Children’s Hospital Los Angeles is one of 14 centers in the Autism Speaks Autism Treatment Network. The following article first appeared in the Winter 2016 issue of The Developing Mind, the newsletter of CHLA’s Boone Fetter Clinic for Autism and Other Developmental and Behavioral Disorders.
For a child with autism spectrum disorder (ASD), visiting the dentist can be an ordeal. The bright lights, loud noises, tastes and smells of oral care products, being touched by people – all these things can create an environment that increases the child’s anxiety and stress. This makes visiting the dentist a real challenge for many families and can lead to poor oral health for their children.
A group of clinicians and researchers at Children’s Hospital Los Angeles (CHLA) and the University of Southern California (USC) have taken on a research project to make dental environments more calming for children with ASD and other young patients struggling with anxiety.
The project is led by José Polido, DDS, head of dentistry at CHLA, and Sharon Cermak, EdD, a professor at USC’s Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy.
The research team started the transformation of the dental environment by projecting slow-moving visual effects onto the ceiling, turning off overhead office lights and bright headlamps and playing soothing music.
Instead of using the usual methods for securing a child in the dental chair, practitioners used a seat cover that looks like a butterfly. Its wings wrap around the child to provide a comforting, deep-pressure hug.
To test this sensory-smart environment, 44 CHLA patients—22 with autism and 22 children not on the autism spectrum—underwent two professional dental cleanings. One cleaning took place in a regular dental environment, while the other took place in the sensory-smart dental environment that the researchers developed.
During each session, the research team measured the child’s physiological signs of anxiety, behavioral distress and pain intensity. [They used painless skin monitors that pick up electrical current that increases with stress.]
They found that children with ASD demonstrated significantly more uncooperative behaviors during the routine dental cleanings compared to the typically developing children. The children with ASD also showed significantly greater signs of physiological stress.
Both groups of children showed decreased psychological anxiety and reported lower pain and sensory discomfort in the sensory-smart dental environment.
Funded by the National Institute of Dental and Craniofacial Research (NIDCR), this study was published in the Journal of Autism and Developmental Disorders. (Read the abstract here.) It led to the publication of five additional papers focused on the team’s sensory-smart dental environment.
The researchers recently received additional funding from the NIDCR to conduct a long-term study. Their goal is to examine the effects of the sensory-smart dental environment in a larger number of children and develop protocols to help other dental clinics create such environments, while also ensuring that these new dental environments don’t place additional financial burdens on patients and their families.
Editor’s note: Autism Speaks has two practical and helpful tool kits for guiding the many dentists and families who want to ease dental visits and foster good dental hygiene for children – and adults – with autism. Click on the title links below to download them free of charge.