Sensory Adapted Dental Environment to Enhance Oral Care for Children With ASD
Condition: Autism
MeSH terms: Autistic Disorder
Study type: Interventional

Summary: 
      The goal of this project is to collect information that will support a later clinical trial
      on the effectiveness of a specially adapted dental environment for children who have
      difficulty tolerating oral care in the dental clinic. We hypothesize that adapting the
      sensory environment in the dental office by modifying the sounds, sights, smells and tactile
      experiences will result in decreased anxiety, increased cooperation, and fewer behavior
      problems for children with Autism Spectrum Disorders, and to a lesser extent for typically
      developing children especially those who have dental anxieties. This has the potential
      contribute to increased child comfort as well as safer, more efficient, and less costly
      treatment for a large population, as potentially more than one-fourth of all children may
      benefit from a sensory adapted dental environment.
    

Detailed description: 
      The goal of this R34 NIDCR Planning and Pilot Data Grant is to collect information to support
      a later clinical trial on the effectiveness of a specially adapted dental environment for
      children who have difficulty tolerating oral care in the dental clinic. Within this project,
      two groups of children were studied: children with autism spectrum disorders (ASD) and
      typically developing children, including those who are over-reactive to sensory stimulation.
      Commonly, such children exhibit anxiety and negative behavioral reactions when confronted
      with experiential aspects of dental visits such as exposure to bright fluorescent lighting,
      touch in or around the mouth, or the texture and smell of various oral care products. We
      pilot tested a sensory adapted dental environment (SADE) to examine its effect on reducing
      anxiety and behavioral problems among the targeted groups of children. The SADE intervention
      includes such adaptations as dimmed lighting, exposure to soothing music, and application of
      a special vest which provides deep pressure sensations that are calming. If our preliminary
      assessment produces promising results, we will later more comprehensively test the
      intervention in a full-scale randomized clinical trial, which will be supported by a U01
      award.

      The specific aims of the R34 grant are to promote the ability to conduct the future trial by:

        1. Developing a manual for the SADE intervention and assessing the intervention's
           feasibility.

        2. Collecting preliminary data on the intervention's effectiveness and potential
           cost-savings.

        3. Pilot testing the recruitment strategy and assessment battery that will be used in the
           anticipated trial.

        4. Developing the system of documents and data management for the future trial.

        5. Generating the proposal for the U01 award to conduct the planned trial.

      Research participants were 45 ethnically diverse children aged 6-12 years, 22 with ASD and 23
      who are typically developing. Each child underwent two dental cleanings four months apart:
      dental cleaning in a standard dental environment and dental cleaning in the sensory adapted
      environment. For each group of children (i.e., ASD and typically developing), these two
      conditions were compared in their effects on anxiety and negative behavioral reactions, as
      measured by videotape coding, psychophysiological indices, and various rating scales.
    

Intervention name(s): Sensory Adapted Dental Environment
Intervention type(s): Behavioral
Intervention description(s): See study arm description.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: autism; electrodermal activity; cooperation; anxiety; distress; stress; oral care; sensory processing; behavior; occupational therapy