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document
Addressing dental fear in children with autism spectrum disorders : a randomized controlled pilot study using electronic screen media . BACKGROUND Dental care is a significant unmet health care need for children with autism spectrum disorders ( ASD ) . Many children with ASD do not receive dental care because of fear associated with dental procedures ; oftentimes they require general anesthesia for regular dental procedures , placing them at risk of associated complications . Many children with ASD have a strong preference for visual stimuli , particularly electronic screen media . The use of visual teaching materials is a fundamental principle in designing educational programs for children with ASD . PURPOSE To determine if an innovative strategy using 2 types of electronic screen media was feasible and beneficial in reducing fear and uncooperative behaviors in children with ASD undergoing dental visits . METHODS We conducted a randomized controlled trial at Boston Children 's Hospital dental clinic . Eighty ( 80 ) children aged 7 to 17 years with a known diagnosis of ASD and history of dental fear were enrolled in the study . Each child completed 2 preventive dental visits that were scheduled 6 months apart ( visit 1 and visit 2 ) . After visit 1 , subjects were randomly assigned to 1 of 4 groups : ( 1 ) group A , control ( usual care ) ; ( 2 ) group B , treatment ( video peer modeling that involved watching a DVD recording of a typically developing child undergoing a dental visit ) ; ( 3 ) group C , treatment ( video goggles that involved watching a favorite movie during the dental visit using sunglass-style video eyewear ) ; and ( 4 ) group D , treatment ( video peer modeling plus video goggles ) . Subjects who refused or were unable to wear the goggles watched the movie using a handheld portable DVD player . During both visits , the subject 's level of anxiety and behavior were measured using the Venham Anxiety and Behavior Scales . Analyses of variance and Fisher 's exact tests compared baseline characteristics across groups . Using intention to treat approach , repeated measures analyses were employed to test whether the outcomes differed significantly : ( 1 ) between visits 1 and 2 within each group and ( 2 ) between each intervention group and the control group over time ( an interaction ) . RESULTS Between visits 1 and 2 , mean anxiety and behavior scores decreased significantly by 0.8 points ( P = .03 ) for subjects within groups C and D. Significant changes were not observed within groups A and B . Mean anxiety and behavior scores did not differ significantly between groups over time , although group A versus C pairwise comparisons showed a trend toward significance ( P = .06 ) . CONCLUSION These findings suggest that certain electronic screen media technologies may be useful tools for reducing fear and uncooperative behaviors among children with ASD undergoing dental visits . Further studies are needed to assess the efficacy of these strategies using larger sample sizes . Findings from future studies could be relevant for nondental providers who care for children with ASD in other medical settings .
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Intervention_Other
electronic screen media
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Intervention_Other
electronic screen media
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Intervention_Control
control ( usual care )
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Intervention_Physical
treatment (
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Intervention_Other
video peer modeling that involved watching a DVD recording of a typically developing child undergoing a dental visit
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Intervention_Physical
) ;
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Intervention_Other
video goggles that involved watching a favorite movie during the dental visit using sunglass-style video eyewear
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Intervention_Physical
(
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Intervention_Other
video peer modeling plus video goggles
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Intervention_Physical
)
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Outcome_Mental
mean anxiety and behavior scores
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Outcome_Mental
Mean anxiety and behavior scores
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Outcome_Mental
reducing fear and uncooperative behaviors
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Participant_Condition
dental fear in children with autism spectrum disorders :
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Participant_Condition
autism spectrum disorders ( ASD )
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Participant_Age
children
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Participant_Condition
ASD
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Participant_Condition
ASD
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Participant_Condition
ASD
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Participant_Sample-size
Eighty ( 80 )
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Participant_Age
aged 7 to 17 years
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Participant_Condition
ASD
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Participant_Condition
ASD