Autism Developmental Profiles and Cooperation with Oral Health Screening.
Check mental age and behavior first—low scores and high problem rates predict dental refusal in preschoolers with autism.
01Research in Context
What this study did
Li et al. (2015) asked parents of the preschoolers with autism about their child’s mental age and problem behaviors.
The team then watched how the kids acted during a routine dental check-up.
They wanted to see which traits made a child fight, cry, or refuse to open their mouth.
What they found
Kids with the lowest mental ages and the most hitting, kicking, or screaming were 5 to 10 times more likely to refuse the exam.
Even moderate behavior problems doubled the chance of non-cooperation.
Cognitive level predicted refusal better than any tooth-brushing habit or past dental visit.
How this fits with other research
Barrett et al. (2015) interviewed older youth and parents in hospitals and heard the same story: sensory pain and communication gaps block care.
Logos et al. (2025) extends this lens to adults, showing that autistic traits still hurt cooperation in police interviews.
Hilton et al. (2010) seems to disagree: they found IQ, not autism, explained most play differences. But the two studies ask different questions—L looked at diagnosis accuracy, while Y looked at real-world cooperation, so both can be true.
Why it matters
Before you book a dental or medical visit, quickly screen mental age and rate top problem behaviors. Kids who score low or high on behavior need extra prep: visual schedules, desensitization visits, or sedation consults. Share these numbers with the dental team so they bring extra staff or shorter appointment slots. A five-minute checklist can save 30 minutes of tears and missed care.
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02At a glance
03Original abstract
To determine the associations between autism developmental profiles and cooperation with an oral health screening among preschool children with autism spectrum disorders (ASDs). A random sample of Special Child Care Centres registered with the Government Social Welfare Department in Hong Kong was selected (19 out of 37 Centres). All preschool children with ASDs were invited to participate in the oral health survey and 347 children agreed to participate (among 515 invited). A checklist of autism developmental profiles: (1) level of cognitive functioning, (2) social skills development, (3) communication skills development, (4) reading skills and (5) challenging behaviours was ascertained. Feasibility of conducting oral health screening in preschool children with ASDs was associated with their cognitive functioning (p = 0.001), social skills development (p = 0.002), communication skills development (p < 0.001), reading skills (p < 0.001) and challenging behaviours (p = 0.06). In regression analyses accounting for age (in months) and gender, inability to cooperate with an oral health screening was associated with high level of challenging behaviours (OR 10.50, 95 % CI 2.89-38.08, p < 0.001) and reduced cognitive functioning (OR 5.29, 95 % CI 1.14-24.61, p = 0.034). Age (in months) was positively associated with likelihood of cooperative behaviour with an oral health screening (OR 1.06, 95 % CI 1.03, 1.08, p < 0.001). Feasibility of conducting population-wide oral health screening among preschool children with ASDs is associated with their developmental profiles; and in particular levels of cognitive functioning, and challenging behaviours.
Journal of autism and developmental disorders, 2015 · doi:10.1007/s10803-015-2416-7