The Impact of Covid-19 Pandemic On The Children With Autism Spectrum Disorder
Condition: Autism With High Cognitive Abilities; COVID-19 Pandemic
MeSH terms: COVID-19; Autistic Disorder; Autism Spectrum Disorder
Study type: Observational

Summary: 
      The Covid-19 outbreak has caused families and individuals to change their life routines and
      eating habits, and has affected their psychology, especially for children with autism, due to
      the change in their routines. These psychological changes may trigger the self-harming
      behavior that is very common in children with autism.

      Dental trauma, a common problem in children and adolescents, can also be seen in individuals
      who need special care such as autism.

      The aim of this study is to evaluate the susceptibility of children with autism to orofacial
      trauma during the pandemic period and compare them with the pre-pandemic period and the
      healthy group, as well as to question the lifestyle, nutritional habits, mood changes and
      oral health behaviors that may be related to the risk of trauma.
    

Detailed description: 
      The study is being carried out in Istanbul University Department of Pediatric Dentistry,
      period between September 2021 - March 2022 following the ethics committee approval 2021/49.
      Patient parents are informed about the study following the initial dental examination of the
      patient and the written informed consents are obtained from parents of all participants
      included in the study.

      The orofacial trauma history, dietary habits and lifestyle changes of children aged 3-14
      years diagnosed with autism in Istanbul University Department of Child Psychiatry and healthy
      children applying to Istanbul University Faculty of Dentistry Department of Pediatric
      Dentistry will be evaluated through a questionnaire to be applied to their families.

      Questionnaire;

        -  13 questions to question the sociodemographic profile,

        -  10 questions to question the child's systemic disease history, oral hygiene habits and
           oral health status,

        -  12 questions to question eating habits,

        -  6 questions to question the child's lifestyle and psychological changes due to the
           Covid-19 pandemic,

        -  20 questions to question the trauma story,

        -  In order to measure the DMFT/dmft status, 1 index will be filled and applied. Intraoral
           examinations of the children with autism who accepted to participate in the study, who
           came to the Istanbul University Child Psychiatry Department for examination, will also
           be examined, if there is any sign or history of trauma, it will be recorded and the
           possible causes of the trauma, its type, time, place and accompanying clinical findings
           will be evaluated and risk factors that may cause trauma (overjet/overbite) will be
           recorded.

        -  While evaluating dental traumas, hard tissue and periodontal tissue injuries will be
           recorded separately.

        -  Since X-rays cannot be taken from these patients, traumas related to the root in hard
           tissue injuries will not be evaluated.

        -  The amount of overjet and overbite; will be examined using an intraoral mirror and a
           periodontal probe. The amount of overjet will be recorded by measuring the distance of
           the upper incisors to the lower incisors when the jaws are in normal closing. When
           measuring the amount of overbite, the amount of covering the cutting edges of the lower
           incisors by the cutting edges of the upper incisors will be determined when the jaws are
           in normal closing.

        -  In addition, the patients with autism who came to the Department of Child Psychiatry of
           Istanbul University for examination and who accepted to participate in the study, will
           be measured with the help of the DMFT/dmft index, whether they have a history of trauma
           or not, while performing intraoral examinations.

      A control group will be formed from healthy children who applied to the Pediatric Dentistry
      Department of Istanbul University without autism, taking into account the gender and age
      distribution of children with autism. Then, the groups will be compared within themselves and
      with each other, taking into account the pandemic period and before.
    

Intervention name(s): Not Applicable (observation)
Intervention type(s): Other
Intervention description(s): Questionnaire
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        A total of 200 patients per month in the 3-14 age group who are being followed up with a
        diagnosis of autism from the Department of Child Psychiatry of Istanbul University, and 165
        children will be selected by simple random sampling method from among the patients who
        applied to the clinic during the study period. On the other hand, healthy controls who
        applied to Istanbul University Faculty of Dentistry, Department of Pedodontics between
        September 6, 2021 and March 31, 2022 and met the inclusion criteria will be included in the
        order of application to the outpatient clinic.
      
Keywords: ASD (autism spectrum disorder); Covid-19; Dental trauma; Eating habits; Lifestyle changes