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: 8332288
• 负责人: Sharon Andrea Cermak
• 金额: $ 29.7万
• 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 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8332288
• 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.

描述（由申请人提供）：该拟议的R34 NIDCR计划和试点数据的目标是收集信息，该信息将支持以后的临床试验，涉及针对在牙科中难以容忍口腔护理的儿童特别适应的牙科环境的有效性诊所。在该项目中，将研究两组儿童：自闭症谱系障碍（ASD）的儿童，通常是成长于儿童，包括那些对感觉刺激过度反应的儿童。通常，当这种儿童面对牙科探访的经验方面，例如暴露于明亮的荧光照明，触摸或周围的嘴巴或各种口腔护理产品的质地和气味时，这些孩子表现出焦虑和负面的行为反应。在计划中的R34赠款中，我们将试点测试一种感官适应的牙齿环境（SADE），该环境具有较大的潜力，可以减少目标儿童群体中的焦虑和行为问题。 Sade的干预包括昏暗的照明，暴露于舒缓音乐的适应性以及提供深层压力感觉的特殊背心。如果我们的初步评估产生有希望的结果，我们稍后将在全尺度随机临床试验中更全面地测试干预措施，该试验将获得U01奖项的支持。 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干预制定手册并评估干预措施的可行性。 2。收集有关干预措施有效性和潜在成本节省的初步数据。 3.试点测试将在预期试验中使用的招聘策略和评估电池。 4.为将来的试验开发文件和数据管理系统。 5。生成U01奖的提案，以进行计划审判。 研究参与者将是40名6-12岁的种族多样化的儿童，20岁的ASD和20名通常正在发展的儿童。每个孩子将相隔四个月进行两次牙科清洁：在标准牙科环境中清洁牙齿，并在感官适应环境中进行牙科清洁。对于每组儿童（即ASD和通常发育中的儿童），将在通过录像带编码，心理生理指数和各种评级量表来衡量的那两个条件对焦虑和负面行为反应的影响中进行比较。 由于计划的研究将有助于更安全，更高效，成本较低的治疗方法，因此它有可能彻底改变基于诊所的牙科护理，以适应不断增长的ASD儿童，以及通常患有牙齿焦虑的儿童。潜在的成本节省和对儿童舒适的贡献是巨大的，因为可能有四分之一的儿童可能会受益于感官适应的牙科环境。