Original articleInfluence of Adapted Environment on the Anxiety of Medically Treated Children with Developmental Disability
Section snippets
Patients
Estimation of sample size was based on published data that used a design similar to ours.18, 19, 20 Accordingly, a required sample size of 32 was calculated, including 16 children with developmental disability and 16 typical children. To ensure that this study was adequately powered and to reduce the risk of type II error, the number of children was increased beyond the suggested number to 40 (20 children for each group). However, only 19 children with developmental disability could be
Measures
The Negative Dental Behaviors Checklist (NDBC) was developed by the research team. Content inter-rater reliability was determined after training 2 independent coders (not researchers participating in this study) and yielded a standardized alpha value of 0.93. The NDBC contains 7 behavioral descriptors: movements of head, forehead, eyes, and mouth, coughing/gagging, crying/screaming, and other. All behaviors were recorded with videotape. Duration of negative behaviors in minutes was measured by
Results
In all analyses, the treatment sequence effect (time 1 versus time 2) was found not to be significant. Therfore we deduced that there was no cross-over effect and the independent treatment environment effect could be independently examined.
Discussion
This study confirms that the SAE creates a significant calming effect for both children with developmental disability and typical children undergoing a high anxiety procedure. In interviews with parents, it was clear that 63% of children with developmental disability exhibit more than average general anxiety, as compared with 38% of the typical children. Although both groups of children were significantly more relaxed during dental care in the SAE, the results of this research indicate that
References (30)
- et al.
The use of topical anaesthesia at children's minor lacerations: an experimental study
Accid Emerg Nurs
(2004) - et al.
Power and sample size calculations: a review and computer program
Control Clin Trials
(1990) - et al.
Power and sample size calculations for studies involving linear regression
Control Clin Trials
(1998) - et al.
Midazolam nasal spray reduces procedural anxiety in children
Pediatrics
(2000) Neurological examination of difficult and poorly cooperative children
J Child Neurol
(2007)- et al.
Needle phobia and stress-reducing medical devices in pediatric and adult chemotherapy patients
J Pediatr Oncol Nurs
(2007) - et al.
Clown doctors as a treatment for preoperative anxiety in children: a randomized, prospective study
Pediatrics
(2005) - et al.
Hypnosis reduces distress and duration of an invasive medical procedure for children
Pediatrics
(2005) International classification of functioning, disability and health (ICF)
(2001)Participation in the occupations of every day life
Am J Occup Ther
(2002)
The ecology of human performance: a framework for considering the effect of context
Am J Occup Ther
The environment: a focus for occupational therapy
Can J Occup Ther
Application of the Person-Environment-Occupation Model: a practical tool
Can J Occup Ther
Behavioral and physiological effect of dental environment sensory adaptation on children's dental anxiety
Eur J Oral Sci
Evaluating Snoezelen for relaxation within chronic pain management
Br J Nurs
Cited by (41)
Adolescent Dental Fear and Anxiety: Background, Assessment, and Nonpharmacologic Behavior Guidance
2021, Dental Clinics of North AmericaCitation Excerpt :It is important to ask about adolescents’ strengths, not just their disabilities.130 Further, it is important to inquire about sensory sensitivities at the initial interview, and interventions such as dimmed lighting, rhythmic music, and slow-moving visuals can provide a more pleasing environment.131 Every adolescent is a unique individual and communication should use person-first language.
Dental anxiety: An understudied problem in youth
2017, Clinical Psychology ReviewDifferences in autonomic functions as related to induced stress between children with and without cerebral palsy while performing a virtual meal-making task
2016, Research in Developmental DisabilitiesCitation Excerpt :Environmental stimuli including emotionally loaded stimuli, also referred to as affective stimuli, may capture and divert attention regardless of their relevance to ongoing tasks (Dolcos & McCarthy, 2006), affecting children's cognitive control processes (Tottenham et al., 2011; Schell & Crone, 2013) and eliciting a range of subjective and autonomic responses (McManis et al., 2001; Shapiro, Sgan Cohen, Parush, & Melmed, 2009; Sharp et al., 2006). Shapiro et al. (2009), for example, demonstrated the significant value of a sensory adapted environment that included special lighting effects, relaxing music, vibrations, and aromas on the comfort level of children with and without developmental disabilities undergoing dental treatment as measured via electrodermal activity. They found that among the children with developmental delays the calming effect was more pronounced compared to typically developing children.
Evaluating a virtual reality sensory room for adults with disabilities
2023, Scientific ReportsAnxiety during the dental care of children aged 4 to 6 years over three consecutive visits
2023, Journal of Clinical Pediatric Dentistry
The authors declare no potential conflicts of interest.