Sharon A. Cermak, Leah I. Stein Duker, Marian E. Williams, Christianne Joy Lane, Michael E. Dawson, Ann E. Borreson, José C. Polido; Feasibility of a Sensory-Adapted Dental Environment for Children With Autism. Am J Occup Ther 2015;69(3):6903220020. https://doi.org/10.5014/ajot.2015.013714
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© 2020 American Occupational Therapy Association
OBJECTIVE. To provide an example of an occupational therapy feasibility study and evaluate the implementation of a randomized controlled pilot and feasibility trial examining the impact of a sensory-adapted dental environment (SADE) to enhance oral care for children with autism spectrum disorder (ASD).
METHOD. Twenty-two children with ASD and 22 typically developing children, ages 6–12 yr, attended a dental clinic in an urban hospital. Participants completed two dental cleanings, 3–4 mo apart, one in a regular environment and one in a SADE. Feasibility outcome measures were recruitment, retention, accrual, dropout, and protocol adherence. Intervention outcome measures were physiological stress, behavioral distress, pain, and cost.
RESULTS. We successfully recruited and retained participants. Parents expressed satisfaction with research study participation. Dentists stated that the intervention could be incorporated in normal practice. Intervention outcome measures favored the SADE condition.
CONCLUSION. Preliminary positive benefit of SADE in children with ASD warrants moving forward with a large-scale clinical trial.
Is there a sufficient number of eligible participants?
Are people willing to participate in the study? What are the most effective methods of recruitment?
Are families and dentists willing to allow videotaping during dental procedures?
Can ASD diagnoses from community professionals be used, or is additional verification of diagnosis necessary?
Do the participants understand the questions in the data collection assessments?
Will participants tolerate placement and wearing of the electrodes?
Will we be able to retain participants?
Within what range of ASD severity will children with ASD be able to participate?
What are the follow-up rates, response rates to questionnaires, and adherence and compliance rates?
Will physiological and psychological outcome measures detect differences?
Given the small sample size, are the findings in the hypothesized direction?
Given the obtained effect sizes, what sample size is needed for a full-scale RCT?
Is the intervention effective for both TD and ASD groups?
Do preliminary findings suggest questions to ask about subgroups of children for whom the intervention may be more or less effective?
Occupational therapy practitioners are uniquely situated to view a variety of health care challenges in a different light. One such challenge is oral care in children with ASD.
Occupational therapy practitioners can help decrease health-related disparities by incorporating their knowledge of sensory processing in stressful health-related situations.
A SADE is feasible to implement and shows the potential to reduce behavioral distress, physiological stress, pain, and sensory discomfort in children with ASD.
It was essential to conduct this feasibility study before conducting a large-scale randomized controlled trial.
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