OVERCOMING BEHAVIORAL CHALLENGES IN AUTISTIC DENTAL PATIENTS

Autism or Autism Spectrum Disorder (ASD) is a group of developmental conditions where children develop unusual social, behavioral, repetitive and communicative skills. This condition stems from a combination of genetic and environmental factors and is usually diagnosed at a very tender age of 2 or 3 years; in some cases; even as late as 5 years of age. The way in which these children learn, think, process and respond is different than non ASD kids, consequently, managing them at home and school may pose challenges for their care-takers.

Wholesome nutrition plays a vital role in the lives of these children. Therefore, maintaining good oral hygiene and dental health becomes crucial along with their overall health regimens. Any hindrance to dental health can hamper this balance.

Behavioral Challenge is crucial to understand

Parents should to orient themselves through doctors, support groups and authentic reading material, to establish communication and teaching if they have an autistic child at home.  Children with autism have difficulty in making social connections and understanding complex emotional interactions. They present a unique set of restricted and repetitive behavior like body movements, object movement, strict adherence to daily activities, short attention span, extreme aggression and resistant to change and new people.

All these behavioral symptoms pose a huge but manageable challenge to care for their dental and overall health. Sometimes, these kids may become extremely aggressive and violent if they do not like a certain type of smell or touch sensation. Imagine trying to vigorously brush their teeth if they develop a certain aversion to teeth brushing or imagine getting a “drill and fill” at a dentist’s – what a nightmare!

The Silver Lining

A few pointers for parents dealing with similar condition

1. DO NOT force or physically restrain kids especially when they are in a highly violent mode. They may hurt themselves or others around them.
2. You can develop a positive outlook on dentists by explainer videos, cartoon videos and dentist-patient animations available online.
3. Do not introduce the idea of a doctor visit as a punishment for not brushing their teeth. These kids do not easily accept negative reinforcements like timeouts and punishments. So such a conditioning may work badly in their favour.
4. Autistic kids hate sudden changes and new interactions, so the dentist has to be introduced to them in a friendly set-up; possibly taking a couple of orientation appointments to ease the child and make him comfortable with dentist and staff before making him sit for any kind of treatment.
5. Music is found to be therapeutic in these kids. Hence playing some soft background music could calm an apprehensive child.
6. Visual pedagogy: Dentists can use this technique in their set ups to slowly introduce dental treatments to autistic kids. It can be in the form of photos, videos and presentations and even live demonstrations.
7. Use of general anesthesia and sedation: Use of anesthesia can be very comforting to parents, safe for the child and more concrete in terms of extensive and pain provoking dental treatments.

As parents, we do everything in our power to give the best to our kids, and then some more! However, do not get disheartened when ahead of time preparation may still result in a bad dental experience. Remember that oral health is a mirror of overall health too… Some kids have severe ASD and anxiety and may require hospital set up for the same. Find a good a specially trained dentist and set up for your kid.

These are not just special kids…but they translate you into a special parent too!

Author

Dr Shradha Naik

MDS

Pediatric and preventive dentist, Mumbai

shrads88@gmail.com