THE USE OF A MOBILE APPLICATION TO IMPROVE THE ORAL HEALTH OF CHILDREN WITH AUTIS
Abstract
Introduction: Individuals with autism spectrum disorder (ASD) often encounter significant challenges when visiting a dentist. Mobile supportive technologies have shown promise as effective assisting tools in promoting oral health-related tasks. This study aimed, in its first stage, to investigate the availability of oral health mobile applications in the Serbian language and Cyrillic script. In the second stage, our goal was to evaluate the effectiveness of an application designed specifically for dentist visits, developed in the Serbian language and using the Cyrillic alphabet.
Method: The cross-sectional study was conducted from November 2021 to February 2022 at the Clinic for Pediatric and Preventive Dentistry at the School of Dental Medicine in Belgrade, Republic of Serbia. The initial stage involved conducting a search of online apps, both in Serbian and English, using specific keywords: "mobile applications," "autism," "dentistry," and "oral health." In the subsequent stage, a sample of 10 families of children with ASD utilized a mobile app in Serbian and using Cyrillic script specifically developed for their dental visits. Progress in cooperation with the dentist among users of this application was assessed using a structured observation protocol based on the TEACCH method.
Results: The content analysis of mobile apps reveals that out of the total number of applications, 64 (70.3%) were deemed functional. More than half of these applications (59.4%) were designed to address developmental, learning, and speech difficulties. In terms of language, only one application aimed at supporting development, learning, and speech was available in Serbian, while three apps were in Croatian, utilizing the Latin script. However, among these mobile apps, only one application was identified for oral health, and it was in English. This indicates a clear need for the development of oral health apps in Serbian. A pilot test suggested that the tested mobile app effectively supports children with ASD in their visits to the dentist.
Conclusion: The research suggests that mobile apps supporting children with ASD during dentist visits are a promising tool. Therefore, efforts should be made to develop and test these types of mobile apps in the Serbian language.
References
Đorđević M, Glumbić N. Application of peer strategy in working with children with autistic spectrum disorders in inclusive school context. Belgrade School of Special Education and Rehabilitation. 2015;21(1):39–52.
Smiljkić Z, Jeremić M, Vuković A, Perić T, Glumbić N, Marković D. Dental treatment in children with autism [article in Serbian]. Stomatolog. 2018;24(2):17–24.
Stein LI, Lane CJ, Williams ME, Dawson ME, Polido JC, Cermak SA. Physiological and behavioral stress and anxiety in children with autism spectrum disorders during routine oral care. Biomed Res Int. 2014;2014:694876.
Jeremić M, Ćirić P, Marković D, Vuković A. Children with special needs in the dental office. Zdravstvena zastita. 2020;49(4):53–66.
Stathopoulou A, Loukeris D, Karabatzaki Z, Politi E, Salapata Y, Drigas A. Evaluation of Mobile Apps Effectiveness in Children with Autism Social Training via Digital Social Stories. iJIM. 2020;14(03):4.
Orellana LM, Martínez-Sanchis S, Silvestre FJ. Training adults and children with an autism spectrum disorder to be compliant with a clinical dental assessment using a TEACCH-based approach. J Autism Dev Disord. 2014;44(4):776–85.
Chhabra N, Chhabra A, Walia G. Prevalence of dental anxiety and fear among five to ten year old children: a behaviour based cross sectional study. Minerva Stomatol. 2012;61(3):83–9.
Walter H, DeMaso D. Disruptive, impulse-control, and conduct disorders. In: Kliegman R, St. Geme J, Blum N, Shah S, Tasker R, Wilson K, editors. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020.
Mandell DS, Novak MM, Zubritsky CD. Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics. 2005;116(6):1480–6.
Fernell E, Eriksson MA, Gillberg C. Early diagnosis of autism and impact on prognosis: a narrative review. Clin Epidemiol. 2013;5:33–43.
Cunningham A, McPolin O, Fallis R, Coyle C, Best P, McKenna G. A systematic review of the use of virtual reality or dental smartphone applications as interventions for management of paediatric dental anxiety. BMC Oral Health. 2021;21(1):244.
Böhnlein J, Altegoer L, Muck NK, Roesmann K, Redlich R, Dannlowski U, et al. Factors influencing the success of exposure therapy for specific phobia: A systematic review. Neurosci Biobehav Rev. 2020;108:796–820.
Benito KG, Walther M. Therapeutic Process During Exposure: Habituation Model. J Obsessive Compuls Relat Disord. 2015;6:147–57.
Slater M. Immersion and the illusion of presence in virtual reality. Br J Psychol. 2018;109(3):431–3.
Botella C, Fernández-Álvarez J, Guillén V, García-Palacios A, Baños R. Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review. Curr Psychiatry Rep. 2017;19(7):42.
Campbell C, Hosey MT, McHugh S. Facilitating coping behavior in children prior to dental general anesthesia: a randomized controlled trial. Paediatr Anaesth. 2005;15(10):831–8.