A PILOT AND FEASIBILITY STUDY OF ELECTRONIC SCREEN MEDIA TO REDUCE DENTAL FEAR AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER

Dental care is a significant unmet health care need for children with Autism Spectrum Disorders (ASD). Many children with ASD do not receive dental care because of fear associated with dental procedures; oftentimes they require general anesthesia for regular dental procedures, placing them at risk of associated complications. Many children with ASD have a strong preference for visual stimuli, particularly electronic screen media; this affinity has been utilized in their educational instruction.

Objective: To determine if an innovative strategy using two types of electronic screen media was feasible and beneficial in reducing fear and uncooperative behaviors in children with ASD undergoing dental visits.

Study procedures

For this randomized control study, we will randomize participants into one of 4 groups: a) control group (Group A); b) video peer modeling only group (Group B); c) immersive VR only group (Group C) and d) video peer modeling plus immersive VR group (Group D). All enrolled children will have a pre-visit in the dental clinic, where they will receive usual care and baseline values of all parameters will be obtained. Medical records of all study children will be flagged so that they are identified upon arrival by the RA. In the exam room, the dental assistant will measure their pulse rate using a pulse oximeter. The dentist and RA will complete the Venham Anxiety and Behavioral Scale during the dental procedure for all study children. All study subjects will be scheduled to return for a follow up preventive dental visit in 4-6 months, which is the usual practice at CHB, depending on the child's oral health status. Children assigned to intervention Groups B and D will be mailed a copy of a DVD of the pre-recorded peer modeled visit 4 weeks before the scheduled return for the preventive dental visit. The parents will be asked to review the video with their child to orient them to all stages of the dental visit. In addition, children assigned to Group C and D will be given a virtual reality headset to watch movies or images during the dental visit. Children assigned to Group A (control group) will receive neither the DVD nor VR headset during the visit. We will repeat all measurements during the return visit for all study children.

Participant randomization: Once we identify the entire sample of eligible subjects, we will generate a list of subjects that have enrolled for the study. With the assistance of the statistician, we will do a random allocation of each subject to Group A, B, C or D.