Jeremy, M Budd
| Jeremy, M Budd |
Jeremy M Budd, Elizabeth Friedman, Jaime Guberman, Hilary Wong, Tiffany Park
Maria Velasco
Division of Pediatric Dentistry, Preventative and Restorative Sciences, University of Pennsylvania School of Dental Medicine
Introduction
Oral health is integral to overall health, yet children with autism spectrum disorder (ASD) often struggle to access dental care due to anxiety and avoidance of sensory-stimulating experiences. Consequently, children with ASD are often treated with general anesthesia (GA) for dental procedures at higher rates compared to neurotypical peers. GA procedures have higher risks of complications and require complex coordination of care in a hospital setting relative to typical procedures done in the outpatient setting. Techniques such as desensitization, visual aids, and distraction have proven to improve the dental experience of children with ASD and may be useful in decreasing need for GA.
Methods
Two tools were developed and implemented as behavioral interventions for patients with ASD: a video and social story. A social story is an educational tool designed to facilitate the exchange of information among parents, professionals, and people with ASD. The behavior modeling video and social story were created to demonstrate the process of a dental visit to patients. In the video, a pediatric dental resident showed the steps of an initial visit and process of taking dental radiographs. Parents were instructed to show their child either the video, or video and social story. Following the visit, parents were given a survey rating their impression of the utility of the tool in mitigating adverse experiences relative to past dental visits. Patients whose parents did not show them the video or social story were used as controls. Statistical analyses following completing of data collection will determine whether the interventions significantly decreased negative ASD-related experiences in the dental setting.
Results
Data collection began on February 1, 2022 and will continue through October 30th, 2022. Prior data collected at the University of Pennsylvania School of Dental Medicine showed a significant increase in the ability of ASD patients to have dental radiographs taken after being shown behavior modeling videos compared to prior visits. Additionally, most parents reported that the behavior modeling videos were helpful and positively changed their child’s behavior at the dental office compared to previous visits. Parents also reported that the behavior modeling video reduced their child’s anxiety.
Conclusion
Given preliminary data from previous pediatric dental residents, a multimodal approach to behavior management of children with ASD should be further explored.