title: Dental care protocol based on visual supports for children with autism spectrum disorders.
abstract: BACKGROUND
  Subjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments. The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs to undergo to oral examination and treatments.
  
  
  METHODS
  83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in order to undergo: an oral examination (stage 1), a professional oral hygiene session (stage 2), sealants (stage 3), and, if necessary, a restorative treatment (stage 4). Each stage came after a visual training, performed by a psychologist (stage 1) and by parents at home (stages 2, 3 and 4). Association between acceptance rates at each stage and gender, intellectual level, verbal fluency and cooperation grade was tested with chi-square test if appropriate.
  
  
  RESULTS
  Seventy-seven (92.8%) subjects overcame both stage 1 and 2. Six (7.2%) refused stage 3 and among the 44 subjects who need restorative treatments, only three refused it. The acceptance rate at each stage was statistically significant associated to the verbal fluency (p=0.02; p=0.04; p=0.01, respectively for stage 1, 3 and 4). In stage 2 all subjects accepted to move to the next stage. The verbal/intellectual/cooperation dummy variable was statistically associated to the acceptance rate (p<0.01).
  
  
  CONCLUSIONS
  The use of visual supports has shown to be able to facilitate children with ASDs to undergo dental treatments even in non-verbal children with a low intellectual level, underlining that behavioural approach should be used as the first strategy to treat patients with ASDs in dental setting.
authors.affiliation: Dental Clinic University of Milan, Via Beldiletto 1, IT 20142 Milan, Italy, maria.cagetti@unimi.it.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Cagetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Mastroberardino
authors.forename: Stefano
authors.initials: S
authors.lastname: Campus
authors.forename: Benedetta
authors.initials: B
authors.lastname: Olivari
authors.forename: Raffaella
authors.initials: R
authors.lastname: Faggioli
authors.forename: Carlo
authors.initials: C
authors.lastname: Lenti
authors.forename: Laura
authors.initials: L
authors.lastname: Strohmenger
mesh_terms: D001296:Audiovisual Aids; D000067877:Autism Spectrum Disorder; D002648:Child; D002985:Clinical Protocols; D019140:Dental Care for Children; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance