Many children struggle with the idea of going to the dentist, but for children with autism, a trip to the dentist office can create anxiety and even panic. Here are some simple suggestions that may ease stress levels and make your dental visit a success.
1. Visual Schedules
A visual schedule is a great way to keep your child with autism organized and focused. It can show your child how many more days he/she has before a dental appointment. A visual schedule can also assist children in becoming independent with remembering to brush their own teeth. A posted visual schedule on the refrigerator in the kitchen, bathroom, or in your child`s bedroom can be a great way for your child to be reminded to brush and floss teeth. Older students can also have daily reminders programmed into their cell phones to keep them organized.
2. Task Analysis
Many children with autism struggle with multi-step instructions. Even the simple act of brushing or flossing their teeth can appear complex to a child with autism. Breaking the process down into smaller steps will allow your child to experience success with chaining together these steps. The steps can be laminated and posted in the child`s bedroom or bathroom at home. They can also be downloaded to their cell phone or iPad for use at school. This will allow the generalization of these new skills between the home and the school with minimal prompting.
Many parents of children with autism are well aware of the use of edibles to reinforce their children. However, edibles do not always to be presented in the form of candy, cookies or pop. Healthier substitutes such as popcorn, sliced fruit or vegetables, or crackers can be offered. This will assist with a reduction in sugary snacks. Healthier snack-related foods can also assist with a reduction in the need to see a dentist.
4. Expert Dentist
Parents of children with autism can be an excellent source of information when it comes to locating a dentist with experience working with children who have special needs. Some dentists have specialized training or experience dealing with children with various challenges. Parents can share with you the experiences they have had with certain local dentists.
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Before scheduling the dental appointment, inform the dentist that your child has autism. Talk about specialized needs and how they can be addressed during their dental appointment. Various options and treatments can be discussed and explained. This may also include the use of sedation anesthesia to keep the child calm during a dental procedure. Finally, let the dentist know what medications your child with autism is currently taking or any allergies. This will all be important information for your dentist to have.
Some children with autism do not transition well to a new environment or interacting with new people. Advocate for your child by explaining this to your dentist. Inquire as to if your child with autism can visit the office prior to the actual dental appointment. This way your child can meet the dentist, sit in the dental chair, see some of the equipment that will be used, ask some questions, etc. This might assist in reducing some of the anxiety the child with autism is encountering.
Parents and teachers can work together to create a social story about a dental appointment or procedure. Stories can be read or reviewed both in the classroom and at home. A well-written social story can assist the student with what to expect during the dental process. He/she can learn that the dentist is a trusted professional who will attempt to cause them no pain.
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Social Stories for autistic children
7. Sensory Needs
Every child with autism is different and will demonstrate different sensory needs. Some children may become frightened by the sound of the drill during a dental procedure. They may need to wear headphones to block out the sound of the drill or to listen to their favorite music to help relax them. Others will be bothered by the lights during the procedure and need to wear sunglasses. Preferred items are important to children with autism. They may want these items with them during their dental procedure. These items could include a stuffed animal, fidget, an iPad, baseball card, cell phone or even a photo of a family member. Some children with autism may also request a weighted blanket be placed across their lap or to wear a weighted vest. All of these sensory items may bring them comfort.
8. Communication Needs
Just as every child with autism may demonstrate different sensory needs, so too will every child display different communication modalities. When stressed, some children may become extremely quiet, have selective mutism, hum, or attempt to rock back and forth. Others will become “hyperlexic” and begin talking a mile a minute. There are even children with autism who are considered non-verbal. They may not be able to voice their level of discomfort or pain. Parents may need to advocate for their children by examining and interpreting their facial and body language.
Some children use American Sign Language (ASL) to communicate. The dentist may mistakenly identify your child as deaf, and this will need to be explained to them. Finally, there are also students with autism that use a communication board such as the Picture Exchange Communication System (PEC), or an iPad with Pro-lo-quo to voice for them to make their needs known. Your child’s form of communication may require you to advocate to be in the same room with them during the dental process to interpret for their communication needs.
9. Preparing for After Care
Work with family members and school personnel on the possible restrictions after various dental procedures. If a student with autism gets braces and likes to chew gum, then they may need to be prompted to chew sugar-free gum as a substitute. They may also have to transition over to a different edible.
One of our older students with autism had all four of his wisdom teeth extracted during a single dental procedure. His preferred food item was popcorn. When he returned to the classroom after his dental surgery, his mouth still had stitches in it. One of his current Independent Learning Tasks was to also follow a task analysis to learn to make his own microwave popcorn.
Once he returned to school, we immediately realized that eating the popcorn could be dangerous to him and tear his stitches. Not following the daily task analysis for making his own popcorn could throw his schedule for the day “off” and cause the student to act out. We tried many substitute food choices such as ice-cream, pudding, soup, and popsicles. However, the student did not like any of these new choices.
Prior planning and working together with parents, school personnel and the dentist can assist with avoiding such situations from occurring. Making the visit to the dental office positive for your child with autism is a definite possibility that everyone should aim for.
10. Prevention and Modeling
The best suggestion for dealing with the dentist is not to have a reason to visit one. Parents can assist with non-dental visits by modeling a healthy diet and good oral hygiene for all members of the family. Avoiding cavities, fillings, or root canals, etc. will reduce both your stress and the stress of your child. However, even with the best possible diet and oral hygiene routine, your child with autism may need to have still his/her teeth cleaned, wisdom teeth removed or even get braces.
This article was featured in Issue 86 – Working Toward a Healthy Life with ASD