Parental attitudes regarding behavior guidance of dental patients with autism.

1Dr. Marshall is a pediatric dentist in private practice in Lynnwood, Wash; 2Dr. Sheller is Director of Education and Resident Training, Department of Dental Medicine, Children’s Hospital & Regional Medical Center, Seattle, Wash; 3Dr. Mancl is research associate professor, Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle; and 4Dr. Williams is a pediatric dentist and orthodontist, Bellevue, Wash. Correspond with Dr. Marshall at mammelon@hotmail.com Abstract: Purposes: The purposes of this study were to evaluate: (1) parents’ ability to predict dental treatment cooperation by their autistic child; (2) behavior guidance techniques (BGTs) used during treatment; and (3) parental attitudes regarding basic and advanced BGTs. Methods: Data were collected from 85 parent/autistic child pairs and their dentists using surveys and treatment records. Results: Parents most accurately predicted if their child would permit an examination in the dental chair (≥88%) and would cooperate for radiographs (≥84%). BGTs utilized most often (>50%) were positive verbal reinforcement (PVR), tell-show-do (TSD), mouthprops, and rewards. In general, basic BGTs were more acceptable (>81%) than advanced BGTs (>54%). The most acceptable techniques (>90%) in order were: PVR, TSD, distraction, rewards, general anesthesia, hand-holding by parent, and mouthprops. When parents evaluated only BGTs used for their child, all BGTs, including a stabilization device, were highly acceptable (>91%), except for staff restraint (74%). Conclusions: Parents were accurate in predicting cooperation for some procedures. The most acceptable and efficacious BGTs in order were: PVR, TSD, distraction, rewards, and hand-holding by parent. Parental perceptions of BGTs were influenced by whether or not they had been used for their child. (Pediatr Dent 2008;30:400-7) Received June 22, 2007 | Last Revision October 10, 2007 | Revision Accepted October 15, 2007