CDA Essentials 2016 • Volume 3 • Issue 7 - page 23

Volume3 Issue7
ssues and
The Goal
Inour practicewe’vedevelopedaprogramcalled thePatientGuidedSensory Integration
Program. It’s a framework thatwealter dependingon thepatient’sneeds andwhat thechild
ismost comfortablewith. Our goal is tocreateanenvironmentwhereachildcan tolerate
care—just simplebrushingandanexamination. It doesn’t necessarilymeanwecanperform
treatment, butwehave tobeable toperformacomprehensiveexam todetermine their
needs. Someof thechildren I seewill still enduphaving sedationor general anesthetic for
treatment butmanyareable to learn to tolerateother procedures. Evenchildrenwhodo
requirealternativecarecangetmost or all of their routinecaredone in theclinic.
Calming environment
Thefirst thing is tohaveagood location inyour office: aquiet areawithout a lot of
distractions.Wehavea roomwhere thechild is allowed to settle for 2–5minuteswhen
theyfirst come to theclinic. It has acoupleof books, abench, amobileon theceilingand
minimal decorationson thewalls. It’s fairly isolatedandquiet.
Pretreatment assessment
The second thingwedo is learnmoreabout thechild from theparent.Weaskaparent
tofill out adetailedquestionnaireandask, “What’sworkedwithyour child?What hasn’t
worked?Howdoyoumotivateyour child?Doyouuse rewardsor reinforcers?”Weuse
that information todeterminehowwe’regoing toworkwith their child. Thechild isoften
nonverbal so it’s theparentwho speaks for their child.
Count and sing!
I use techniques likecounting tofiveand singing. It helps in settingupboundaries from
thefirst visit.Most of the time,whenevermyhands areon thechild, I startwithcountingor
singing tofiveandmyhands comeoffby the time I get tofive.Wecreatea senseof trust,
and there’s ahugeelement of trustwithall children. It setsupa start andafinish.Most of us
can tolerate something for five seconds—even if I do it fifty times, they know I’ll be stopping.
HeatherCoulter Jackson is a registereddental hygienistwho specializes in treating childrenwithautismand
other special needs—kidswhousuallywon’t tolerate treatment inother clinics. She’s acquiredher skills through
considerable training, 25years of experienceand, to some extent, intuition. She spokewithCDAaboutwhat
shedoes to successfully treat childrenwithautism,whose impaired communicationand social, behavioural and
intellectual functioning canmake itdifficult toprovidedental care.Ms.Coulter Jacksonworks in thepediatric
dental clinic ofDr.CliveFriedman inLondon,Ontario.
Photo (oppositepage): Heather
Coulter Jacksonusesdeep
earswhilecounting tofive ina
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