Autism & Developmental

Effectiveness of audiovisual distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder.

KS et al. (2017) · 2017
★ The Verdict

Cartoon video glasses give a tiny calm bump during dental work; add escape extinction if you want lasting cooperation.

✓ Read this if BCBAs helping autistic clients tolerate medical or dental visits.
✗ Skip if Clinicians already using full exposure-plus-extinction protocols.

01Research in Context

01

What this study did

The team fitted 20 autistic kids, with video glasses that played cartoons during a dental sealant visit.

They counted heart beats before, during, and after the dentist worked. No control group, just the same child with and without the glasses.

02

What they found

Heart rate dropped a little—about 5 beats per minute—when the cartoons were on.

Kids stayed in the chair, but the change was small and the study had no comparison group.

03

How this fits with other research

McConnell et al. (2020) worked with older autistic clients who hit and screamed at the dentist. They added escape extinction to gradual practice and saw big drops in problem behavior. Their strong design shows distraction alone gives only weak calm; you need to block escape too.

Jackson et al. (2022) moved chairs and tables in autism classrooms and saw engagement jump. Like KMcIntyre et al. (2017), they tweaked the room, not the child, but the classroom change had larger, clearer effects.

Pérez-Fuster et al. (2022) used augmented-reality goggles to teach joint attention. Both studies strap tech to young kids’ heads, yet AR taught a skill while video eyewear only soothed for a minute.

04

Why it matters

If you only need a quick dip in heart rate, cartoon glasses are easy and cheap. For real dental cooperation, pair them with graduated exposure and extinction of escape. Tell parents the glasses are a helper, not a fix.

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→ Action — try this Monday

Try video eyewear as a supplement, but keep breaks contingent on calm behavior, not crying.

02At a glance

Intervention
other
Design
pre post no control
Sample size
28
Population
autism spectrum disorder
Finding
weakly positive
Magnitude
small

03Original abstract

<h4>Background</h4>The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder.<h4>Materials and methods</h4>This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5-9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples <i>t</i>-test was used to assess the significance of changes in pulse and O<sub>2</sub> saturation levels during each visit.<h4>Results</h4>International Caries Detection and Assessment System-code 2 was found to be the most prevalent (<i>n</i> = 58; 52%). A significant difference (<i>P</i> < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions.<h4>Conclusion</h4>Initial desensitization appointment and "tell-show-do" approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental procedures.

, 2017 · doi:10.4103/1735-3327.208768