Cons of Dental Hygiene Videos Funny
February is National Children's Dental Health Month and if you have helped a child brush his or her teeth, you know it can be challenging. Dental hygiene probably ranks 3rd on a child's list of things that are not fun, right after nap time and eating vegetables! For a child with autism spectrum disorder, this can be an especially stressful activity. Unfortunately, dental hygiene is not something that can be overlooked. Poor oral health can result in cavities, infections, and in some cases more serious health problems.
To help prevent or ease some of the difficulties that might occur for your child, we'll discuss some tips to maintain proper oral health in children with autism.
Challenges in Dental Hygiene for Kids with Autism
Poor dental hygiene can be problematic for anyone, but it can be especially tricky for children with autism due to an increased occurrence of heightened sensitivities. Brushing their teeth can bring on a variety of sensations which could be gustatory, auditory, tactile, or all of these. If the child with autism is feeling pain in their teeth or gums, they might not be able to communicate what they are experiencing, which makes things even more challenging for them and those around them. They can become overwhelmed and stressed which can result in an escalation of behavioral problems.
Other Consequences of Poor Dental Hygiene
One unintentional consequence of poor dental hygiene for children with autism is that the other children in the family might also end up with bad habits. One study found that less attention may be given to the dental habits of siblings without ASD in households who have children on the autism spectrum, due to the stress surrounding overall dental hygiene practices.
Additionally, children with autism often have fewer visits to the dentist than do children without autism, due to the stress that occurs for the child and their parents when they go. As a result of sensory challenges, going to the dentist is an overwhelmingly unpleasant experience for these kiddos.
Learning to execute daily dental hygiene skills independently often requires more supervision and oversight for longer periods of time.
Tips for Good Dental Hygiene Habits in Kids
Fortunately, it is possible for most children (yes, including those with autism!) to develop the ability to independently care for their teeth and establish good dental hygiene habits.
1. Getting Comfortable with a Toothbrush
The first step in learning to brush one's teeth is to be comfortable with having a toothbrush in your mouth. If your child is resistant to brushing their teeth, the best place to start is to get them comfortable with allowing a toothbrush to go in their mouth, and then tolerating the sensation of the toothbrush being pushed against their teeth.
One way to help your child accomplish this is by reinforcing their efforts by having the toothbrush in their mouth for a few seconds, and then slowly increasing the amount of time. You could use a timer to help your child know when it's okay to be done with the task.
2. Make Toothbrushing Fun
Although your child may never love brushing their teeth, they can learn to be okay with it and may not oppose the activity in the long run. Try and make it fun and inclusive for your child by turning it into a family activity. Have siblings brush their teeth or brush your own teeth while your child is brushing theirs so they can watch and imitate. Consider buying a toothbrush that lights up or that plays music. These features on toothbrushes often serve as timers and last for the recommended two minutes. You can also help make it fun by having a positive attitude and being upbeat when it's time for tooth brushing.
3. Create a Task Analysis
Simply put, a task analysis involves breaking down an overall skill into smaller steps. To use a task analysis for tooth brushing, break down the general task into smaller steps, like this:
- Get out the toothbrush
- Open the toothpaste
- Put the toothpaste on the toothbrush
- Brushing each section of your teeth
- Rinse your mouth
- Clean the toothbrush
How detailed you are in creating the task analysis will depend on the level of assistance your child needs to complete the task independently; therefore, a child who needs a lot of help with brushing their teeth would require a more detailed task analysis.
You can create a datasheet that involves writing down each individual step on a piece of paper. This is the physical task analysis. You can then record how well your child does on each step daily (or at minimum weekly) to see if they are making progress on the skill.
4. Prompt Fading - Give Less Help Over Time
Prompting refers to helping your child (when they need it) to guide them to be more successful with a specific task. When providing prompting to your child when brushing their teeth, you can offer them tangible prompts to physically help them brush their teeth as needed. It is important to be selective with this type of prompting in order to prevent your child from becoming even more resistant to brushing their teeth. You can also use verbal prompts by using your words to remind your child to brush their teeth. Visual prompts are used by establishing a routine that is created with visual images, such as pictures that indicate the steps in the routine. And finally, you can also use auditory prompts, which could be setting an alarm to remind them to brush.
The important thing to remember about prompting is that in order for it to be effective you must fade out the prompts that involve you helping your child over time. You want to focus on the end goal of your child caring for their teeth independently, requiring less help from you.
5. Provide Positive Reinforcement
Positive reinforcement is a concept that refers to experiencing something beneficial after one completes a specific task, which results in a higher likelihood that the individual will complete that same task again in the future. A good starting point in teaching your child to care for their teeth is to consider where your child is currently at with the ability to brush their teeth independently. If they are just starting to learn this skill and they don't like to keep the toothbrush in their mouth, you might offer a positive reinforcer if they put the toothbrush in their mouth with just water on it for 30 seconds. Alternatively, if your child already occasionally brushes their teeth and they can do it pretty well on their own (but not at the frequency you would prefer – daily, or multiple times a day for example) you might offer a reinforcer at the end of every day in which they brush their teeth.
Using a Token System
A token system is another method of using positive reinforcement. With this system, you create a chart to track when your child brushes their teeth. Each time they brush their teeth, they get a sticker or a checkmark on the chart which is worth points; once they earn a certain number of points on the chart, they earn a prize. An example of increasing the frequency of a behavior by the use of a token system would be to set an initial goal of brushing their teeth 6 out of 7 days a week, then rewarding them (based on the sticker system) once they have reached that goal. Once the goal is met regularly, you could then increase it to being once a day for 7 days. Then, later on, you could set the goal for them to brush their teeth twice a day, and so on.
Going to the Dentist
Children with autism often struggle with going to the dentist. Parents and dentists can use certain proactive strategies to help these children be less stressed during a dental visit.
A few things to consider in preparation for a dental visit:
- Some pediatric dentists specialize in working with children with autism and other adaptive needs. Research the practices in your local community to determine which office will be the best fit for you and your family.
- Parents should always communicate with the child's dentist before appointments to inform them about their child's functioning; this includes their individual communication skills, sensory issues, and tips for how to help the child stay calm and relaxed.
- Parents and dentists should keep the child very well informed about what the process will be like to go to the dentist. Try helping your child understand what it will be like to get a dental cleaning or a certain procedure in a fun and supportive way.
- Dentists should gently inform the child about the instruments they use during the appointment.
- Encourage the child to be more comfortable with the dentist's office and the people that will be involved in their care by planning a field trip to the practice – one that does not involve the child getting any work done.
- Bring items and activities that your child likes to the appointment. It is typically okay to offer electronic devices or videos if it doesn't interfere with the dental procedures, though be sure to check with your dentist on their preference prior to your visit.
- Always consult with the child's dentist on whether general anesthesia should be used for your child.
- Keep your child safe by keeping dental equipment and other items out of arm's reach.
- Have an established plan in case your child does engage in any challenging behaviors and be sure to communicate it with the dentist and/or staff prior to the appointment.
We are in this Together!
Helping your child get better at brushing their teeth and establishing good dental hygiene can be complex. Remember, almost all children and their families face challenges maintaining ideal oral hygiene. For kids with autism, your approach should be individualized to the unique needs of your child and their current abilities.
If you would like more guidance on helping your child with dental hygiene, contact a Behavior Analyst at Behavioral Innovations. We are here to help!
References
Capozza LE, Bimstein E. Preferences of parents of children with autism spectrum disorders concerning oral health and dental treatment. Pediatr Dent J. 2012;34:480–4.
Hage, S., Lopes-Herrera, S. A., Santos, T. F., Defense-Netvral, D. A., Martins, A., Sawasaki, L. Y., & Fernandes, F. (2020). Oral hygiene and habits of children with autism spectrum disorders and their families. Journal of clinical and experimental dentistry, 12(8), e719–e724. https://doi.org/10.4317/jced.56440
Lai B, Miano M, Roberts MW, Hooper SR. Unmet dental needs and barriers to dental care among children with autism spectrum disorders. J Autism Dev Disord. 2012;42:1294–303.
Stein LI, Polido JC, Najera SO, Cermak SA. Oral care experiences and challenges in children with autism spectrum disorders. Pediatr Dent J. 2012;34:387–91.
Source: https://behavioral-innovations.com/blog/oral-health-kids-with-autism/
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