Predicting Dental Behaviors in Children with Autism Spectrum Disorder A Pilot Study

1. Predicting Dental Behaviors in Children with Autism Spectrum Disorder A Pilot Study Matracia SY, Thikkurissy S, Casamassimo PS, McTigue DJM, De los Reyes E Nationwide Children’s Hospital/Ohio State University, Columbus, Ohio Special Acknowledgement to Deborah Weatherby for Clinical Assistance • RESULTS • Data from 30 children were analyzed. A total of 46% children presented with diagnosis of Autism, followed by 13% PDDNOS • ADHD and Mental Retardation noted in 23% Pts • Both caregiver and child responsible for brushing the child’s teeth at home in 56% of subjects • No significant relationship between verbal ability and dmft score (p=.067) • Significant relationship between child behavior in dental chair as rated by Frankl Scale and whether the child was toilet trained (p=.037) • No significant relationship was noted between score on the Childhood Autism Rating Scale (CARS) and behavior in dental chair (p=.65) INTRODUCTION Autism Spectrum Disorder (ASD) is an umbrella term that includes autistic disorder, Asperger Syndrome, and pervasive developmental disorder-not otherwise specified (PDD-NOS). The manifestations of ASD are not always immediately visible, however three core symptoms of ASD remain: 1. impairment of social interaction 2. deficits in communication 3. restrictive and repetitive activities There is a high degree of variability in behavior of children with ASD. Likewise, their ability to cooperate varies from child to child. Predicting dental behavior in children with ASD is challenging, but extremely important to understand in order to provide a true dental home for the children and deliver comprehensive treatment for them. • METHODS • IRB approved study at two sites: the Nationwide Children’s Hospital Main Campus Dental Clinic and off-site Autism Center (Dublin) • Inclusion criteria: children with ASD diagnosed by a behavior assessment team, ages 6 to 13 years old • Diagnosis based on the Diagnostic and Statistical Manual of Mental Disorder 4th edition (DSM-IV) • Behavior was measured during exam and prophy using an ordinal Frankl scale CONCLUSION While the sample size of this pilot study does not provide adequate statistical power, results are consistent with previous studies that correlate toilet training status of a child with autism spectrum disorder as a possible indicator of potential behavior in the dental chair • OBJECTIVES • To assess predictive factors of dental behavior in children with ASD, based on parental survey, other behaviors and a clinical dental exam. References: 1.Marshall et al. Cooperation Predictors for Dental Patients With Autism. Pediatric Dentistry. 2007;15:369-76 2.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder, 4thh edition (1994) 4th edition Text Revision (2000) 3.Koein U, Nowak A. Autistic Disorder: a review for the pediatric dentist, Pediatric Dentistry 1998