Octavia Alfini, Sitthisettapong Thanya, Dewanto Iwan
School of Dentistry, Faculty of Medical and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia.
Pediatric Dentistry Department, Faculty of Dentistry Thammasat University, Pathum Thani, Thailand.
Spec Care Dentist. 2025 May-Jun;45(3):e12827. doi: 10.1111/scd.12827. Epub 2023 Jan 18.
Conducting Dental examination in children with autism is challenging due to the limitation in cooperativeness that is caused by impairment of communication, social interaction, and sensory sensitivities.
This study aims to provide evidence base for the structural-visual approach in reducing uncooperativeness behavior to dental care in children with autism spectrum disorder (ASD).
Searches were conducted in the electronic databases PubMed, PsycINFO, and Cochrane from inception to October 2021 (CRD42022383409). Randomized controlled trials (RCTs), non-RCTs, and pre/post-test and qualitative studies that conducting visual pedagogy and visual learning methods were included. The quality of evidence was assessed with Cochrane Collaboration's Risk of Bias Tool for RCTs, Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) for non-RCTs, and Critical Appraisal Skill Program (CASP) for qualitative studies.
The initial search identified 270 studies, and 256 remained after removing duplicates. After screening titles and abstracts, 62 studies were remained for full-text assessed, and finally 13 eligible studies were selected for reviews. The studies analyzed various structural-visual interventions, participants, study design, countries, and outcomes.
The structural-visual approach could reduce uncooperative behavior in children with ASD. Future study should investigate the wide range of age and varied behavior approach as the evidence-based of the clinical management.
由于沟通、社交互动受损以及感官敏感导致的合作性受限，对自闭症儿童进行牙科检查具有挑战性。
本研究旨在为结构化视觉方法提供证据基础，以减少自闭症谱系障碍（ASD）儿童在牙科护理中的不合作行为。
从数据库建立至2021年10月在电子数据库PubMed、PsycINFO和Cochrane中进行检索（CRD42022383409）。纳入进行视觉教学法和视觉学习方法的随机对照试验（RCT）、非随机对照试验、前后测试和定性研究。使用Cochrane协作网的RCT偏倚风险工具、非随机干预研究的偏倚风险（ROBINS-I）对非RCT进行证据质量评估，使用定性研究的批判性评估技能计划（CASP）进行评估。
初步检索识别出270项研究，去除重复项后剩余256项。在筛选标题和摘要后，62项研究进入全文评估，最终13项符合条件的研究被选入综述。这些研究分析了各种结构化视觉干预、参与者、研究设计、国家和结果。
结构化视觉方法可以减少ASD儿童的不合作行为。未来的研究应调查更广泛的年龄范围和不同的行为方法，作为临床管理的循证依据。
