Table 3 Intervention techniques for managing children with ASD

Lefer et al. 2019 [27]

No control groups

çATED app showing pictures of dental examination using iPad

65.4% percentage individuals showed improved compliance during oral assessment

Time interval:

 Eight months (evaluation at two-, four-, six-, and eight-month)

Zink et al. 2018 [19]

Picture exchange communication system by flashcards with pictures of routine at dental office

A communication app consists of representative images accompanied by written and corresponding audio comments describing the phases of the dental treatment

Decrease in number of dental visits and attempts to acquire each skill between two groups (3/5) respectively

Time interval:

 Not applicable

Hidayatullah et al. 2018 [28]

No control group

(Applied Behaviour Analysis) ABA based management methods using image cards

Improvement in behavioural stages for 11 children

One child was able to complete all stages

Time interval:

 Treatment was conducted four times at one-week intervals for a month

Nilchian et al. 2017 [20]

Standard examination without any intervention

Visual pedagogy (set of colouring pictures illustrated dental examination steps)

Cooperation during fluoride therapy increased in the case group (6/1) respectively

Cooperation in the control group did not increase in most stages

Both groups presented the same findings in opening of mouth and showing the teeth, or entering the office, and sitting in the chair or examination with mirror

Time interval:

 Practices for 8 weeks

Tounsi et al. 2017 [31]

No control group

Dental desensitisation

77% of ASD children were successfully examined within 1 to 2 visits in compared to 88% by the fifth visit

12.5% could not receive dental examination

Time interval:

 Two visits only

Murshid et al. 2017 [33]

No control group

A children’s book preparing children and their parents for the first dental visit

47.5% of ASD children acted positively during the dental procedure

37.5% showed positive effect on the behaviour of children according to their parents’ evaluation

Time interval:

 6 months (evaluation at week-1 and 4 months)

Nelson et al. 2017 [30]

No control group

Progressive desensitisation with individualised reinforcements. (The child is gradually exposed to glimpses from the dental setting that cause anxiety, and rewards as positive reinforcement.)

Minimal threshold examination (MTE) was achieved for 77.4% of all children within 1 to 2 visits and 87.5% in 5 visits or less

Desensitisation was effective in achieving an MTE for most children

Time interval:

 5 dental visits

AlHumaid et al. 2016 [32]

Standard Behavioural Guidance Techniques (SBGTs) including tell-show-do (TSD), voice control (VC), nitrous oxide (NO), passive restraint, and active restraint (AR)

D-TERMINED Programme used the familiarisation process through the philosophy of repetitive tasking

D-TERMINED programme group had significantly lower referral rate compared to the SBGTs group

Frankl scale showed significant improvement in the behaviour of test group in compared to SBGTs group

52% of participants showed improvement in behaviour

Time interval:

 Mean number of dental visits: 2–6

Marion et al. 2016 [21]

No control group

Dental stories available via different media (paper, tablet computer, and computer)

Nine (64%) caregivers found the dental story useful

Two (14%) caregivers found the aid was only helpful for themselves

Time interval:

 6-month until follow-up survey was completed

Mah & Tsang, 2016 [22]

TSD (tell-show-do) only

Visual pedagogy with TSD method

Cooperation level during dental treatment increased

Completed more steps in final appointment

Decreased time required to achieve child cooperation

Lower level of behavioural distress

Time interval: 3 weeks

Cagetti et al.2015 [29]

No control group

Visual aid: Sketch of the steps of the four planned dental procedures:

(Oral examination, dental hygiene appointment, fissure sealants, and restorative procedure)

77 subjects (92.8%) overcame both stage 1 and 2

6 subjects (7.2%) refused stage 3

3 subjects (7.2%) refused stage 4

Time interval:

 1.5 months

Cermak et al. 2015 [23]

Regular dental environment (RDE) – existing practise and setting

Sensory adapted environment (SADE) applied in the dental environment in three aspects, i.e. visual, auditory, and tactile:

Visual: Shading the windows with curtains and turning off the dental chair

Auditory: playing rhythmic music lamp

Tactile (deep pressure): papoose board looks like a butterfly with its wings

Significant decrease in electrodermal activity (EDA) in SADE compared to RDE

Effect size of the SADE vs RDE (0.23ASD/0.29 non-ASD)

Time interval:

 3–4 months

Isong et al. 2014 [24]

Usual care (Group A)

Group B: A DVD video of a typically developed child having a dental appointment was used for video peer modelling

Group C: Sunglass-style eyewear was used for children to view a favourite movie during a dentist visit

Group D: Video of peer modelling plus video goggles

Between visits 1 and 2, the mean anxiety and behaviour scores decreased significantly among subjects within groups C and D compared to others

Time interval:

 6 months (evaluated baseline and at the end of the study)

Orellana et al. 2014 [25]

No control group

TEACCH-Based Approach (Treatment and Education of Autistic and related Communication-handicapped Children)

The mean number of steps achieved significantly increased in children between pre- and post-intervention

Time interval:

 4 weeks (evaluated baseline and at the end of the study)

Lowe & Lindemann, 1985 [26]

Negative reinforcements (e.g. “you won’t get lunch”), if positive reinforcements (e.g. rewards) failed

Positive reinforcements, with tell-show-do (TSD)

Using Positive reinforcements (85% ASD/ 90% Non-ASD) was successfully examined on first visit

Negative reinforcement was used among 8 ASD and 2 Non-ASD children

ASD/Non-ASD (10/18) patients underwent bitewing radiographs

Time interval: NA