An evaluation of in vivo desensitization and video modeling to increase compliance with dental procedures in persons with mental retardation.

Conyers et al. (2004) tested two ways to help adults with severe intellectual disability sit through dental work.

Five adults got in-vivo desensitization: they practiced each step of a dental visit in real life, starting with just sitting in the chair and ending with a full cleaning.

Three of the same adults also watched a video of someone else doing the steps. The team tracked how many steps each person finished without refusing.

In-vivo desensitization worked for all five adults. Every person finished more steps than before.

Video modeling helped only one of the three who watched it. Live practice beat watching someone else.

Dudley et al. (2019) looked at 33 studies and found adults with ID still have terrible dental health. Carole’s 2004 result shows one reason why: we rarely give them real practice, so they avoid care.

Lejuez et al. (2001) showed that higher reinforcer rates make behavior harder to stop. Carole used the same idea—praise and small treats during each tiny step—to keep clients in the chair longer.

Duker et al. (1991) used extinction to make gestures vary. Carole used gradual exposure to make dental behavior stronger. Both single-case ABA designs prove we can shape new responses in severe ID.

If your client runs from the dentist, don’t just show a video. Bring a portable chair, bib, and mirror to the day program or home. Practice one step at a time, reinforce every success, and build up to the real visit. You can cut missed appointments and save teeth.