Effectiveness of a tooth-brushing programme using the picture exchange communication system (PECS) on gingival health of children with autism spectrum disorders
The Picture Exchange Communication System (PECS) is a communication system for children with autism spectrum disorders (ASD). The aim of this study was to assess the effect of a PECS-based tooth-brushing programme on gingival health in children with ASD and assess parents’ perception of PECS.
This was a prospective interventional study. Using PECS as a pictures/cards series showing a structured tooth-brushing method, 37 children with ASD (31 males, 6 females) (average age 9.49 ± 4.10, 4–16 years) and their parents/caregivers were trained on tooth-brushing twice, 2 weeks apart. Data collected after examinations (baseline, 3, 6-months) included gingival and plaque indices (GI, PI) and two questionnaires (baseline, 6-months) for demographic data and parents’ perception of PECS including difficulty rating (easy, hard, very hard) and PECS usefulness.
Most children with ASD had language abilities (64.9%) and prior PECS use (67.6%). Both GI and PI significantly dropped between baseline and both re-evaluations, (P < 0.001). Age, among studied factors, significantly affected PI only at all stages (P < 0.001). Most parents/caregivers (75.7%) rated PECS as hard, but useful (100%). Age and PECS prior use significantly affected PECS difficulty rating (P = 0.000 and 0.031, respectively), while sex did not (P > 0.05).
PECS though rated as hard was useful in improving gingival health in children with ASD.
KeywordsAutism spectrum disorder Picture exchange communication system (PECS) Tooth-brushing programme Gingival index Plaque index
This work was supported by the Deanship of Research, at Jordan University of Science and Technology, Irbid 22110, Jordan (Grant # 20110011).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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