CDA Essentials 2016 • Volume 3 • Issue 7 - page 24

24
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Volume3 Issue7
I
ssues and
P
eople
Strategies
for careof childrenwithautism
Ms.Coulter Jacksondescribesvariousapproaches that they
useat theirpractice. “We’ve takenpieces fromallof these
programsandcombined them tocreateourownprogram.
Wechoose fromanyof thesestrategiesbasedonachild’s
tolerance to it.”
D-TerminedProgram:
Thisprogramhelpsachildwithautism
become familiarwith thedentalpracticesettingand learn
cooperationskillsbyusing repetitive taskingoverashort
interval. Forexample, I sit thechildback in thechair, repeat
“Legsout straight, handsonyour tummy,”andsee thechild in
shortappointmentsover thecourseof anumberofdays.
Orofacial therapy:
Thismethodofdesensitizationwas taught
byArgentinianphysicianDr.Castillo-Morales.
Itusesdifferentapproaches includingstabilizationof the jaw
anddeeppressureandvibrationon the joints. Itcanhelp the
childbegin toaccept touchandsetup thedurationofeach
procedure (i.e., counting to5whileapplyingpressure).
Errorless learning:
This technique reinforcesgood
behaviours; it’ssomethingweweredoing innately, although
wedidn’tknow therewasa technicalname for it. It’scontinual
positive reinforcement. Insteadof saying “Putyourhandsback
down,”we take theirhands,put themback in their lapand
thensay “Good job, nice listening.”
Music therapyandcounting:
MartineHennequin, a
psychologist fromFrance, lecturesonherworkwithadults
withDownSyndromeanduseofmusic therapy. She
attendedourclinic inLondon,Ontario,whereshehelpedus
to learnaboutusingmusicasadistraction tool. Somechildren
toleratescalingandpolishingas longas I sing for them.
Parentsandsupport staffoften join in too!
Social stories:
Mostchildrenwithautismhaveusedsome
formof asocial story,which involvesusingphotographs
inastory—ithelps to teachachildaboutwhat toexpect
for theirvisit to theclinic. Itwould includeapictureofme,
Dr. Friedman, and theclinic.
Pivotal response therapy (PRT):
Rather than target individual
behavioursoneata time, PRT targetspivotal areasof achild’s
development suchasmotivation, responsiveness tomultiple
cues, self-management, andsocial initiations. Partof the
overallgoalofeachvisit is tofindamethodof tolerance for
overall care—not just foroneparticularprocedure—and
PRThelpswith this.
Watch the eyes
Theway I determinewhether or not I’mgoing to
continuewhat I’mdoing isby lookingat thepatient’s
eyes. So if thechild is smilingandattentive I keep
going. Some kidswillmakeeyecontact andothers
won’t. Childrenwithautismoftenhavedifficulty
makingeyecontact so Iwait until achild tries tomake
eyecontact—that’soneway I can tellwhetherwhat
I’mdoingmakes themcomfortableor not.
Learn from experts
Our biggest problem inpediatricdentistry is that
whenour patientsgrowup, theydon’t haveapractice
tomove to. If dentists ingeneral practicecould learn
someof themethodsweusewithour patients, then
thesechildrencouldmake the transition right into
another practiceas adults.
a
This interviewhasbeeneditedandcondensed.
Theviewsexpressedarethoseoftheauthoranddonotnecessarilyreflecttheopinionsorofficialpolicies
oftheCanadianDentalAssociation.
Visit
for the full interviewand to
seehowHeatherworkswithchildren
in theclinic. Inonevideo, sheusesdeep
pressure, orofacialmassage, counting,
singingandcontinual positive
reinforcementwithayoungboywith
autism. Another video showsHeather
working successfullywitha12-year-old
girlwithDownSyndromeandautism
whofirst visited theclinicatage two,
when shewasunable to tolerateeven
entering theclinic.
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