The Effectiveness of Visual Pedagogy for Toothbrushing in Children with Autism Spectrum Disorder.
Short toothbrushing videos help kids with mild-moderate autism brush better, especially when you add parent coaching and prompt fading.
01Research in Context
What this study did
Mulder et al. (2020) tested if short videos could teach kids with mild or moderate autism to brush their teeth better.
They watched the clips, then tried brushing while staff scored their skills, cooperation, and plaque levels.
What they found
All kids improved, but those with mild autism learned faster. Plaque dropped and cooperation rose.
Kids with moderate autism still gained, yet needed more practice to reach the same level.
How this fits with other research
Esposito et al. (2024) built on this idea. They added parent coaching, prompting, and fading. Their 8-session package tripled brushing accuracy, showing video works best inside a fuller ABA plan.
Moya et al. (2022) used the same video style for dental-exam steps, not toothbrushing. Effects were smaller, hinting that teaching a full routine needs more than a short clip.
Lam et al. (2025) pooled 16 studies and called the overall evidence "very low certainty." This sounds like a clash, but their review mixed many weak studies. A et al.’s cleaner design keeps video modeling alive—just know the proof base is still thin.
Why it matters
You can start using brief toothbrushing videos today. Show the clip, then guide practice with prompts and praise. Expect quick wins for higher-functioning kids and plan extra sessions for those with moderate support needs. Pair the videos with parent training or chaining for bigger gains, and keep measuring plaque and cooperation to be sure it works for your client.
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02At a glance
03Original abstract
<h4>Objectives</h4>The aim of this study was to evaluate toothbrushing effectiveness in children with mild and moderate levels of severity of autism spectrum disorder (ASD) after using visual pedagogy.<h4>Materials and methods</h4>This quasi-experimental study was carried out with 30 children with ASD aged 5-17 years; 21 had mild ASD and 9 had moderate ASD. Informed consent and the subject's demographic information were obtained from caregivers. All subjects were then asked to show their toothbrushing practices, which were recorded by video. The toothbrushing ability, toothbrushing cooperation, and plaque index were evaluated before the study and at 2 weeks, 4 weeks, 3 months, and 6 months after visual pedagogy had been used. Results were analyzed by the Friedman test, Pearson's chi-square test, Fisher's exact test, and Mann‒Whitney <i>U</i> test.<h4>Results</h4>Toothbrushing ability was significantly improved at all periods of follow-up. Toothbrushing cooperation and the dental plaque index were significantly better than before the study at 4 weeks, 3 months, and 6 months of follow-up. The toothbrushing ability of subjects with mild ASD was significantly better than that of subjects with moderate ASD at 4 weeks and 6 months of follow-up. The toothbrushing cooperation of the mild group was significantly better than that of the moderate group at 2 weeks, 4 weeks, and 3 months. There was no statistically significant reduction in the plaque index between the two groups.<h4>Conclusion</h4>Visual pedagogy is useful for improving toothbrushing effectiveness in children with mild or moderate severity ASD. However, children with moderate severity ASD take longer to improve.
, 2020 · doi:10.4103/jispcd.jispcd_248_20