Efficacy of sensory immersion therapy and involvement therapy in reduction of state anxiety during oral examination in children with autism spectrum disorder - a clinical trial

Autism is a complex neurodevelopment disarray described as a behavioral syndrome, consisting of marked impairment in social interaction and communication skills and sensorimotor problems combined with stereotyped and restricted behaviour. Children with autism spectrum disorder (ASD) experience higher levels of anxiety in comparison to both neurotypical children and those with externalizing issues. This increased anxiety tends to escalate as they grow older, underscoring its distinctive characteristic within this particular population. ASD usually becomes apparent by the age of 3 and is diagnosed through criteria specified in the DSM, which encompass limitations in social interaction and communication. Recognized characteristics in autistic individuals, such as significant challenges in utilizing various non-verbal communication methods, difficulty in forming social connections and sharing interests and experiences, delayed or absent language development, and rigid adherence to routines, often accompanied by sensory sensitivities, intellectual disabilities, or epilepsy, can impede both professional and home dental care. Thus, individuals with ASD are more prone to oral health problems. In chairside Pediatric practice, common challenges encountered with these children include a reluctance to seek attention, avoidance of eye contact, episodes of temper tantrums, and heightened reactivity to sensory stimuli like sound, light, or pain. These factors can exacerbate difficulties in behaviour management and potentially lead to avoidance of future dental appointments. Providing dental treatment for ASD children presents challenges due to unfamiliar stimuli and environments, often resulting in uncooperative behaviours. Dental anxiety further complicates oral care, ultimately affecting oral health. Effective oral behaviour management in Pediatric dentistry should encompass personalized strategies and precise communication to enhance the success rate of oral care for children with autism. Children with ASD often face difficulties in sensory processing, with studies suggesting that as many as 95% of them are sensitive to loud noises, changes in textures, bright light, or any other sudden shifts in their environment. These sensory issues can affect their ability to engage with the world and may conduce feelings of anxiety. Research by Atari et al. suggests that incorporating sensory interventions can help reduce anxiety and improve overall well-being in these children. Motor difficulties in children with ASD arise during early childhood, often followed by deficits in social communication, and generally increases over time, hindering opportunities for social interaction. Leary and Hill suggested that motor skill plays a key role in communication and social interaction. Therefore, improving motor abilities in ASD children may leads to positive effects on their participation in physical activities, thus opening significant pathway for social interaction. Hence, there is a need to tailor strategies to fit their likes and dislikes and to accommodate their behavioral limitations. This makes behavior management easier while also allowing us to instill a positive attitude towards dentistry. Therefore, in this study sensory and motor interventions will be implemented to reduce anxiety and enhance overall well-being. Thus, the purpose of this study is to evaluate the efficacy of sensory immersion therapy with involvement therapy in reducing state dental anxiety among children with ASD Level – 1