An Evaluation of Brief Scheduled Breaks to Reduce Distress in Typical and Develop

对减少典型和发展中的痛苦的短暂计划休息的评估

• 批准号: 7938441
• 负责人: KEITH D ALLEN
• 金额: $ 18.56万
• 依托单位: UNIVERSITY OF NEBRASKA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-06 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7938441
• 关键词: 8 year old; Address; Autistic Disorder; Behavior; Behavioral; Caring; Child; Child Care; Cognitive; Controlled Study; Cost-Benefit Analysis; Data; Dental; Dental Students; Dentists; Developmental Disabilities; Disabled Children; Distress; Effectiveness; Evaluation; Healthcare; Improve Access; Individual; Intervention; Investigation; Methods; Mouth Diseases; Oral health; Participant; Population; Preparation; Preventive; Procedures; Randomized Controlled Trials; Reaction; Reporting; Research; Research Project Grants; Schedule; Targeted Research; Techniques; Testing; Time; cost effectiveness; disability; emotional distress; programs; public health relevance

DESCRIPTION (provided by applicant): Although most children seen by dentists are well behaved and cooperative, 20-25 percent of all children are sufficiently distressed and disruptive that many practitioners are not willing to provide care for these children, limiting their access to quality oral health care. The problems are even more pronounced in children with autism and related developmental disabilities. This is compounded by the fact that most dental students report little or no preparation in providing care to individuals with disabilities resulting in few dentists treating children with developmental disabilities. This is a particular concern because children with developmental disabilities, who do not have the ability to understand and assume responsibility for or cooperate with preventive oral health practices, are particularly susceptible to oral disease. Despite recent calls for additional nonpharmacological methods of behavior management to address these challenges, there are relatively few well-controlled empirical evaluations of nonpharmacological methods of behavior management for use with children and even fewer well-controlled studies or programs of research targeting children with autism or related developmental disabilities. The purpose of this research project is to address both of these needs: first, to conducted a well-controlled, randomized trial of a promising behavioral management procedure, and second, to extend a program of research that has found this technique to be effective with a small number of difficult children but has never been tested in large numbers of children or in children with disabilities. Participants will be 180 children, 2-8 years of age requiring restorative dental treatment and will include both typically developing children as well as those with autism and related developmental disabilities. Participants in the experimental condition will receive a program of scheduled breaks provided by the dentist, which has been found in preliminary studies to be a potent intervention in highly disruptive young children. Observations of distress behavior as well as ratings of child reactions will provide direct assessment of program benefits while comparison of time spent on behavior management will provide data for a cost-benefit analysis. The investigation extends a program of research dedicated to evaluating nonpharmacological behavior management methods for dentists has the potential to improve access to quality oral health care for all children. PUBLIC HEALTH RELEVANCE: The purpose of this research project is to evaluate a behavior management intervention involving brief scheduled breaks to reduce distress in children undergoing restorative dental treatment. The research accomplishes several important needs by using a well- controlled, randomized trial of a promising behavioral management procedure and then testing its effectiveness with both typically developing children as well as those with autism and related developmental disabilities. In addition, the investigation extends a program of research dedicated to evaluating nonpharmacological behavior management methods for dentists and includes a cost-benefit analysis. Ultimately, if the behavior management procedure proves as effective for large numbers of children as it has in small pilot investigations, it has the potential to improve access to quality oral health care for children.

描述（由申请人提供）：尽管大多数儿童在牙医那里表现良好且合作，但20- 25%的儿童非常痛苦和破坏性，许多从业者不愿意为这些儿童提供护理，限制了他们获得高质量口腔保健的机会。这些问题在患有自闭症和相关发育障碍的儿童中更为明显。这与大多数牙科学生报告很少或根本没有准备为残疾人提供护理的事实相结合，导致很少牙医治疗发育障碍儿童。这是一个特别令人关切的问题，因为患有发育性残疾的儿童没有能力理解和承担预防性口腔保健做法的责任或与之合作，因此特别容易患口腔疾病。尽管最近人们呼吁使用更多的非药物行为管理方法来应对这些挑战，但对儿童行为管理的非药物方法进行的对照良好的经验评估相对较少，针对自闭症或相关发育障碍儿童的对照良好的研究或研究项目就更少了。这个研究项目的目的是解决这两个需求：首先，对一个有前途的行为管理程序进行一个控制良好的随机试验；其次，扩展一个研究项目，该项目发现该技术对少数困难儿童有效，但从未在大量儿童或残疾儿童中进行过测试。参与者将是180名2-8岁需要牙齿修复治疗的儿童，其中既有正常发育的儿童，也有自闭症和相关发育障碍的儿童。实验条件下的参与者将接受由牙医提供的计划休息，在初步研究中发现，这对高度破坏性的幼儿是一种有效的干预。对痛苦行为的观察以及对儿童反应的评分将提供对项目效益的直接评估，而对行为管理所花费时间的比较将为成本效益分析提供数据。该调查扩展了一项致力于评估牙医非药物行为管理方法的研究计划，该方法有可能改善所有儿童获得高质量口腔保健的机会。