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在感官适应的牙科环境中进行牙科治疗时自闭症谱系障碍儿童的交感神经反应

Sympathetic Response of Children With Autism Spectrum Disorder During Dental Treatment Performed in a Sensory-Adapted Dental Environment.

作者信息

Kaintura Akansha, Ramar Kavitha, Sankar U Ganapathy

机构信息

Pediatrics and Preventive Dentistry, Sri Ramaswamy Memorial Kattankulathur Dental College, Chennai, IND.

Pedodontics and Preventive Dentistry, Sri Ramaswamy Memorial Kattankulathur Dental College, Chennai, IND.

出版信息

Cureus. 2024 Aug 12;16(8):e66685. doi: 10.7759/cureus.66685. eCollection 2024 Aug.

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social interaction, communication, and sensory processing. These challenges often make dental visits overwhelming and distressing for children with ASD. This study explores the use of electrodermal activity (EDA) to measure physiological stress responses and evaluates strategies to enhance cooperation during dental treatments in a sensory-adapted dental environment. We conducted a case series involving three children with ASD who required dental treatment. Each child's physiological responses to dental stimuli were monitored using EDA, which measures changes in skin conductance levels and skin conductance responses. Interventions included the use of dim lighting, the avoidance of loud noises, the application of firm pressure, the provision of sensory toys, social stories before appointments, and desensitization and video modeling techniques. All three patients exhibited phasic variations in EDA levels in response to stressful stimuli and tonic changes with calming stimuli. Case 1 responded to bright lights and unfamiliar settings with increased phasic activity, while calming stimuli like firm pressure resulted in tonic changes. Case 2 showed similar phasic responses to a weighted lap pad and tonic changes with music. Case 3 reacted to confined spaces and sudden light and touch with phasic variations and both a massager and music-induced tonic changes. Interventions were tailored to each patient's specific stressors, resulting in improved cooperation and reduced stress levels. The study demonstrates the effectiveness of EDA as a tool for monitoring stress responses in children with ASD during dental treatments. Tailoring interventions to individual sensory needs can significantly enhance patient cooperation and comfort. These findings highlight the importance of adapting dental environments and protocols to accommodate the unique needs of children with ASD, with collaborative efforts from occupational therapists and dentists.

摘要

自闭症谱系障碍(ASD)是一种神经发育状况,其特征是在社交互动、沟通和感觉处理方面存在困难。这些挑战常常使患有ASD的儿童在看牙时感到不堪重负和痛苦。本研究探讨了使用皮肤电活动(EDA)来测量生理应激反应,并评估在适应感觉的牙科环境中增强牙科治疗期间合作的策略。我们进行了一个病例系列研究,涉及三名需要牙科治疗的ASD儿童。使用EDA监测每个儿童对牙科刺激的生理反应,EDA测量皮肤电导水平和皮肤电导反应的变化。干预措施包括使用昏暗灯光、避免噪音、施加稳固压力、提供感觉玩具、预约前讲社交故事以及脱敏和视频示范技术。所有三名患者在应对应激刺激时EDA水平呈现阶段性变化,在应对舒缓刺激时呈现持续性变化。病例1对强光和陌生环境的反应是阶段性活动增加,而稳固压力等舒缓刺激则导致持续性变化。病例2对加重的膝上垫有类似的阶段性反应,对音乐有持续性变化。病例3对狭窄空间以及突然的光线和触摸有阶段性变化反应,按摩器和音乐都能引起持续性变化。干预措施根据每个患者的特定应激源进行调整,从而提高了合作程度并降低了应激水平。该研究证明了EDA作为监测ASD儿童牙科治疗期间应激反应工具的有效性。根据个体感觉需求调整干预措施可显著提高患者的合作程度和舒适度。这些发现凸显了调整牙科环境和方案以适应ASD儿童独特需求的重要性,需要职业治疗师和牙医的共同努力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9ce/11389651/dffa57d222c9/cureus-0016-00000066685-i01.jpg

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