behavioral guidance Flashcards
barriers
1) PAIN!! and fear of pain
2) environmental barriers
- access to care, financial, lack of care providers in neighborhood, transportations, sibling care
3) epigenetics of anxiety
parenting styles
1) authoritative
- warm, control
2) authoritarian
- no warm, control
3) permissive
- warm, no control
4) neglectful
- neither
general characteristics
1) most prevalent in younger children, dissipate with age
2) imagination -> age
3) trust -> honesty
4) perceptions of others no dependent on appearance -> being sincere
5) act on emotions -> immediate reaction to stimuli
infant 0-15 mo
1) object permanence
- lacking
2) play
3) receptive language
4) expressive language
- babbling
5) maternal Abs go down
6) can be seen for pathology and trauma
- SDF is good
toddler 15 mo - 2 years
1) object permanence
- better
2) expressive language and receptive language
3) sensorimotor stage
4) pre-cooperative
5) learning to walk (trauma cases)
6) lap to knee-knee exams
7) SDF, SMART ,ITR (minor caries)
8) sedation or GA for major caries and oral surgery
pre-schooler 2-6 years
1) preoperational stage
2) social and language skills
3) euphemisms are super important
4) lap > chair
5) toothbrush > prophy angle
6) minimal restoration > routine + N2O
transition 6-11 years
1) concrete operational
2) routine, radiographs, tell show do
adolescence 11-18
1) heightened self awareness, peer status, priorities shift, preventive habits deteriorate
2) procedures similar to adults but may be excrious
3) sports, trauma risk
kid friendly office
1) kids area
2) toys
3) videos
4) small patient mirrors
5) euphemisms
communication with parents
1) do not ask child if they are in pain!
2) no use of fears or threats, scolding, ridiculing
AM appointments
1) minimal waiting room time
2) short appointments
3) flexible goals, back up plans
approching patient
1) evaluate the pt at eye level
2) nickname
3) talk to parent
4) separate
5) distract
communication style
1) one thing at a time
2) gender influences
3) voice modulations
4) non verbal communications
- facial expression and body language
positive reinforcement
1) praise them specifically
distraction
1) can be obvious or subtle
2) often during LA
3) story telling, singing, movie, etc.
tell show do
1) tell what will be done
2) show on finger
3) do the procedure
passive physical restraint
1) staff or parent
2) hands over patient hands or arms
3) during key points in procedure
4) papoose board: specific consent required
active restraint
1) holding hands, legs, shoulders
2) hand holding is done a lot
mouth prop
tooth pillow
1) molt mouth prop or the bite block (not used a lot)
injections
1) topical
2) inject slowly
3) distract
nitrous oxide
1) cooperative ability
2) no eating pre op
- nausea
3) silly gas, space gas
conscious sedation and general anesthesia
1) usually in patients with disability or pre-cooperative
behavior rating and documentation
1) document
