Oral care interventions for autistic individuals: A systematic review / Lucía I FLORÍNDEZ in Autism, 29-1 (January 2025)  

Public ISBD [article]  inAutism > 29-1 (January 2025) . - p.41-52 Titre : Oral care interventions for autistic individuals: A systematic review Type de document : Texte imprimé et/ou numérique Auteurs : Lucía I FLORÍNDEZ, Auteur ; Dominique H COMO, Auteur ; Evelyn LAW, Auteur ; Christine F TRAN, Auteur ; Robert JOHNSON, Auteur ; José C POLIDO, Auteur ; Sharon A CERMAK, Auteur ; Leah I STEIN DUKER, Auteur Article en page(s) : p.41-52 Langues : Anglais (eng) Mots-clés : autism  dental  oral care  oral health  systematic review Index. décimale : PER Périodiques Résumé : Oral care-related challenges are well documented in the autistic community. This review examined interventions designed to improve oral health in autistic individuals across the lifespan. Through a systematic process, 36 studies were identified which focused on improving home-based oral care skills and routines, and reducing fear, anxiety, and/or negative behaviors in the dental clinic. Studies incorporated preparatory interventions to support home-based hygiene activities or improve an approaching dental encounter (n = 29), most often using visual aids, and/or strategies to manage behavioral difficulties exhibited in the dental office (n = 17). Some studies used both approaches (n = 10), combining visual aids prior to a visit with behavior management in the dental office. Using an evidence-based rubric, methodological quality of most articles was only "adequate" (n = 8) or "weak" (n = 23). Findings provide preliminary support for preparatory home-based visual interventions to improve toothbrushing and/or ready patients for dental visits, and distraction or sensory-reducing interventions to improve experiences in the dental clinic. Only one study purposefully recruited autistic adults and no studies included intervention elements tailored to race/ethnicity, culture, and/or socioeconomic status. This review highlights the need for high-quality studies investigating the impact of oral care-related interventions for autistic individuals and identifies a gap in interventions for autistic adults and those from minoritized populations.Lay abstractOral care-related challenges are well documented in the autistic community; dental care remains one of the most prevalent unmet health needs among autistic individuals. This review examined interventions designed to improve oral health in autistic individuals from children and adult populations. Through a systematic process, 36 studies were identified. These studies focused on improving home-based oral care skills and routines and reducing fear, anxiety, and/or negative behaviors in the dental clinic. Studies incorporated different types of techniques for facilitating oral care practice, including preparatory interventions to support home-based hygiene activities or improve an approaching dental encounter (n = 29), most often using visual aids, and/or strategies to manage behavioral difficulties exhibited in the dental office (n = 17). Some studies used both approaches (n = 10), combining visual aids prior to a visit with behavior management. Using an evidence-based rubric, we reviewed the methodological quality of the studies and found that most were only "adequate" (n = 8) or "weak" (n = 23) in reporting their evidence. This review has two key findings: (1) there is support for preparatory home-based visual interventions to improve toothbrushing and/or ready patients for dental visits; and (2) distraction or sensory-reducing interventions may also improve experiences in the dental clinic. Only one study purposefully recruited autistic adults, and no studies included intervention elements tailored to race/ethnicity, culture, and/or socioeconomic status. This review highlights the need for more studies investigating the impact of oral care-related interventions for autistic individuals of all ages and identifies a gap in interventions for autistic adults and those from minoritized populations. En ligne : https://dx.doi.org/10.1177/13623613241260171 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=544 [article] Oral care interventions for autistic individuals: A systematic review [Texte imprimé et/ou numérique] / Lucía I FLORÍNDEZ, Auteur ; Dominique H COMO, Auteur ; Evelyn LAW, Auteur ; Christine F TRAN, Auteur ; Robert JOHNSON, Auteur ; José C POLIDO, Auteur ; Sharon A CERMAK, Auteur ; Leah I STEIN DUKER, Auteur . - p.41-52. Langues : Anglais (eng) in Autism > 29-1 (January 2025) . - p.41-52 Mots-clés : autism  dental  oral care  oral health  systematic review Index. décimale : PER Périodiques Résumé : Oral care-related challenges are well documented in the autistic community. This review examined interventions designed to improve oral health in autistic individuals across the lifespan. Through a systematic process, 36 studies were identified which focused on improving home-based oral care skills and routines, and reducing fear, anxiety, and/or negative behaviors in the dental clinic. Studies incorporated preparatory interventions to support home-based hygiene activities or improve an approaching dental encounter (n = 29), most often using visual aids, and/or strategies to manage behavioral difficulties exhibited in the dental office (n = 17). Some studies used both approaches (n = 10), combining visual aids prior to a visit with behavior management in the dental office. Using an evidence-based rubric, methodological quality of most articles was only "adequate" (n = 8) or "weak" (n = 23). Findings provide preliminary support for preparatory home-based visual interventions to improve toothbrushing and/or ready patients for dental visits, and distraction or sensory-reducing interventions to improve experiences in the dental clinic. Only one study purposefully recruited autistic adults and no studies included intervention elements tailored to race/ethnicity, culture, and/or socioeconomic status. This review highlights the need for high-quality studies investigating the impact of oral care-related interventions for autistic individuals and identifies a gap in interventions for autistic adults and those from minoritized populations.Lay abstractOral care-related challenges are well documented in the autistic community; dental care remains one of the most prevalent unmet health needs among autistic individuals. This review examined interventions designed to improve oral health in autistic individuals from children and adult populations. Through a systematic process, 36 studies were identified. These studies focused on improving home-based oral care skills and routines and reducing fear, anxiety, and/or negative behaviors in the dental clinic. Studies incorporated different types of techniques for facilitating oral care practice, including preparatory interventions to support home-based hygiene activities or improve an approaching dental encounter (n = 29), most often using visual aids, and/or strategies to manage behavioral difficulties exhibited in the dental office (n = 17). Some studies used both approaches (n = 10), combining visual aids prior to a visit with behavior management. Using an evidence-based rubric, we reviewed the methodological quality of the studies and found that most were only "adequate" (n = 8) or "weak" (n = 23) in reporting their evidence. This review has two key findings: (1) there is support for preparatory home-based visual interventions to improve toothbrushing and/or ready patients for dental visits; and (2) distraction or sensory-reducing interventions may also improve experiences in the dental clinic. Only one study purposefully recruited autistic adults, and no studies included intervention elements tailored to race/ethnicity, culture, and/or socioeconomic status. This review highlights the need for more studies investigating the impact of oral care-related interventions for autistic individuals of all ages and identifies a gap in interventions for autistic adults and those from minoritized populations. En ligne : https://dx.doi.org/10.1177/13623613241260171 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=544

Pediatricians' role in healthcare for Latino autistic children: Shared decision-making versus "You?ve got to do everything on your own" / Amber M ANGELL in Autism, 27-8 (November 2023)  

Public ISBD [article]  inAutism > 27-8 (November 2023) . - p.2407-2421 Titre : Pediatricians' role in healthcare for Latino autistic children: Shared decision-making versus "You?ve got to do everything on your own" Type de document : Texte imprimé et/ou numérique Auteurs : Amber M ANGELL, Auteur ; Olivia J LINDLY, Auteur ; Daniella FLORÍNDEZ, Auteur ; Lucía I FLORÍNDEZ, Auteur ; Leah I STEIN DUKER, Auteur ; Katharine E ZUCKERMAN, Auteur ; Larry YIN, Auteur ; Olga SOLOMON, Auteur Article en page(s) : p.2407-2421 Mots-clés : Autism spectrum disorders  family functioning and support  health services  qualitative research Index. décimale : PER Périodiques Résumé : Despite documented healthcare disparities among Latino autistic children, little is known about how their families experience the autism "diagnostic odyssey." Pediatricians have a critical role in the "diagnostic odyssey," but when it becomes arduous, parents may also use complementary health approaches, particularly when conventional care does not adequately address their concerns. Shared decision-making is important in healthcare for autistic children, especially when parents also choose complementary health approaches; but little is known about shared decision-making among Latino parents of autistic children. We conducted a 12-month ethnography with 12 bicultural/bilingual Latino families of autistic children to understand their healthcare experiences (conventional and complementary health approaches) for their children, focusing on shared decision-making. Thematic analysis revealed: (1) most pediatricians were involved early in the "diagnostic odyssey" but were largely uninvolved thereafter; (2) conventional healthcare was satisfactory to the parents for physical health, but not developmental issues; and (3) parents who used complementary health approaches were more frustrated about a lack of autism information from pediatricians than those who did not. Finally, (4) we describe two exemplars of successful shared decision-making between Latino parents and pediatricians. Increasing pediatricians' autism knowledge and ability to discuss complementary health approaches may facilitate shared decision-making and reduce healthcare disparities for Latino autistic children.Lay AbstractLatino parents may choose to use complementary health approaches, such as vitamins, supplements, and special diets, for their autistic children. However, they might not tell their pediatrician about their complementary health approach use if they worry that the pediatrician will disapprove or judge them. This fear, along with pediatricians' lack of autism knowledge, creates barriers to "shared decision-making" between parents and pediatricians. Shared decision-making is a process where families and healthcare providers collaborate and exchange information in order to come to an agreement about treatment options. In our qualitative study with 12 bilingual Latino families of autistic children, we interviewed and observed families to learn about their experiences with both conventional healthcare (their pediatrician) and complementary health approaches. Our study results describe the parents' different pathways to an autism assessment, a process that is sometimes called the "diagnostic odyssey." The parents reported that conventional healthcare met their needs for their child?s physical health but not for their child?s developmental challenges. The parents who used complementary health approaches for their autistic children were more frustrated about a lack of autism information from pediatricians than those who did not use complementary health approaches. Finally, we describe two examples of successful shared decision-making between parents and pediatricians. We conclude that pediatricians who are able to talk about complementary health approaches with Latino families may help to facilitate shared decision-making and reduce healthcare disparities for Latino autistic children. En ligne : http://dx.doi.org/10.1177/13623613231163056 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=513 [article] Pediatricians' role in healthcare for Latino autistic children: Shared decision-making versus "You?ve got to do everything on your own" [Texte imprimé et/ou numérique] / Amber M ANGELL, Auteur ; Olivia J LINDLY, Auteur ; Daniella FLORÍNDEZ, Auteur ; Lucía I FLORÍNDEZ, Auteur ; Leah I STEIN DUKER, Auteur ; Katharine E ZUCKERMAN, Auteur ; Larry YIN, Auteur ; Olga SOLOMON, Auteur . - p.2407-2421. in Autism > 27-8 (November 2023) . - p.2407-2421 Mots-clés : Autism spectrum disorders  family functioning and support  health services  qualitative research Index. décimale : PER Périodiques Résumé : Despite documented healthcare disparities among Latino autistic children, little is known about how their families experience the autism "diagnostic odyssey." Pediatricians have a critical role in the "diagnostic odyssey," but when it becomes arduous, parents may also use complementary health approaches, particularly when conventional care does not adequately address their concerns. Shared decision-making is important in healthcare for autistic children, especially when parents also choose complementary health approaches; but little is known about shared decision-making among Latino parents of autistic children. We conducted a 12-month ethnography with 12 bicultural/bilingual Latino families of autistic children to understand their healthcare experiences (conventional and complementary health approaches) for their children, focusing on shared decision-making. Thematic analysis revealed: (1) most pediatricians were involved early in the "diagnostic odyssey" but were largely uninvolved thereafter; (2) conventional healthcare was satisfactory to the parents for physical health, but not developmental issues; and (3) parents who used complementary health approaches were more frustrated about a lack of autism information from pediatricians than those who did not. Finally, (4) we describe two exemplars of successful shared decision-making between Latino parents and pediatricians. Increasing pediatricians' autism knowledge and ability to discuss complementary health approaches may facilitate shared decision-making and reduce healthcare disparities for Latino autistic children.Lay AbstractLatino parents may choose to use complementary health approaches, such as vitamins, supplements, and special diets, for their autistic children. However, they might not tell their pediatrician about their complementary health approach use if they worry that the pediatrician will disapprove or judge them. This fear, along with pediatricians' lack of autism knowledge, creates barriers to "shared decision-making" between parents and pediatricians. Shared decision-making is a process where families and healthcare providers collaborate and exchange information in order to come to an agreement about treatment options. In our qualitative study with 12 bilingual Latino families of autistic children, we interviewed and observed families to learn about their experiences with both conventional healthcare (their pediatrician) and complementary health approaches. Our study results describe the parents' different pathways to an autism assessment, a process that is sometimes called the "diagnostic odyssey." The parents reported that conventional healthcare met their needs for their child?s physical health but not for their child?s developmental challenges. The parents who used complementary health approaches for their autistic children were more frustrated about a lack of autism information from pediatricians than those who did not use complementary health approaches. Finally, we describe two examples of successful shared decision-making between parents and pediatricians. We conclude that pediatricians who are able to talk about complementary health approaches with Latino families may help to facilitate shared decision-making and reduce healthcare disparities for Latino autistic children. En ligne : http://dx.doi.org/10.1177/13623613231163056 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=513

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