Parent Training for Dental Care in Underserved Children With Autism: A Randomized Controlled Trial

Fenning, Rachel M.; Butter, Eric; Macklin, Eric A.; Norris, Megan; Hammersmith, Kimberly J.; McKinnon-Bermingham, Kelly; Chan, James; Stephenson, Kevin G.; Albright, Charles M.; Scherr, Jessica; Moffitt, Jacquelyn; Lu, Frances; Spaulding, R.J.; Guijon, John; Hess, Amy; Coury, Daniel L.; Kuhlthau, Karen; Steinberg-Epstein, Robin

doi:10.1542/peds.2021-050691

Cited by 11 publications

(7 citation statements)

References 53 publications

(70 reference statements)

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“…Three studies introduced strategies that focused on how to effectively produce changes in attitudes and behavior towards oral health care, implemented in people with intellectual disability and autistic disorder spectrum. The study by Mun et al ( 14 ) assessed the effectiveness of a dental hygiene care programme implemented by Dental Hygienists in a population with intellectual disability whereas the study by Fenning et al ( 15 ) emphasized the importance of training the parents to improve oral hygiene standards in children with autistic spectrum disorders. Oral health variables such as plaque index or caries activity measured the impact of these strategies, reporting promising results for targeting special groups with individualized and creative methods ( 14 , 15 ).…”

Section: Resultsmentioning

confidence: 99%

Management of dental caries lesions in patients with disabilities: Update of a systematic review

Molina

Zar²,

Dougall³

et al. 2022

Front. Oral. Health

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The aim of this systematic review was to update an existing review on the management of dental caries lesions in patients with disabilities so as to provide an up-to-date summary of the evidence. Randomized clinical trials and cohort studies related to preventive and restorative programmes for dental caries among people requiring special care, published in English, Spanish, Portuguese, French and German languages from February 1st 2011 to April 1st 2022, were retrieved from three databases (“updated review”). From the 1,105 titles identified using the search topic “Caries AND Disability”, 17 papers informed in the analyses: 6 referring to caries preventive strategies and 11 related to restorative care strategies. Most of these studies targeted children and adults with intellectual/physical disability, although preventive and therapeutic strategies were also reported for frail older adults and onchohematological patients. Fluorides in tablets, gels or varnishes forms and the use of xylitol as a sugar substitute were reported as effective approach to prevent the onset of caries in high-risk groups. Minimally intervention treatment options such as the Hall technique, the ART approach and the use of SDF for arresting caries, were deemed suitable and effective strategies for treating existing lesions in-office. In conclusion, in the past decade (2011–2022) an increased number of articles reported strategies to prevent and manage caries among people requiring special care. Although an array of preventive and therapeutic strategies for dental caries exists, more and better-quality clinical evidence is needed to offer guidance to inform policy and practice for special care dentistry.

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Section: Resultsmentioning

confidence: 99%

Management of dental caries lesions in patients with disabilities: Update of a systematic review

Molina

Zar²,

Dougall³

et al. 2022

Front. Oral. Health

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“…This article describes the development process and usability testing of OHR incorporated into an app aimed to empower parents with oral health knowledge and appropriate strategies to effect behaviour change, such as toothbrushing at home and dental examination at the office for autistic children (Dias et al, 2010; Fenning et al, 2022). To our knowledge, this is the first article that illustrates not only the involvement of an EWG in development of evidence-based OHR for an app targeting caregivers of autistic children, but also obtaining input from parents of autistic children regarding the suitability of resources, features of the app and app usability.…”

Section: Discussionmentioning

confidence: 99%

Development of oral health resources and a mobile app for caregivers and autistic children through consensus building

Tan

Nair²,

Duggal

et al. 2023

Autism

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This study aimed to (1) develop evidence-based resources and (2) test face, content validity, and usability of a newly developed mobile application (app) to equip and empower caregivers with resources and skills to promote better oral health for autistic children. A series of resources on oral health, including information on oral diseases and home care and social stories on dental visits were developed. Concurrently, an app was developed by dentists, occupational therapist and software developers. The resources underwent content validation by an international panel of paediatric dentists (Expert Working Group). Face validation of the resources and usability testing of the app by parents were then carried out. Validation and feedback were obtained by the Delphi method, with consensus set at 70% agreement. A total of 12 resources and 2 social stories were developed. Consensus was achieved among the Expert Working Group regarding the content and illustrations of the resources and social stories. Both the Expert Working Group and parents agreed that the resources were easy to read and understand. Parents also found the app easy to use, aesthetically pleasing and help them to better care for their child’s oral health. Lay Abstract Caregivers of autistic children often lack knowledge regarding oral homecare and when and where to see the dentist. To address this need, we developed a series of information on oral health. An autistic child assisted in developing two social stories to showcase a dental visit. A mobile app was developed to deliver the above mentioned. Other features include creation of customised social stories and visual schedule and an inbox to allow dentists to send messages to parents. The developed information and social stories were reviewed by experts and parents. The app also underwent anonymous and independent testing by parents. Overall the information and app were well received by the experts and parents.

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“…Following intervention assignment, we deployed an adapted version of Nock and Kazdin’s (2005) Participation Enhancement Intervention (PEI) at the conclusion of the baseline visit (see also Fenning, Butter, Macklin et al, 2022; Fenning, Butter, Norris et al, 2022). Our adapted PEI represented a brief motivational interviewing module designed to optimize intervention engagement and reduce anticipated barriers.…”

Section: Methodsmentioning

confidence: 99%

Comparative effects of mindfulness-based stress reduction and psychoeducational support on parenting stress in families of autistic preschoolers

Neece

Fenning

Morrell

et al. 2023

Autism

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Relative to parents of children with neurotypical development and other developmental disabilities, parents of autistic children experience higher levels of parenting stress, which are associated with deleterious consequences for parents’ mental and physical health and child functioning. Despite urgent calls to action, parenting stress is rarely addressed directly in interventions for families of autistic children, and less so in underserved and racial/ethnic minority populations where clinical needs are greater. This study tested the efficacy of mindfulness-based stress reduction, compared to a psychoeducation and support intervention, in reducing parenting stress among diverse families of autistic preschoolers. Participants ( N = 117) were randomly assigned to the mindfulness-based stress reduction or psychoeducation and support groups; assessments were conducted at baseline, immediately postintervention, and 6 and 12 months postintervention. Results indicated significant reductions in parenting stress across both the mindfulness-based stress reduction and psychoeducation and support intervention conditions; however, reductions in parenting stress were greater for parents in mindfulness-based stress reduction than in psychoeducation and support. Furthermore, the benefit of mindfulness-based stress reduction relative to psychoeducation and support increased over time, with significant group differences in parenting stress detected at 12-month follow-up. Lay abstract Parents of autistic children often experience high levels of parenting stress, which can have negative mental and physical effects on both the parent and child. This study tested the efficacy of mindfulness-based stress reduction in reducing parenting stress in parents of preschool-aged autistic children compared to a psychoeducation and support intervention. We assessed parenting stress before and after the interventions and at 6- and 12-month follow-up. Both interventions significantly decreased parenting stress, but mindfulness-based stress reduction reduced stress more than did psychoeducation and support, with the strongest effect observed 1 year later. This suggests that the stress-reducing benefits of mindfulness-based stress reduction persist and may increase over time.

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Parent Training for Dental Care in Underserved Children With Autism: A Randomized Controlled Trial

Cited by 11 publications

References 53 publications

Management of dental caries lesions in patients with disabilities: Update of a systematic review

Management of dental caries lesions in patients with disabilities: Update of a systematic review

Development of oral health resources and a mobile app for caregivers and autistic children through consensus building

Comparative effects of mindfulness-based stress reduction and psychoeducational support on parenting stress in families of autistic preschoolers

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