11-year-old Panos loves to smile and sing — but getting him to show his teeth to a dentist hasn’t always been easy. When he visited a dentist near his home for his first cleaning, the experience was a tough one. “He was overwhelmed by the new environment and refused to open his mouth,” explains his mother, Alexia. “He wouldn’t even sit in the dentist chair.”
Panos has autism spectrum disorder (ASD) and has sensory challenges in new environments and medical settings, a common experience for children with ASD. “We tried everything we thought of to distract Panos during his cleaning, but it was still a challenge — we knew we needed to keep looking for a better fit,” shares Alexia.
Another dentist believed that Panos would need to be given anesthesia when they noticed cavities were forming, however Alexia wasn’t comfortable with this approach and decided to reach out to Boston Children’s Department of Dentistry for a second opinion.
Panos — who also has epilepsy — has been a patient in other Boston Children’s programs for years, so Alexia was comfortable reaching out to the dentistry team for their input. She was relieved to learn that Panos had other options: “The team at Boston Children’s immediately suggested an alternative approach,” she says.
Enter Child Life — and Steve Harvey
Alexia and Panos already knew child life specialist Emily Langello in the Autism Spectrum Center when they would go to the hospital for other appointments, so they were excited when they learned they would be helping Panos with his upcoming dentist appointment.
Child life specialists help to normalize the hospital experience by using distraction techniques and play that are tailored to each child’s interests and unique needs. For Panos, hearing a studio audience cheering — specifically, on the game show Family Feud, hosted by Steve Harvey — helps comfort and motivate him. “Panos just loves him,” Alexia shares.
Social narratives, which are picture books that use simple language, are often helpful for patients who have ASD and other related conditions to prepare for a new experience. Child Life Services has a selection of pre-made social narratives available called “My Hospital Story”. Using these narratives, patients can prepare for different hospital procedures or visits. However, if the pre-made social narratives aren’t doing the trick, child life specialists will learn a patient’s special interest and create a personalized story for the child to follow — like Panos with Steve Harvey.
Child life specialist Theresa McCarthy explains, “Many children with ASD have special interests that comfort them. Whether it’s SpongeBob SquarePants or a character from Paw Patrol, we learn what that interest is, and we incorporate it into the intervention to provide familiarity to the patient.”
Survey says, “clean teeth!”
Ahead of Panos’ teeth-cleaning appointment, Langello brought Steve Harvey’s cutout to the Department of Dentistry and took photos of the cutout at each step of the patient journey. A personalized story was created and sent to the family prior to help Panos become familiar with the new environment and expectations.
On the day of the appointment Panos was a little anxious at first, but when he saw the Steve Harvey cutout, he felt confident and relaxed. “Steve” joined Panos at each step of the appointment, going first so that Panos could watch what the dentist was doing. When it was his turn with the dentist, he was receptive and calm. Alexia was relieved that he was able to finally have a proper dental check-up for the first time in his life, and the dentist said that he didn’t have any cavities — so no anesthesia needed!
Once the appointment ended, McCarthy and the dental team allowed Panos to explore the exam room so he would feel even more prepared for future visits. He felt comfortable enough to sit in the dentist’s chair and even pretended to clean Steve Harvey’s teeth. “Seeing Panos use role reversal medical play to process his experience was really just an incredible way to end the appointment,” shares McCarthy. By the end of the visit, Panos had clean teeth and was even telling his mom that he didn’t want to leave.
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