J Am Dent Assoc. 2011 Mar;142(3):281-7. doi: 10.14219/jada.archive.2011.0167.
There are a limited number of studies addressing behavior management techniques and procedural modifications that dentists can use to treat people with an autism spectrum disorder (ASD).
The authors conducted a search of the dental and behavioral analytic literature to identify management techniques that address problem behaviors exhibited by children with ASDs in dental and other health-related environments.
Applied behavior analysis (ABA) is a science in which procedures are based on the principles of behavior through systematic experimentation. Clinicians have used ABA procedures successfully to modify socially significant behaviors of people with ASD. Basic behavior management techniques currently used in dentistry may not encourage people with cognitive and behavioral disabilities, such as ASD, to tolerate simple in-office dental procedures consistently. Instead, dental care providers often are required to use advanced behavior management techniques to complete simple in-office procedures such as prophylaxis, sealant placement and obtaining radiographs. ABA procedures can be integrated in the dental environment to manage problem behaviors often exhibited by children with an ASD.
The authors found no evidence-based procedural modifications that address the behavioral characteristics and problematic behaviors of children with an ASD in a dental environment. Further research in this area should be conducted.
Knowledge and in-depth understanding of behavioral principles is essential when a dentist is concerned with modifying behaviors. Using ABA procedures can help dentists manage problem behaviors effectively and systematically when performing routine dental treatment. Being knowledgeable about each patient's behavioral characteristics and the parents' level of involvement is important in the successful integration of the procedures and reduction of in-office time.
针对牙医可用于治疗自闭症谱系障碍（ASD）患者的行为管理技术和程序修改，相关研究数量有限。
作者对牙科和行为分析文献进行了检索，以确定可用于治疗在牙科和其他健康相关环境中表现出行为问题的 ASD 儿童的管理技术。
应用行为分析（ABA）是一门科学，其中程序是基于通过系统实验得出的行为原则。临床医生已成功地使用 ABA 程序来改变 ASD 患者的具有社会重要性的行为。目前在牙科中使用的基本行为管理技术可能无法鼓励患有认知和行为障碍（如 ASD）的人始终能够耐受简单的门诊牙科程序。相反，牙科护理提供者通常需要使用先进的行为管理技术来完成简单的门诊程序，如洁牙、窝沟封闭和拍摄 X 光片。ABA 程序可以整合到牙科环境中，以管理 ASD 儿童经常表现出的行为问题。
作者未发现针对牙科环境中 ASD 儿童的行为特征和问题行为的循证程序修改。应在该领域开展进一步研究。
当牙医关注行为修正时，了解和深入理解行为原则至关重要。使用 ABA 程序可以帮助牙医在进行常规牙科治疗时有效地、系统地管理行为问题。了解每位患者的行为特征和家长的参与程度，对于成功整合程序和减少门诊时间非常重要。
