Use of Visual Pedagogy to Help Children with ASDs Facing the First Dental Examination: A Randomized Controlled Trial

Abstract

Autism Spectrum Disorders (ASDs) are neurodevelopmental disorders that don’t have a direct effect on oral health, but severe difficulties in oral hygiene and dental procedures expose people with ASDs to an increased risk of oral diseases. This RCT aimed to evaluate which pedagogical tool was the best to prepare children with ASDs for their first dental examination, either video or photo aids. Two different criteria were used to evaluate their efficacy: the achieved steps into which the procedure was divided (n = 8), and the level of cooperation according to the Frankl Behavioral Scale. One hundred-thirteen subjects were randomly assigned to the two groups and 84 subjects completed the trial (Video group n = 41; Photo group n = 43). A predictive model for the achievement of the Preliminary (1–4) or Dental (4–8) steps was performed using a multivariate logistic regression procedure. Children in the Video group achieved more steps, but the comparison between groups was statistically significant only for the Preliminary steps (p = 0.04). The percentage of subjects judged as cooperating was similar in the two groups. The results of this study underline that behavioural intervention should be used as an effective strategy to prepare subjects with ASDs for a dental examination.

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

“…Adapting to the individualised needs of Autistic patients can include electronic communication systems that prepare the patients for their experience at a dental clinic and address their fear of the dental environment [ 46 , 47 ]; adapting the environment to the sensory needs of Autistic individuals to reduce physical and behavioral stress [ 7 , 11 ]; familiarisation by using visual model techniques [ 48 ]: as well as pre-treatment questionnaires and social stories to enable the Autistic patient and the dental practitioner prepare for their dental visit [ 49 ].…”

Behavioral guidance for improving dental care in autistic spectrum disorders

“…Each of them should be used when needed and adapted to the patient's capability for obtaining collaboration: This is the base for continuing dental cures for a lifetime ( 44 , 45 ). Behavioral intervention with visual tools, either video or photograph, has been successfully used to prepare children for the first dental examination ( 46 ) and for tooth brushing ( 47 ) and, either culturally adapted or not, may improve oral health status ( 48 ). Furthermore, virtual reality and video modeling have been used successfully to improve oral hygiene ( 49 , 50 ), and apps have been found to be more effective than pictures in accepting some procedures ( 51 ).…”

Evaluation of visual pedagogy teaching method for improving oral hygiene practice in children with Autism: An interventional study

“…Cirio (2022)[ 24 ] opined that successful dental healthcare for autistic children has the requirement of close cooperation and a good relationship between parents and dentists. One must try to reduce the waiting time for autistic children before treatment.…”

“…Cirio et al . (2022)[ 27 ] evaluated the effectiveness of both video and photograph (pedagogical tools) and concluded that the behavioral intervention through visual aids should be used as a strategy to prepare patients with ASDs for their first dental examination.…”