Page 42 - FINAL COMPENDIUM 2020-2021 27.2.2022

PARENTAL BARRIERS IN PROVIDING ORAL HEALTHCARE FOR CHILDREN WITH AUTISM
SPECTRUM DISORDER

‘Ainun Mardhiah MAH, Norintan AM, Maryani MR
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is
characterised by persistent impairments of the social and interaction function with
restrictive, repetitive behaviour. Some co-morbidities namely behavioural and sensory
impairments, learning disabilities, affected cognitive function and emotional and
psychological impairments are sometimes observed. Provision of oral health care to
children with ASD was reported to be difficult, both at home and in the clinic settings due
to the aforementioned impairments. Issues related to dental treatment cost, availability
of and accessibility to oral health care, and personnel-related factors were among the
barriers in providing oral health care reported by parents of children with ASD. Objectives:
This study assessed 1) parental level of oral health knowledge (OHK) and their attitudes
towards oral health (OHA), and 2) parental perceived barriers in providing oral healthcare
(OHC) for their children with ASD, in terms of the contributing and facilitating factors, and
their recommendations to improve the perceived barriers. Materials and methods: This
was a cross-sectional study using both quantitative and qualitative methods to address
different study objectives. Parents’ OHK and OHA levels were assessed using self–
administered questionnaires, developed based on literature reviews. It was distributed to
150 parents of children with ASD (obtained by convenient sampling method), attending
three Autism Rehabilitation Centres (ARCs) in the Kuala Lumpur and Selangor. Three Focus
Group Discussion (FGD) sessions were conducted to address the second objective.
Quantitative study data were analysed using Statistical Package for Social Sciences (SPSS)
ver.20.0 whereas the qualitative data were analysed using thematic analysis. Results: The
response rates for the quantitative and qualitative part were 93.3% and 70.0%,
respectively. Majority of the parents had poor OHK level (61.9%) and negative OHA
(71.1%). The overall mean score for OHK and OHA were 7.03 ±1.91 and 7.63±1.38
respectively. Parents aged more than 40 years old had higher OHK mean score compared
to their counterpart (7.5± 2.4; p=0.006). Six main recurring themes were observed in
responses related to the factors contributing to barriers in providing OHC for children
with ASD, namely 1) children’s behavioural and sensory impairments, 2) factors related to
time in obtaining OHC and 3) accessibility to oral healthcare providers who are both
knowledgeable and skilful, 4) perceived lack of priority on providing OHC to ASD children
The facilitating factors perceived by parents were the availability of autism-friendly
dentist and having support from families, friends and other people. Parents
recommended on the need to increase the availability of autism-friendly dental clinics,
and training and education of doctors and dentists.

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