Behaviour Management in Children Flashcards
What is anxiety?
vague unpleasant feeling
premonition of undesirable event
What is fear?
strong reaction to a specific event
What is a phobia?
intense disproportional fear
Anxiety manifests itself as …
behaviour
What are the causes of dental anxiety?
- previous dental experience
- parental influence
- peer influence
- previous medical experience (white labcoat syndrome)
- personality trait
- awareness of a dental problem
List the dental anxiety scales available
- modified child dental anxiety scale (MCDAS)
- Corahs modified dental anxiety scale
- Venhams Picture Test
- Childrens Dental Fear Survey Schedule (CFSS)- Dental subscale
What ways can we help anxious children?
- prevent anxiety from developing
- trustworthy
- listen to worries and concerns
- local anaesthetic - treatment should be more comfortable
- topical anaesthetic vs stab and squirt
- time and patience
How should topical anaesthesia be applied?
- dry mucosa
- leave for 2-3 minutes, give it time to work
What are the effects of child patient anxiety?
- parent avoids dental visits- cancellations/FTA
- clinicians becoming stressed
Childrens behaviour is classfied by the degree of cooperation. What are the classes of childrens behaviour?
- co-operative
- potentially co-operative
- pre co-operative- too young to cooperate
- lacking co-operative ability (specific disability affecting ability to co-operae)
What are the aims of behaviour management methods ?
- improve communication process
- eliminate inappropriate behaviours
- reduce anxiety
List behaviour manangement techniques available
- prepatory information
- non-verbal communication
- communication with patient
- moedelling
- tell-show- do
- giving patient control signals
- behaviour modelling and positive reinforcement
- distraction
- negative reinforcement
- behaviour contracts
- cooling-off period- externalisation
- systemic desensitisation
What are the principles of verbal communication
- be understandable
- questioning
- listening
- reassure
- praise
- humour
What are the principles of non-verbal behaviour?
- body language
- proximity-personal space
- eye contact
- reinforcers
- level and posture
- empathy
For non-verbal communication, the message can be conveyed by the _____ as much as the people
environment
surgery surroundings
How can you get the child settled in the chair?
- gain assistance from the child
- consider more upright position
- help patient back to head rest
- behaviour direction
- there is an option to remove the head rest on the chair so that you are closer to the child patient
- always warn patient before you move the chair
Give examples of behaviour directions that can be given
- sitting still
- hand position- “hands on your lap”
What can you adopt when verbally communicating to children?
“childrenese”
the language of children
In voice control, a variation in _____, _____ or _____ can be used to influence and direct childs behaviour
tone, pace or volume
What voice control technique can you implement to reinforce/recognise good behaviour?
bright and airy
What voice control technique can you implement to calm anxiety ?
even and low
What voice control technique can you use to indicate poor behaviour to a child?
low and quiet
What must you do if you intent to use voice control techniques on a child?
MUST inform their parents
What are the types of modelling techniques?
- live
- symbolic
What is live modelling?
non fearful (reliable) child successfully receiving treatment
demonstrates behaviours you want to see in a child
e.g. sibling
What is symbolic modelling?
use of videos or cartoons to demonstrate behaviours you want to see in a child
When does modelling work best?
- same sex child
- similar age (5-7) year olds
similar procedures
What does the tell-show-do procedure involve? Give an example
- explain procdedure in child friendly (appropriate) language
- demonstrate procedure
- treat the child patient
e.g. 3 in 1- polising/drilling, fissure sealants
What techniques can you employ with enhancing control ?
- stop signal
- countdown - agree with patient how long you will operate without stopping
What is behaviour shaping?
this is influencing behaviour toward the ideal by planned introduction to procedures
move through the stages at the child’s pace
What is positive reinforcement?
strengthening of a pattern of behaviour which increases the probability of that behaviour being displayed in the future
more than reassurance
PRAISE
Give factors to consider for positive reinforcement
- praising specific behaviour e.g. sitting still
- the timing of the praise
- do not use rewards as bribes
- social stimuli can be used e.g. facial expression, approval
- don’t praise disruptive behaviours
What is the purpose of using distractions?
- using distracting stimulus to divert attention away from disruptove behaviours and potentially unpleasant sensory stimuli
Give examples of distractors
- cartoon
- audiotapes
- TV
- virtual reality
- stories
- lip holding
- leg raising (be careful as head can move)
- talking whilst carrying out procedure
What is negative reinforcement?
strengthening of a pattern of behaviour by the removal of a stimulus which the individual perceives as unpleasant as soon as the required behaviour is exhibited
What is punishment?
application of an unpleasant stimulus to inappropriate behaviour
What does externalisation involve?
- change of environment
- cooling-off period
What is systemic desensitisation?
- teaching child to relax
- procedure broken down in progressive stages
- child given control
Give an example of systemic desensitisation
With LA syringe
* outside mouth with cap on
* inside mouth with cap on
* inside mouth with cap off
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