Product Description:
Purpose: The purpose of this case study was to evaluate the feasibility and effectiveness of using brief scheduled breaks to reduce the distress of a disruptive child undergoing restorative dental treatment.
Method: A 6 year old female who showed clinically significant disruptive behavior was selected. Using an interrupted time-series experimental design, repeated direct observations were collected during 4 scheduled appointments. The first and third appointments served as control conditions where dental treatment was completed as usual. The second and fourth appointments served as experimental conditions where brief breaks were delivered on schedule. The clinician wore a device that signaled when (i.e., every 25, 40 or 55 seconds) to take a break. The clinician could flexibly lengthen time between breaks at his discretion.
Results: During control conditions the child was disruptive, on average, about 37% of time, while in the experimental conditions, using scheduled breaks, she was disruptive about 23% of the time. In addition, during control injections, disruptive behavior occurred from 70-100% of the time and required that treatment be terminated to manage behavior, while during experimental injections, disruptive behavior occurred only 40-50% of the time.
Conclusions: The differences between control and experimental conditions, especially during injections, represent clinically significant differences in disruptive behavior exhibited by this child. The dentist was able to achieve these differences using a flexible schedule of brief breaks. This approach may help expand the behavioral approaches available for managing distressed children. A large randomized, controlled, trial using a between-subjects design is in progress.
