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AAPD Journal Article Abstract

Author:	Jennifer Marshall, Barbara Sheller, Bryan J. Williams, Lloyd Mancl, Charles Cowan
Title:	Cooperation Predictors for Dental Patients with Autism
Abstract:	Purpose: This study evaluated potential predictors of cooperation during dental appointments for children with autism. Methods:  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. Results: 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 echolalic 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). Conclusions: 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. (Pediatr. Dent.  2007;29:369-76) Received August 17, 2006 / Revision Accepted November 3, 2006.