Marshall Jennifer, Sheller Barbara, Williams Bryan J, Mancl Lloyd, Cowan Charles
Children's Hospital and Regional Medical Center, Seattle, Wash., USA.
Pediatr Dent. 2007 Sep-Oct;29(5):369-76.
This study evaluated potential predictors of cooperation during dental appointments for children with autism.
Data were collected from 108 parent/child pairs and their dentists. Questions included: (1) medical/dental history; (2)functional language; (3) personal hygiene skills; (4) academic setting; and (5) achievements. Behavior was scored using the Frankl scale.
Subjects were 80 males and 28 females 2.7 to 19 years old with a mean age of 9.8 years. Frankl scores were 65% uncooperative (definitely negative or negative) and 35% cooperative (positive or definitely positive). Multiple factors predicted uncooperative behavior: (1) appointment type (P=.03); (2) concurrent medical diagnoses (P=.04); (3) nonverbal/minimal or echololic language (P=.005); (4) inability to understand language appropriate for age (P=.02); (5) inability to follow multistep instructions (P=.04); (6) parents providing most/all tooth-brushing (P=.004); (7) partially or not toilet trained at 4+ years (P=.02); (8) inability to sit for a haircut (P=.01); (9) attending special education (P<.001); and (10) inability to read at 6+ years (P<.001).
Five questions readily answered by a caregiver may indicate a child's cooperative potential. Preappointment inquiry about toilet training, toothbrushing, haircuts, academic achievement and language can give the dentist insight into the child's ability to respond positively to behavior guidance techniques based on communication.
本研究评估了自闭症儿童看牙时合作的潜在预测因素。
收集了108对家长/儿童及其牙医的数据。问题包括:(1)病史/牙科病史;(2)功能性语言;(3)个人卫生技能;(4)学业环境;(5)成就。使用弗兰克量表对行为进行评分。
研究对象为80名男性和28名女性,年龄在2.7至19岁之间,平均年龄为9.8岁。弗兰克量表评分显示,65%的儿童不合作(绝对消极或消极),35%的儿童合作(积极或绝对积极)。多个因素可预测不合作行为:(1)就诊类型(P = 0.03);(2)并发的医学诊断(P = 0.04);(3)非语言/极少语言或模仿语言(P = 0.005);(4)无法理解适合其年龄的语言(P = 0.02);(5)无法遵循多步骤指令(P = 0.04);(6)家长承担大部分/所有刷牙工作(P = 0.004);(7)4岁以上仍部分或未完成如厕训练(P = 0.02);(8)无法安静地坐着理发(P = 0.01);(9)就读特殊教育学校(P < 0.001);(10)6岁以上仍不识字(P < 0.001)。
照顾者能轻易回答的五个问题可能表明儿童的合作潜力。看牙前询问如厕训练、刷牙、理发、学业成就和语言情况,可让牙医了解儿童对基于沟通的行为指导技巧做出积极反应的能力。