Behavior management-based applied behaviour analysis within dental examination of children with autism spectrum disorder

Abstract

Background: Autism spectrum disorder (ASD) is a developmental disorder with three main characteristics: communication disorders, social interaction disorders and repetitive behavior. The main problem faced when treating child patients with this disorder is the difficulty of establishing communication with the result that they are unable to understand instructions. One form of therapy frequently applied in cases of autism is that of applied behavior analysis (ABA). It is easier for children with ASD to absorb information visually. Purpose: The purpose of this study was to evaluate the effectiveness of ABA-based behavior management using visual media in the form of picture cards for oral examination of children with ASD. Methods: The study design was observational descriptive in nature and the sample selection was based on purposive sampling. The study was conducted by observing changes in childrens’ behavior during treatment administered four times a month. The subjects were 13 children with ASD who met the study criteria and were receiving treatment for autism at Prananda special school in Bandung. The collated data related to changes in subjects’ behavior observed during four meetings assessed on the basis of score 1 confirming compliance with instructions and 0 indicating non-compliance. A Kruskal-Wallis statistical analisysis test was used to analyze the data. Results: The results showed a general increase in the former over the latter initial behavior during treatment. Statistical analysis showed that the coefficient of Kruskal-Wallis was meaningful in terms of statistical significance with a p-value of 26.947 (<0.05). The multiple comparison value for average ranks was 15.68 (SD 18.69). Conclusion: The conclusion of this study is that the application of a behavior management-based analytical methodology is effective in supporting the oral examination of children with ASD.

Is Visual Pedagogy Effective in Improving Cooperation towards Oral Hygiene and Dental Care in Children with Autism Spectrum Disorder? A Systematic Review and Meta-Analysis

“…Therefore, forty-one papers were assessed; eighteen papers were discarded ( Table S3 ). Twenty-three studies were finally included in this systematic review: nine studies concerned tooth brushing and oral hygiene skills in children with ASDs and 14 studies concerned their cooperation during dental procedures ( Figure 1 ) [ 4 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. The majority of the papers included (21 studies) were published in the last decade, with 10 papers published from 2018 to 2020 [ 14 , 16 , 17 , 19 , 21 , 22 , 23 , 26 , 28 , 32 ] ( Table 1 ).…”

“…Regarding the type of study, five were RCTs [ 20 , 23 , 27 , 29 , 31 ] and 18 were non-randomized studies, of which 11 papers were interrupted time series studies (ITSSs) [ 4 , 14 , 15 , 17 , 18 , 19 , 22 , 25 , 26 , 28 , 32 ], two were controlled before and after studies (CBAs), and five were before and after comparison studies (BAs) [ 16 , 30 , 33 , 34 , 35 ]. Regarding the type of study design, 12 studies were single-arm trials [ 4 , 15 , 16 , 17 , 18 , 19 , 25 , 26 , 28 , 30 , 33 , 34 ], 10 were double-arm trials [ 14 , 20 , 21 , 22 , 23 , 24 , 29 , 31 , 32 , 33 ], and one was a multi-arm trial [ 27 ]. Eight papers had a sample size greater than 50 participants [ 4 , 17 , 19 , 21 , 22 , 27 , …”

“…The patients’ ages ranged from 3 to 23 years, with an overall minimum average age of 4.50 years and maximum of 12.28 years. Thirteen studies reported the intellectual disability level of the children involved [ 4 , 17 , 20 , 21 , 22 , 24 , 26 , 27 , 28 , 29 , 31 , 32 , 33 ].…”

“…In the first group, articles that investigated the effectiveness of visual pedagogy in improving oral hygiene skills in children with ASDs were included [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. In the second group, articles that investigated the effectiveness of visual pedagogy in improving the patient’s cooperation during dental care were included [ 4 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. To facilitate the synthesis, the results were summarized in tables.…”

Effectiveness of Applied Behavior Analysis (ABA) with regard to tooth brushing in autistic children

“…Another difference from the picture cards used by Hidayatullah was that, in this study, the picture operator donned a mask and gloves. 12 This approach was adopted as a means of rendering the subjects more familiar with the researcher and understanding fully that he/she would clean their teeth with a prophylactic brush. One factor influencing the success of care is the level of recognition of the operator demonstrated by the subject.…”