Management + Leadership

Eight steps you can take to treat children with autism

One out of sixty-eight children are diagnosed with Autism Spectrum Disorder (ASD). [1]As such, many of your future patients will fall somewhere on this spectrum. Autism encompasses a wide range of neurodevelopmental disorders characterized by social impairment, communication difficulty and restrictive, repetitive stereotyped behavior. [2]

How Will Autism Affect Your Patients:

Children with ASD have difficulty interpreting what others are thinking or feeling because they don’t understand social cues, such as tone of voice or facial expressions. When interacting with others, children with ASD may fail to respond to their names and often avoid eye contact. [3]

Approximately 40% of ASD children are nonverbal and don’t speak, but this does not mean that those with ASD cannot understand language.[4] The learning, thinking and problem-solving abilities of people with ASD range from highly gifted to severely challenged. Some individuals with ASD excel in visual skills, music, math and art.

Why ALL Dentists Need to Be Prepared to Work With ASD Patients:

More people than ever are being diagnosed with Autism, there has been a ten-fold increase in the past 40 years.[5] Autism is the fastest growing serious developmental disability in the U.S. It is not clear how much of this is due to a better defining and broadening of ASD and an increased effort to diagnose. Regardless, an overall increase in the number of people with autism cannot be ruled out. These children need oral health care providers who are willing to make adjustments to their care model to accommodate individuals on the ASD spectrum.

Possible Oral Manifestations of Autism:[6]

  • Bruxism
  • Non-nutritive chewing
  • Tongue thrusting
  • Self injury (picking at lips, cheek biting, lead to ulcerations)
  • Erosion (many parents report regurgitation)
  • Some consume high-sugar snacks frequently as rewards
  • Poor oral hygiene because home care is difficult
  • Limited dietary preference
  • Xerostomia
  • Hyper gag reflex

8 Steps You Can Take to Treat Kids with Autism

Prior to dental care:

  1. Desensitization appointments – Have an initial appointment to introduce the child to the office and staff without any treatment
  2. Home-based preparation – Have parents prepare with the child and go through a visual schedule of the appointment [7]

During the appointment:

  1. Review visual schedule of the appointment when child arrives for treatment
  2. Speak in clear, concrete terms without using metaphors. For individuals with limited language, use visual depictions of the procedures
  3. Reduce sensory inputs such as lights, sounds and smells
  4. Use the same staff, operatory and appointment time for each visit
  5. Be aware of the side effects of their medications, often children with Autism will be taking multiple medications
  6. Look for signs of abuse – abuse is more common among children with developmental disabilities

Working with children with autism can be deeply rewarding. You are likely to develop a fulfilling relationship with both the child and family because of the need to work closely with them. In turn, the parents are often very appreciative, and may refer other families. When care for a child with autism is successfully completed it can be a great source of pride and accomplishment for the whole dental team.

~Quinn Yost, Los Angeles ’16, District 10 & 11 legislative coordinator

Sources

[1] CDC, Autism Spectrum Disorder http://www.cdc.gov/media/releases/2014/p0327-autism-spectrum-disorder.html

[2] Autism Fact Sheet, NIH. http://www.ninds.nih.gov/disorders/autism/detail_autism.htm

[3] International Center for Autism Research & Education http://www.icare4autism.org/what-is-autism/overview/

[4] Autism Speaks, Treating Children with Autism Spectrum Disorder http://www.autismspeaks.org/docs/sciencedocs/atn/dental-toolkit.pdf

[5] http://www.autismspeaks.org/what-autism

[6] The Center for Pediatric Dentistry, Children with Autism Spectrum Disorder http://www.thecenterforpediatricdentistry.com/intranet/special_needs_fact_sheets/dental_providers/Autism-Dental.pdf

[7] Autism Speaks, Dental Guide http://www.autismspeaks.org/sites/default/files/documents/dentalguide.pdf

 

Quinn Yost

I am a third year dental student at UCLA School of Dentistry. ASDA has played a big role in shaping my dental school experience. Last year I served as UCLA's Legislative Liaison and this year have the opportunity to be ASDA's districts 10 & 11 Legislative Coordinator. Outside of dentistry I am engaged to the most incredible girl and am looking forward to our future together. I also love the outdoors: camping, hiking, rock climbing, mountain biking, etc.

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