The Autistic Patient

By  Jamie Collins, RDH

Treating those with Autism brings the question, how do we deal with the sensory and increase odds of success? Autism affects the families of 1 in 54 children in the United States,  becoming the fastest growing developmental disability. As healthcare providers we without a doubt will see an Autistic patient within our scope of practice.  Autism Spectrum Disorder (ASD) encompasses varying symptoms that may or may not be expressed with each individual and may include intellectual or developmental delays that can have an impact of everything from social, communication and self-regulation behaviors.

In dentistry we are facing not only the behavior concerns, we are also faced with sensory issues.  One of the most common traits of Autism is the strong attraction to aversion of sensory stimuli.  Lights, sounds and touch are common triggers for a person affected with Autism that can quickly lead to the end of an activity.  Additionally,  the sensory issues with touch are also taste and texture, which equates to  everything we do in dentistry that has a taste or odd texture associated with it. The sensation of vibration from handpieces can be overwhelming causing sensory overload and inhibiting dental care.  There are many ways to prepare for any special needs patient within the dental practice, including an intake interview with parents or caregivers to learn what the strength, weakness and expectations are.  Realistic goals and expectations should be manageable, and it helps to learn about the individual patient and ways to motivate the child and their abilities.  Many individuals on the Autism Spectrum have an intense interest in one or more topics and focus on, learn their interests and find a common ground for discussion. Make a connection where you can and use those interests to motivate the patient

Autism is regarded as an intellectual and developmental disorder, but rarely does it stand alone.  Commonly associated conditions may include sleep disorders, ADHD and gastrointestinal disturbances just to name a few. Medications are used to treat the symptoms of Autism and other disorders and can have drastic impact on dental health.  Paired with poor personal hygiene these medications can lead to xerostomia, periodontal concerns and increased decay rates.

Learning the habits and limitations of an Autistic patient are imperative to finding a homecare routine they are willing and able to stick with.  Special needs patients are at higher risk for adverse oral conditions, finding ways to teach how THEY learn are key!  Individuals affected by Autism have difficulty understanding abstract ideas and figures of speech, they take everything you say literally. Provide written step-by-step homecare instructions that are clear and concise, many affected by ASD have trouble remembering and sequencing thus written instructions are a must have item.  Implementing pressure and limiting stimuli can help control outbursts and increase cooperation.

Small steps can make the biggest impact on ensuring success in a dental appointment. There are many tips and tricks that I often use when treating any patient with an intellectual or developmental disability to increase the odds for success.


Contributor:

Jamie Collins, RDH is a clinical practicing hygienist in Idaho state. She has been in the dental field for nearly twenty years both as an assistant and hygienist. In addition to clinical practice Jamie is also an educator, has contributed to multiple textbooks, and curriculum development. In addition to writing textbooks she is also a frequently published international author for RDH Magazine, DentistyIQ and RDH eVillage.

View Jamie’s full bio