SkillFlix for Dental Professionals: Video-based Microskills Training to Improve Dental Professionals' Response to Problem Behaviors of Pediatric Patients with IDD

ABSTRACT Children with intellectual and developmental disabilities (IDD) display more physiological stress and anxiety as well as exhibit more problem behavior during dental exams than typically developing peers. In the United States, children with IDD are significantly more likely to need dental visits beyond preventative care and to have unmet oral health needs; this results in a greater prevalence of dental caries and periodontitis and less access to prophylactic dental care. Further, there is a scarcity of pediatric dental professionals, which is greater still for professionals explicitly trained to work with individuals with IDD and facilities that can accommodate their needs. The American Academy of Pediatric Dentistry (AAPD) has outlined several behavior management strategies for working with children, including guidelines for the use of chemical and physical restraint. Despite AAPD guidelines, pediatric dentists often lack knowledge of behavioral principles and may be more likely to use restraint in the face of problem behaviors. However, interdisciplinary teams have demonstrated the utility of behavioral interventions to decrease problem behaviors of children with IDD in dental settings. To address potential gaps in training, the proposed project will develop a series of Microskills™ training videos (i.e., 30-180 second video models) to demonstrate behavior management strategies dental professionals can use to mitigate problem behaviors of children with IDD. Skills to be addressed will include pre-appointment communication, positive reinforcement, negative reinforcement (i.e., escape), and tolerance training. This Phase I project will develop a prototype of SkillFlix for Dental Professionals: Video-based Microskills Training to Improve Dental Professionals’ Response to Problem Behavior of Pediatric Patients with Intellectual and Developmental Disabilities. Phase I will focus on establishing the SkillFlix platform for dental professionals and accessing the efficacy and acceptability of the resource for training them behavioral mitigation skills in clinical settings. Training providers to enact mitigation strategies in clinic is expected to improve outcomes at individual dental appointments as well as improve life-long access to preventative dental care in this population. Phase I development will: 1) use teams of interdisciplinary experts and guardians of children with IDD; 2) conduct formative research through focus groups, interviews, and UX research; 3) develop and refine the SkillFlix education platform; 4) develop content and complete video production for 20 Microskills videos; and 5) conduct a pilot study to assess the resource’s effectiveness in changing dental professional trainees’ use of behavioral management strategies, communication with patients and guardians, confidence, and knowledge in working with children with IDD.