Correlates of oral health fatalism in caregivers of children with autism spectrum disorder

Abstract

Aims To study correlates of oral health fatalism (OHF) in caregivers of children with autism spectrum disorder (ASD). Methods and results This exploratory analysis used baseline data from 118 Medicaid‐eligible families of children with ASD in a multi‐site randomized clinical trial of a parent training intervention supporting home oral hygiene and dental visits. About half (46%) of caregivers agreed with the statement “most children eventually develop dental cavities,” endorsing OHF. Hispanic caregivers more strongly endorsed OHF than non‐Hispanics (cumulative odds ratio = 2.4, 95% confidence interval [CI]: 1.2‐4.7, P = .014). Caregivers living alone with children less strongly endorsed OHF than caregivers cohabitating with other adults (cumulative odds ratio = 0.39, 95% CI 0.17‐0.86, P = .019). Multivariable analysis maintained significance of ethnicity (P = .030) but not living situation (P = .052). Additional analyses included demographics, parenting beliefs, and children's oral hygiene and oral health status. Conclusion About half the caregivers endorsed OHF, with Hispanic caregivers more strongly endorsing OHF. OHF was not significantly associated with oral health behaviors or status, consistent with emerging literature suggesting fatalism is not necessarily linked to health behavior. Further exploration of OHF correlates in families of children with ASD is needed; ethnicity, living situation, child age, and caries status are of interest.

Barriers to Oral Health Care for Autistic Individuals—A Scoping Review

“…Parental perceptions were noted as a major concern in eight of the 16 papers in this scoping review [ 23 , 29 , 33 , 35 , 37 , 38 , 39 , 41 ]. Some parents and carers reported being overwhelmed and/or embarrassed regarding the behavior and lack of cooperation of the Autistic individual [ 23 , 35 ].…”

“…Parents who are overwhelmed by their children’s special needs and behavioral problems are unable to focus on home care such as toothbrushing and have little energy left for oral care including regular dental visits [ 35 ]. For parents, the management of an Autistic child can result in fatalism and fear and so oral health is not always a priority in view of the overwhelming medical and behavioral issues that these families must manage [ 33 ].…”

“…In the study by Hammersmith et al, a multi-site randomised clinical trial was conducted and identified that 46% of caregivers for Autistic persons expect that the majority of children will develop dental cavities [ 33 ]. This paper identified an oral health fatalistic view and a higher incidence of unmet dental needs for Autistic persons [ 33 ].…”

“…In the study by Hammersmith et al, a multi-site randomised clinical trial was conducted and identified that 46% of caregivers for Autistic persons expect that the majority of children will develop dental cavities [ 33 ]. This paper identified an oral health fatalistic view and a higher incidence of unmet dental needs for Autistic persons [ 33 ]. Further research to address the inequities in oral health is recommended to reduce the higher incidence of dental disease amongst this population and to educate parents and carers on the importance of good oral health [ 33 ].…”

“…This paper identified an oral health fatalistic view and a higher incidence of unmet dental needs for Autistic persons [ 33 ]. Further research to address the inequities in oral health is recommended to reduce the higher incidence of dental disease amongst this population and to educate parents and carers on the importance of good oral health [ 33 ].…”