Using Video Modeled Social Stories to Improve Oral Hygiene in Children With Autism Spectrum Disorder
Condition: Autism Spectrum Disorder; Dental Caries
MeSH terms: Dental Caries; Autistic Disorder; Autism Spectrum Disorder
Study type: Interventional

Summary: 
      We hypothesize that oral hygiene habits in children 8-12 years of age can be improved using
      video format Social Story intervention techniques. The purpose of this study is to
      investigate the effectiveness of video format social stories used to inform and educate
      children and parents about proper dental hygiene technique over a 6 week intervention period.
      We will measure the success of intervention using data collected from clinical exams and
      caregiver/participant surveys. Evaluation of data collected will be used to determine the
      effectiveness of the intervention.
    

Detailed description: 
      In this pilot study improvement of tooth brushing practices in children with Autism Spectrum
      Disorder between the ages of eight and twelve years old will be evaluated. Participants
      placed in two randomized groups will watch a Youtube format instructional video twice each
      day immediately before each brushing during the three-week intervention period.

      The video intervention will teach participants to use the usual and customary hygiene skills.
      Participants will view a child in their age range demonstrating proper brushing using the
      Bass brushing technique. The video will also have written narration at the bottom of the
      screen delivering printed information using Social Story style prompts. The Social Story
      prompts will also be read aloud for auditory delivery of information. The video will be two
      to three minutes long.

      Success of intervention will be determined using data collected at multiple times during the
      pilot. First, clinical exams will be completed before the intervention, half way through the
      intervention, and at the end of three weeks to evaluate how clean the patients oral cavity
      appears. Exams should take no more than twenty minutes in the dental chair. Second, Qualtrics
      emails will be sent to the patient's caregiver at 5:30 AM and 4:30 PM each day during
      intervention providing access to the instructional video. After opening the email and
      watching the video, there will be a simple "yes or no" survey question asking the caregiver
      if the video was watching before that brushing session. Finally, more in depth caregiver
      surveys will be completed at the end of each week during the intervention consisting of no
      more than fifteen questions. The surveys will evaluate the caregiver's perception of
      intervention success. At completion of the intervention the video will be made available to
      all participants via Youtube.com. One final survey will be sent to caregivers three weeks
      post intervention to determine if the video is still being used for hygiene reinforcement.

      Multiple efforts for study control will be implemented. To control for the impact that
      watching a video twice a day may have Group 2 will watch a control video. Group 1 will watch
      a dental hygiene video. Clinical evaluators will also be blinded to prevent bias when
      evaluating the two groups clinically. One examiner will conduct initial exams. A second
      examiner will conduct all subsequent exams with no knowledge of what group each patient is
      assigned. Evaluators will be calibrated pre-study evaluating hygiene patients at the dental
      clinic.

      All participants in this study will also be enrolled at Yale Child Study Center to measure
      the participants IQ using autism specific IQ testing methods.
    

Intervention name(s): video modeled social story
Intervention type(s): Behavioral
Intervention description(s): Patient will watch a Youtube compatible video of a child in the same age range as the study participants demonstrating proper brushing technique. The video will be paired with written subtitles created using the Social Story format. The subtitles will be read to the participant as the video plays. The patient will watch the video immediately before each brushing session morning and night for the three week intervention. After the intervention period the video will be made available on Youtube.com for the participants to use as they wish.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Autism; Dental Caries; Prevention; Oral Hygiene