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 Table of Contents  
LETTER TO EDITOR
Year : 2015  |  Volume : 4  |  Issue : 2  |  Page : 119-121

Innovations in managing children with special health care needs


Department of Pedodontics and Preventive Dentistry, Dr. Syamala Reddy Dental College Hospital and Research Centre, Bangalore, Karnataka, India

Date of Web Publication10-Apr-2015

Correspondence Address:
Tulika Wakhloo
Department of Pedodontics and Preventive Dentistry, Dr. Syamala Reddy Dental College Hospital and Research Centre, #111/1, SGR College Main Road, Munnekolala, Marathahalli, Bangalore - 560 037, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.153635

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How to cite this article:
Wakhloo T, Aradhya K. Innovations in managing children with special health care needs. Int J Health Allied Sci 2015;4:119-21

How to cite this URL:
Wakhloo T, Aradhya K. Innovations in managing children with special health care needs. Int J Health Allied Sci [serial online] 2015 [cited 2022 Jun 30];4:119-21. Available from: https://www.ijhas.in/text.asp?2015/4/2/119/153635

Sir,

The American Academy of Pediatric Dentistry (AAPD) defines special healthcare needs as "any physical, developmental, mental, sensory, behavioral, cognitive, or emotional impairment or limiting condition that requires medical management, healthcare intervention, and/or use of specialized services or programs. The condition may be congenital, developmental, or acquired through disease, trauma, or environmental cause; and may impose limitations in performing daily self-maintenance activities or substantial limitations in a major life activity. Healthcare for individuals with special needs requires specialized knowledge acquired by additional training, as well as increased awareness and attention, adaptation, and accommodative measures beyond what are considered routine." [1]

Technological advances which have proven to improve skills in special children can be integrated by the pediatric dentists in their clinical practice for successfully instituting dental treatment in this group of patients. Computer and video technologies have been used to bring efficiency in managing children with special healthcare needs. Computers motivate children with autism due to their predictability and consistency as compared to unpredictable nature of human responses. [2] The computer places the child in control and enhances his/her independent functioning skills. [2] Furthermore, smartphones and tablets are making their way into day-to-day clinical practice because of the many advantages that these tools offer.

Adaptive hardware

In order to access the computer, children with special healthcare needs require the following devices to be adapted with the standard computers. [2]

Touchscreen tablets

It allows the child to navigate and interact with the computer by touching the screen rather than operating the mouse.

Trackballs

It allows the child to move the mouse around the screen by rolling a stationary ball around his fingertips or hands.

Intellikeys USB

It consists of an alternate keyboard connected to the computer. Unlike standard keyboards with a fixed set of keys, the configuration of Intellikeys can be changed by sliding different overlays into the touch sensitive area. It is available from Intellitools.

Big keys plus

It is an alternative keyboard with larger 1 inch square keys and color-coded alphabets on a standard sized keyboard. It is an exclusive trademark of Greystone Digital Inc.

Behavior management

Behavior guidance of the child with special healthcare needs can be challenging. Children with disabilities may exhibit resistant behaviors due to their anxiety and lack of understanding of dental care. [1]

Video modeling

It is an excellent tool to teach numerous skills to special children. Children enjoy repetitive viewing of videos due to the predictability of the given information. It includes self-help skills such as brushing teeth and washing hands, language comprehension and expression, and directions to complete various routines. Also, it can be used to demonstrate how to appropriately engage in social situations. [2],[3]

Google sketch up

It is three-dimensional (3D) software created by Google called Sketch Up. It can be used by the dentist for anxiety management by designing virtual environments for children to show what to expect before they encounter the real situation. [4] In addition, the easy to use iPad version at an affordable price has become the most recommended assistive communication device. In the iPad application store, numerous applications are available for children with special needs. Sounding Board is one such application. It is an iPad/iPhone touch application where children with communication disorders can use the symbols to create their message. It is available for download at itunes store.

Assistive technology

Assistive technology means any item; piece of equipment; or product system whether acquired commercially, off-the-shelf, modified, or customized which is used to increase, maintain, or improve functional capabilities of individuals with disabilities. [2] Eye gaze communication system is a form of augmentative communication that has been developed for compensating impairments and disabilities of the nonspeaking individuals. It enables individuals with complex physical disabilities to control the computer through the use of eyes. Pediatric dental patients who benefit from augmentative communication systems include those with cerebral palsy, multihandicaps, severe mental retardation, and autism. American Sign Language Application for the iPhone enables the dentist to convert words to sign language vocabulary. Computer-Assisted Real Time Transcription (CART) is a service in which speech is recorded for display in a typed format which children can read on screen. It can be used for communicating with the deaf child patient during treatment and for providing postoperative instructions.

Empowering parents

Asperger Strength Audio Program: Asperger syndrome is an autism spectrum disorder (ASD). This audio program is equivalent to a 2-day workshop and contains eight CD plus CD-ROM with written outline for parents and covers information on strategies for behavior management, depression, and anxiety in children suffering from this syndrome. [5]

Rethink.com

It is an award winning model which includes individual assessment program, tracking tools that can be accessed through mobile devices, comprehensive video-based curriculum for parents, and trained clinicians available to provide support via phone, video conferencing, and online chat. [6]

Consultants

It is a behavior-based training program for parents and provides skills necessary to be their child's home-based therapist. [7]

Eden autism services

It is an online discussion forum providing free monthly webinars and live chats.

Innovations in preventive care

Considering the high incidence of oral defensiveness, large amount of plaque accumulation is found in children with ASDs. The risk of developing oral disease is therefore increased when children resist daily oral hygiene as well as professional oral care procedures. Also, individuals with special healthcare needs may be at increased risk for oral diseases which further jeopardize the patient's health. [8]

Disability Learning Tool-Brushing teeth with music!! The system shows a positive result in increasing the independence among autistic children. The collaboration of 3D animation and music therapy significantly helps the autistic children to remember the steps of brushing teeth. [9]

DenTrust three-sided toothbrush for autism and special needs: DenTrust is an advanced three-sided design toothbrush which completely surrounds teeth to assure maximum coverage per brushing stroke. Its ultralon bristles are automatically positioned at the recommended 45-degree angle to reach-in and effectively clean the gum line even in the most difficult to reach areas. [10]


  Conclusion Top


There is an increasing need to develop and integrate interventions that are specifically designed for children with special healthcare needs. However, meaningful intervention outcomes are obtainable only when interventions are built on the child's individual strengths and interests. This paper highlights the technological advances which can be effectively used to deliver comprehensive preventive and therapeutic dental care to this special population of children.

 
  References Top

1.
American Academy of Pediatric Dentistry. Guidelines on management of dental patients with special health care needs. Reference Manual 2014;35:157-62.  Back to cited text no. 1
    
2.
Stokes S (Cooperative Educational Service Agency #7, Department of Special Education). Autism: Interventions and Strategies for success. Wisconsin Department of Public Instruction through IDEA Discretionary Grant no: 2000-9907-21; 2001.  Back to cited text no. 2
    
3.
Lookatmenow.org [Internet]. Look At Me Now!; c 2014. Available from: http://www.lookatmenow.org [Last updated on 2014 Nov 9; Last cited on 2014 Nov 10].  Back to cited text no. 3
    
4.
Sketchup.com [Internet]. Trimble Navigation Limited.; c 2013. Available from: http://www.sketchup.com [Last updated on 2014 Nov 5; Last cited on 2014 Nov 10].  Back to cited text no. 4
    
5.
Aspergerstrength.com [Internet]. On Point Press.; c 2014. Available from: http://www.aspergerstrength.com [Last cited on 2014 Nov 10].  Back to cited text no. 5
    
6.
Rethinkfirst.com [Internet]. New York: Inc 500.; c 2008- 13. Available from: http://www.rethinkfirst.com [Last updated on 2013 Oct 21; Last cited on 2014 Nov 10].  Back to cited text no. 6
    
7.
H3consultants.com [Internet]. Virtual Behavior Family, BEARS Inc.; c 2014. Available from: http://www.h3consultants.com [Last cited on 2014 Nov 10].  Back to cited text no. 7
    
8.
DeMattei R, Cuvo A, Maurizio S. Oral assessment of children with an autism spectrum disorder. J Dent Hyg 2007;81:65.  Back to cited text no. 8
    
9.
Othman A, Kamarudin F. Disability Learning Tool: Brushing - teeth using music for Autism. Proceedings of EDULEARN 11 Conference; 2011 July 4 - 6; Barcelona, Spain.  Back to cited text no. 9
    
10.
Dentrust.com [Internet]. USA: Dentrust for Autism and Special Needs. Ntt America Inc.; Available from: http://www.dentrust.com [Last updated on 2014 Jan 29; cited 2014 Nov 10].  Back to cited text no. 10
    




 

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