structure to follow and a record to come back to ^[2]. Some put off getting in touch, and some were so worried it would go wrong that they did not try ^[2].

Avoiding the phone is not only an autistic experience. In a 2022 survey of 507 autistic and 157 non-autistic adults, 78% of the autistic group and 38% of the non-autistic group said they generally avoid the telephone where possible ^[3]. Separately, difficulty using the telephone to book an appointment was a reason to avoid or delay a GP visit for 62% of the autistic group and 16% of the other group ^[3].

ADHD can bring something similar. In one US interview study of 18 adults with ADHD, a person described the effort of getting ready to call and then waiting on hold. People in that study said ADHD symptoms often made steps of seeking help, including scheduling an appointment, hard to manage ^[4].

What can you say during a call?

A few short lines can be said at any point, and each one leaves a little room to think. You can change any of them to sound like you.

To open the call:

"Hello, my name is ___. I'm calling about ___."

If you lose your place, or a question comes that you did not plan for:

"Could I have a moment to think?"

If the information arrives faster than you can hold it:

"Could you say that again more slowly?"

When a detail matters, you can check it back, as ADDitude describes ^[8]:

"I want to make sure I got this right. Is it ___?"

When the call includes details, dates or instructions:

"Could you send that to me by email or text?"

If you would rather use writing for the whole thing, you can say so at the start:

"Is there an email address or an online form I can use instead?"

And at the end of any call where something was decided:

"Let me repeat what we agreed: ___."

What can a call card look like?

A call card is a few lines written before the call and kept where you can see them. ADDitude describes the same idea: jotting down what you want to say and useful phrasing, then ticking off each point as it is covered ^[8].

Why I am calling: ___
The one thing I need from this call: ___
What they may ask me (name, date of birth, a reference number, dates that suit me): ___
My questions: 1. ___ 2. ___
Notes during the call: ___

The notes line is there because writing key points down makes a call easier to recall afterwards ^[8]. One filled-in line is already a card. It can be as short as you like.

What can make a call easier to take?

These ideas come from ADDitude's guidance for adults with ADHD ^[8]. Others may find them useful too.

A quiet place for the call, with earphones if they help. Or asking the other person to move somewhere quieter.
Some people use a calming habit of their own before the call, which leaves more attention for the conversation.
Notes taken during the call, or right after it.

Your phone can take some pressure off as well. On an iPhone, two features are described by Apple:

Live Speech (iOS 17 or later) speaks typed text aloud, including on phone calls ^[6]. The steps are in When you can't find the words.
Declining with a text, or Type to Reply. An incoming call can be declined with a text message, either a default reply or a custom one, edited in Settings > Apps > Phone > Respond with Text. With Type to Reply, the iPhone speaks your typed message to the caller, and the caller's answer shows on your screen as text ^[7].

Menu names change between iOS versions.

About this article

The ideas come from surveys and interviews with autistic adults and adults with ADHD ^[1][2][3][4], a UK health trust page ^[5], and guidance pages from ADDitude and Apple ^[6][7][8]. The Apple steps are for iPhone and were read from the support pages.
The lines to say and the call card are Mindum's own wording. The figures and reasons from the 2021 survey come from the authors' public presentation ^[2] and the published abstract ^[1].
Avoiding calls can have many explanations. If calls get in the way of appointments or of contact you need, a clinician who knows neurodevelopmental conditions can look at that with you.

Sources

Howard PL, Sedgewick F. 'Anything but the phone!': Communication mode preferences in the autism community. Autism. 2021;25(8):2265-2278. doi:10.1177/13623613211014995
Howard PL, Sedgewick F. Communication Mode Preferences in the Autism Community. Presentation slides, Bristol Conversations in Education, University of Bristol, 2020. PDF
Doherty M, Neilson S, O'Sullivan J, Carravallah L, Johnson M, Cullen W, Shaw SCK. Barriers to healthcare and self-reported adverse outcomes for autistic adults: a cross-sectional study. BMJ Open. 2022;12(2):e056904. doi:10.1136/bmjopen-2021-056904
Sgro G, Coit M, Sullivan BD, Valentine M, Chavez S, Tran A. Barriers to Attention-Deficit/Hyperactivity Disorder Diagnosis in Adults: Findings from a Qualitative Study. Final report. Mathematica, for ASPE, US Department of Health and Human Services. 10 January 2025. aspe.hhs.gov
Oxford Health NHS Foundation Trust. Reasonable adjustments and autism: phone calls. Leaflet page, last reviewed 20 December 2024. oxfordhealth.nhs.uk
Apple Support. Use Live Speech on iPhone. support.apple.com/en-us/105018
Apple Support. Answer or decline incoming calls on iPhone. iPhone User Guide. support.apple.com
Tuckman A. ADD and Phone Anxiety. ADDitude, updated 28 July 2025. additudemag.com/add-phone-anxiety

By Mindum. An app to track and regulate emotions, energy, and focus.