04 juin 2021

Brossage des dents chez les enfants avec un diagnostic de "troubles du spectre de l'autisme": analyse qualitative des difficultés parentales et solutions en France

Aperçu: G.M.

Objectif : Les soins bucco-dentaires d'un enfant avec un diagnostic de "trouble du spectre de l'autisme (dTSA) sont un défi, non seulement pour les dentistes, mais aussi pour les parents. L'objectif de cette étude était d'évaluer les difficultés rencontrées par les parents dans le maintien de l'hygiène bucco-dentaire chez les enfants autistes et les solutions qu'ils ont trouvées pour faciliter cet acte quotidien. 

Méthodes : Un questionnaire à questions fermées et ouvertes sur les caractéristiques de l'enfant et la santé bucco-dentaire à domicile, réalisé via Google Form, a été envoyé aux familles françaises à travers 301 associations de parents d'enfants autistes. Pour l'analyse quantitative, la régression logistique a été utilisée. Les réponses ouvertes ont été analysées par thème. 

Résultats : Cette étude a inclus 756 enfants âgés de 14,4 (± 8,1) ans. Les filles étaient 1,7 (IC à 95 % : 1,1-2,8) fois plus susceptibles d'avoir des difficultés à se brosser les dents que les garçons. Patients non verbaux (OR : 3,2 ; IC à 95 % : 2,2-4,9), patients autistes (OR : 2,8 ; IC à 95 % : 1,4 à 5,2), patients utilisant des pictogrammes (OR : 1,6 ; IC à 95 % : 1,1-2,4) et les enfants plus jeunes (OR : 0,9 ; IC à 95 % : 0,9-0,9) étaient significativement plus susceptibles de rencontrer des difficultés à tolérer le brossage des dents.
L'analyse qualitative a montré que les parents utilisaient trois moyens principaux pour faciliter le brossage des dents : planifier, modéliser et rendre le brossage agréable. Soixante-dix-neuf pour cent des parents ne se sentent pas suffisamment informés sur les différents outils et techniques de prévention de l'hygiène bucco-dentaire pour leurs enfants avec un dTSA et souhaiteraient être sensibilisés à la gestion quotidienne de l'hygiène bucco-dentaire. 

Conclusion : Le rôle des parents reste essentiel et les professionnels doivent travailler en collaboration avec eux.

. 2021 Jun 3.   doi: 10.1007/s40368-021-00640-3. 

Toothbrushing in children with autism spectrum disorders: qualitative analysis of parental difficulties and solutions in France

M Teste  1 , A Broutin  1 , M Marty  1 , M C Valéra  2 , F Soares Cunha  3   4 , E Noirrit-Esclassan  5
Affiliations

Abstract

Purpose: The oral care of a child with autism spectrum disorders (ASD) is a challenge, not only for dentists, but also for parents. The objective of this study was to evaluate the difficulties encountered by parents in maintaining oral hygiene in autistic children and the solutions they found to facilitate this daily act.

Methods: A questionnaire with closed and open questions about characteristics of the child and oral health at home, conducted via Google Form, was sent to French families through 301 associations of parents with autistic children. For the quantitative analysis, logistic regression was used. The open answers were analysed by theme.

Results: This study included 756 offspring aged 14.4 (± 8.1) years. Girls were 1.7 (95% CI: 1.1-2.8) times more likely to have toothbrushing difficulty than boys. Nonverbal patients (OR:3.2; 95% CI: 2.2-4.9), autistic patients (OR:2.8; 95% CI: 1.4-5.2), patients using pictograms (OR:1.6; 95% CI: 1.1-2.4), and younger children (OR:0.9; 95% CI: 0.9-0.9) were significantly more likely to encounter difficulties in tolerating toothbrushing. The qualitative analysis showed that parents used three main ways to facilitate toothbrushing: planning, modelling and making it enjoyable. Seventy-nine percent of parents did not feel sufficiently informed about the different oral hygiene prevention tools and techniques for their ASD children and would like to be educated in the daily management of oral hygiene.

Conclusion: The role of parents remains essential and professionals should work in collaboration with them.

Keywords: Autism spectrum disorders; Parental perception; Qualitative analysis; Toothbrushing.

References

    1. Al-Batayneh OB, Nazer TS, Khader YS, Owais AI. Effectiveness of a tooth-brushing programme using the picture exchange communication system (PECS) on gingival health of children with autism spectrum disorders. Eur Arch Paediatr Dent. 2020;21(2):277–83. - DOI
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013. - DOI
    1. Bishop MR, Kenzer AL, Coffman CM, Tarbox CM, Tarbox J, Lanagan TM. Using stimulus fading without escape extinction to increase compliance with toothbrushing in children with autism. Res Autism Spectr Disord. 2013;7(6):680–6. - DOI
    1. Brignell A, Chenausky KV, Song H, Zhu J, Suo C, Morgan AT. Communication interventions for autism spectrum disorder in minimally verbal children. Cochrane Database Syst Rev. 2018;11(11):CD012324. - PubMed
    1. da Silva SN, Gimenez T, Souza RC, Mello-Moura ACV, Raggio DP, Morimoto S, et al. Oral health status of children and young adults with autism spectrum disorders: systematic review and meta-analysis. Int J Pediatr Dent. 2017;27(5):388–98. - DOI
    1. Dawson-Squibb J-J, Davids EL, Harrison AJ, Molony MA, de Vries PJ. Parent education and training for autism spectrum disorders: scoping the evidence. Autism. 2020;24(1):7–25. - DOI
    1. Du RY, Yiu CKY, King NM. Oral health behaviours of preschool children with autism spectrum disorders and their barriers to dental care. J Autism Dev Disord. 2019;49(2):453–9. - DOI
    1. Gandhi RP, Klein U. Autism spectrum disorders: an update on oral health management. J Evid Based Dent Pract. 2014;14(Suppl):115–26. - DOI
    1. Kirkovski M, Enticott PG, Fitzgerald PB. A review of the role of female gender in autism spectrum disorders. J Autism Dev Disord. 2013;43(11):2584–603. - DOI
    1. Leiva-García B, Planells E, Planells Del Pozo P, Molina-López J. Association between feeding problems and oral health status in children with autism spectrum disorder. J Autism Dev Disord. 2019;49(12):4997–5008. - DOI
    1. Lopez Cazaux S, Lefer G, Rouches A, Bourdon P. Toothbrushing training programme using an iPad(®) for children and adolescents with autism. Eur J Paediatr Dent. 2019;20(3):277–84. - DOI
    1. Marshall J, Sheller B, Mancl L. Caries-risk assessment and caries status of children with autism. Pediatr Dent. 2010;32(1):69–75. - PubMed
    1. Onol S, Kırzıoğlu Z. Evaluation of oral health status and influential factors in children with autism. Niger J Clin Pract. 2018;21(4):429–35. - PubMed
    1. Ornoy A, Weinstein-Fudim L, Ergaz Z. Genetic syndromes, maternal diseases and antenatal factors associated with autism spectrum disorders (ASD). Front Neurosci. 2016;10:316. - DOI
    1. Paquet A, Olliac B, Golse B, Vaivre-Douret L. Nature of motor impairments in autism spectrum disorder: A comparison with developmental coordination disorder. J Clin Exp Neuropsychol. 2019;41(1):1–14. - DOI
    1. Persico AM, Napolioni V. Autism Genetics. Behav Brain Res . 2013;251:95–112. - DOI
    1. Picardi A, Gigantesco A, Tarolla E, Stoppioni V, Cerbo R, Cremonte M, et al. Parental burden and its correlates in families of children with autism spectrum disorder: a multicentre study with two comparison groups. Clin Pract Epidemiol Ment Health . 2018;14:143–76. - DOI
    1. Pilebro C, Bäckman B. Teaching oral hygiene to children with autism. Int J Paediatr Dent. 2005;15(1):1–9. - DOI
    1. Popple B, Wall C, Flink L, Powell K, Discepolo K, Keck D, et al. Brief report: remotely delivered video modeling for improving oral hygiene in children with ASD: a pilot study. J Autism Dev Disord. 2016;46(8):2791–6. - DOI
    1. Robertson CE, Baron-Cohen S. Sensory perception in autism. Nat Rev Neurosci. 2017;18(11):671–84. - DOI
    1. Rotholz DA, Kinsman AM, Lacy KK, Charles J. Improving early identification and intervention for children at risk for autism spectrum disorder. Pediatrics. 2017;139(2):e20161061. - DOI
    1. Siu QKY, Yi H, Chan RCH, Chio FHN, Chan DFY, Mak WWS. The role of child problem behaviors in autism spectrum symptoms and parenting stress: a primary school-based study. J Autism Dev Disord. 2019;49(3):857–70. - DOI
    1. Smutkeeree A, Khrautieo T, Thamseupsilp S, Srimaneekarn N, Rirattanapong P, Wanpen W. The Effectiveness of visual pedagogy for toothbrushing in children with autism spectrum disorder. J Int Soc Prev Community Dent. 2020;10(4):415–23. - DOI
    1. Tarazi FI, Sahli ZT, Pleskow J, Mousa SA. Asperger’s syndrome: diagnosis, comorbidity and therapy. Expert Rev Neurother. 2015;15(3):281–93. - DOI
    1. Thurm A, Farmer C, Salzman E, Lord C, Bishop S. State of the field: differentiating intellectual disability from autism spectrum disorder. Front Psych. 2019;10:526. - DOI
    1. Weil TN, Inglehart MR. Three- to 21-year-old patients with autism spectrum disorders: parents’ perceptions of severity of symptoms, oral health, and oral health-related behavior. Pediatr Dent. 2012;34(7):473–9. - PubMed
    1. Williams AC. Autoextraction of twelve permanent teeth in a child with autistic spectrum disorder. Int J Pediatr Dent. 2016;26(2):157–9. - DOI
    1. Yorke I, White P, Weston A, Rafla M, Charman T, Simonoff E. The association between emotional and behavioral problems in children with autism spectrum disorder and psychological distress in their parents: a systematic review and meta-analysis. J Autism Dev Disord. 2018;48(10):3393–415. - DOI
    1. Young H, Oreve M-J, Speranza M. Clinical characteristics and problems diagnosing autism spectrum disorder in girls. Arch Pediatr. 2018;25(6):399–403. - DOI
Publié par à
Libellés : ,

Aucun commentaire:

Enregistrer un commentaire

Inscription à : Publier les commentaires (Atom)