Use of a Simulated-Virtual Training Module to Improve Dental Hygiene Students' Self-Reported Knowledge, Attitudes, and Confidence in Providing Care to Children with Autism Spectrum Disorder: A pilot study.

Purpose: Autism spectrum disorder (ASD) is a developmental disorder affecting an individual's ability to communicate, interact, behave, and learn. The purpose of this study was to determine knowledge, attitudes, and confidence of dental hygiene students in providing care to children with ASD as a mechanism for evaluating dental hygiene curricula for patients with special needs.Methods: A simulated-virtual training (SVT) intervention was developed as an interactive approach for educating dental hygiene students on providing care to a child patient with ASD. The SVT intervention consisted of a scenario in which the clinician "interacted" with a child with ASD who was having difficulty in the dental environment. Pre- and post-test surveys measured students' knowledge, attitudes, and perceived confidence related to providing dental hygiene services to children with ASD prior to and following the intervention. The Wilcoxon Signed Rank was used to determine statistical significance at the p=.05 level.Results: Thirty-three second year dental hygiene students completed the pre- and post-test surveys for a response rate of 97%. Statistically significant differences were observed for self-reported confidence to provide care to patients with ASD upon graduation, assessment of the unique needs of children with ASD, and an understanding of the dental needs for children with ASD (p<0.05). Participants' confidence with performing dental hygiene services on children with ASD greatly increased, with statistically significant difference found for almost all services (i.e., oral exam, oral hygiene instruction, oral photos, radiographs, scaling, fluoride treatment; p<0.05) except selective polishing. Most (90%) agreed that there is a need for additional/elective resources to help increase comfort in providing care to children with ASD.Conclusion: Results indicate the SVT intervention increased students' knowledge, attitudes, self-perceived confidence, and comfort. Dental and dental hygiene curricula could include technologies and intervention methods to advance access to dental care by children with ASD.

A Feasibility Study of Autism Behavioral Markers in Spontaneous Facial, Visual, and Hand Movement Response Data.

Autism spectrum disorder (ASD) is a neurodevelopmental disability with atypical traits in behavioral and physiological responses. These atypical traits in individuals with ASD may be too subtle and subjective to measure visually using tedious methods of scoring. Alternatively, the use of intrusive sensors in the measurement of psychophysical responses in individuals with ASD may likely cause inhibition and bias. This paper proposes a novel experimental protocol for non-intrusive sensing and analysis of facial expression, visual scanning, and eye-hand coordination to investigate behavioral markers for ASD. An institutional review board approved pilot study is conducted to collect the response data from two groups of subjects (ASD and control) while they engage in the tasks of visualization, recognition, and manipulation. For the first time in the ASD literature, the facial action coding system is used to classify spontaneous facial responses. Statistical analyses reveal significantly (p <0.01) higher prevalence of smile expression for the group with ASD with the eye-gaze significantly averted (p<0.05) from viewing the face in the visual stimuli. This uncontrolled manifestation of smile without proper visual engagement suggests impairment in reciprocal social communication, e.g., social smile. The group with ASD also reveals poor correlation in eye-gaze and hand movement data suggesting deficits in motor coordination while performing a dynamic manipulation task. The simultaneous sensing and analysis of multimodal response data may provide useful quantitative insights into ASD to facilitate early detection of symptoms for effective intervention planning.

Structured Instruction With Modified Storybooks to Teach Morphosyntax and Vocabulary to Preschoolers Who are Deaf/Hard of Hearing.

Children who are deaf/hard of hearing (D/HH) are at risk for diminished morphosyntactical and vocabulary development. The purpose of this study was to examine the effects of repeated reading combined with structured instruction. Targets were a morphosyntactical form and novel vocabulary words. Participants were 3 preschoolers who are D/HH who were receiving instruction with an oral approach. Data from a multiple baseline design indicated that all children acquired the targeted skills and demonstrated high levels of generalization of these skills to untrained context. Implications for teaching young children who are D/HH using repeated storybook reading are discussed.

Interventions for the Reduction of Dental Anxiety and Corresponding Behavioral Deficits in Children with Autism Spectrum Disorder.

PURPOSE: Autism Spectrum Disorder (ASD) can greatly inhibit a child's communication and social interaction skills, impacting their comfort during dental hygiene treatment and services. Children with ASD may exhibit sensory sensitivities, fear of the unfamiliar and lack of socio-cognitive understanding, leading to anxiety and corresponding behavioral deficits. Since the prevalence rates for ASD have risen significantly in the past decade, increased emphasis has been placed on educational and behavior guidance techniques, which can be helpful for children with ASD because of their increased capabilities in visual-processing. The purpose of this literature review is to summarize the interventions available to reduce dental anxiety in children with ASD, and to determine which strategies are best suited for implementation by the dental hygienist. Advancements in technology and socio-behavioral interventions were assessed for appropriate use, efficacy and engagement in the target population. Interventions were categorized into the following groups: picture cards, video technologies and mobile applications.