Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism

感官适应牙科环境可增强自闭症儿童的口腔护理

• 批准号: 8210862
• 负责人: Sharon Andrea Cermak
• 金额: $ 23.44万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8210862
• 关键词: Anxiety; Area; Auditory; Autistic Disorder; Award; Behavior; Behavior monitoring; Behavioral; Calculi; Caring; Characteristics; Child; Childhood; Clinic; Clinical Trials; Code; Cost Savings; Crossover Design; Data; Dental; Dental Anxiety; Dental Care; Dental Clinics; Dental Offices; Dentists; Diagnosis; Effectiveness; Effectiveness of Interventions; Environment; Esthesia; Exhibits; Exposure to; Future; General Anesthesia; Goals; Grant; Hispanics; Intervention; Lighting; Los Angeles; Manuals; Measures; Minority; Music; National Institute of Dental and Craniofacial Research; Oral cavity; Oral health; Parents; Participant; Pediatric Hospitals; Personal Satisfaction; Population; Prevalence; Problem behavior; Procedures; Psychophysiology; Randomized Clinical Trials; Reaction; Research; Research Project Grants; Sedation procedure; Sensory; Sensory Process; Site; Smell Perception; Solutions; Subgroup; System; Tactile; Taste Perception; Testing; Texture; Tooth Diseases; Touch sensation; Treatment Efficacy; Video Recording; Videotape; Vision; Visit; Visual; aged; autism spectrum disorder; base; data management; design; experience; high risk; indexing; innovation; intervention effect; novel; oral care; pressure; psychologic; sound

DESCRIPTION (provided by applicant): The goal of this proposed R34 NIDCR Planning and Pilot Data Grant is to collect information that will support a later clinical trial on the effectiveness of a specially adapted dental environment for children who have difficulty tolerating oral care in the dental clinic. Within this project, two groups of children will be studied: children with autism spectrum disorders (ASD) and typically developing children, including those who are over- reactive to sensory stimulation. Commonly, such children exhibit anxiety and negative behavioral reactions when confronted with experiential aspects of dental visits such as exposure to bright fluorescent lighting, touch in or around the mouth, or the texture and smell of various oral care products. In the planned R34 grant, we will pilot test a sensory adapted dental environment (SADE) that has a strong potential to reduce anxiety and behavioral problems among the targeted groups of children. The SADE intervention includes such adaptations as dimmed lighting, exposure to soothing music, and application of a special vest which provides deep pressure sensations that are calming. If our preliminary assessment produces promising results, we will later more comprehensively test the intervention in a full-scale randomized clinical trial, which will be supported by a U01 award. The specific aims of the R34 grant are to promote the ability to conduct the future trial by: 1. Developing a manual for the SADE intervention and assessing the intervention's feasibility. 2. Collecting preliminary data on the intervention's effectiveness and potential cost-savings. 3. Pilot testing the recruitment strategy and assessment battery that will be used in the anticipated trial. 4. Developing the system of documents and data management for the future trial. 5. Generating the proposal for the U01 award to conduct the planned trial. Research participants will be 40 ethnically diverse children aged 6-12 years, 20 with ASD and 20 who are typically developing. Each child will undergo two dental cleanings four months apart: dental cleaning in a standard dental environment and dental cleaning in the sensory adapted environment. For each group of children (i.e., ASD and typically developing), the two conditions will be compared in their effects on anxiety and negative behavioral reactions, as measured by videotape coding, psychophysiological indices, and various rating scales. Because the planned research will contribute to safer, more efficient, less costly treatment, it has the potential to revolutionize clinic-based dental care for the growing population of children with ASD, as well as for typically developing children who have dental anxieties. The potential cost savings and contribution to child comfort are dramatic, as potentially more than one-fourth of all children may benefit from a sensory adapted dental environment. PUBLIC HEALTH RELEVANCE: Adapting the sensory environment in the dental office by modifying the sounds, sights, smells and tactile experiences has the potential to revolutionize clinic-based dental care for the growing population of children with Autism Spectrum Disorders, as well as for typically developing children who have dental anxieties. These adaptations will result in both decreased anxiety and negative behaviors during care. This will contribute to increased child comfort as well as safer, more efficient, and less costly treatment for a large population, as potentially more than one- fourth of all children may benefit from a sensory adapted dental environment.

描述(由申请人提供)：这项拟议的R34 NIDCR规划和试点数据赠款的目标是收集信息，以支持稍后的临床试验，即为在牙科诊所耐受口腔护理困难的儿童提供特别适应的牙科环境的有效性。在这个项目中，将研究两组儿童：患有自闭症谱系障碍(ASD)的儿童和典型的发育中儿童，包括那些对感觉刺激反应过度的儿童。通常，当面对牙科就诊的体验方面时，这类儿童会表现出焦虑和负面行为反应，比如暴露在明亮的荧光灯下，触摸口腔或口腔周围，或者各种口腔护理产品的质地和气味。在计划中的R34拨款中，我们将对感官适应牙科环境(SADE)进行试点测试，该环境具有很强的潜力，可以减少目标儿童群体中的焦虑和行为问题。Sade干预包括调暗灯光，听舒缓的音乐，以及应用一种特殊的背心，提供让人平静的深度压力感。如果我们的初步评估产生了有希望的结果，我们将在稍后的全面随机临床试验中更全面地测试干预措施，该试验将得到U01奖的支持。R34赠款的具体目的是通过以下方式促进进行未来试验的能力：1.为SADE干预制定一份手册，并评估干预的可行性。2.收集关于干预的有效性和可能节省的费用的初步数据。3.试行将在预期的审判中使用的征聘战略和评估单元。4.为今后的审判开发文件和数据管理系统。5.生成U01裁决的提案，以进行计划中的审判。研究参与者将是40名年龄在6-12岁之间的不同种族的儿童，其中20人患有自闭症，20人处于典型发育阶段。每个孩子将每隔四个月接受两次牙齿清洁：在标准牙齿环境中进行牙齿清洁，在感官适应环境中进行牙齿清洁。对于每一组儿童(即自闭症和典型的发展中的儿童)，将通过录像带编码、心理生理学指数和各种评级量表来衡量这两种情况对焦虑和负面行为反应的影响。由于这项计划中的研究将有助于更安全、更有效、成本更低的治疗，它有可能为越来越多的自闭症儿童以及典型的患有牙科焦虑症的儿童带来基于诊所的牙科护理的革命性变化。潜在的成本节约和对儿童舒适性的贡献是巨大的，因为潜在的超过四分之一的儿童可能受益于感官适应的牙齿环境。 公共卫生相关性：通过改变声音、视觉、气味和触觉体验来调整牙科办公室的感觉环境，有可能为越来越多患有自闭症谱系障碍的儿童以及典型的患有牙科焦虑症的儿童带来基于临床的牙科护理的革命性变化。这些适应将导致护理期间焦虑和负面行为的减少。这将有助于提高儿童舒适度，以及为大量人口提供更安全、更有效和更便宜的治疗，因为可能有超过四分之一的儿童受益于感官适应的牙科环境。