The Journal of Pediatrics
Volume 154, Issue 4 , Pages 546-550, April 2009

Influence of Adapted Environment on the Anxiety of Medically Treated Children with Developmental Disability

  • Michele Shapiro, OT, MSc

      Affiliations

    • Issie Shapiro Educational Centre, Raanana, Israel
    • School of Occupational Therapy, Faculty of Medicine, Hebrew University, Hadassah, Jerusalem, Israel
    • Corresponding Author InformationReprint requests: Michele Shapiro, OT, MSc, PO Box 29, Raanana, 43100, Israel
  • ,
  • Harold D. Sgan-Cohen, DMD, MPH

      Affiliations

    • Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University, Hadassah, Jerusalem, Israel
  • ,
  • Shula Parush, OT, PhD

      Affiliations

    • School of Occupational Therapy, Faculty of Medicine, Hebrew University, Hadassah, Jerusalem, Israel
  • ,
  • Raphael N. Melmed, MD, FRCP

      Affiliations

    • Department of Medicine, Faculty of Medicine, Hebrew University, Hadassah, Jerusalem, Israel

Received 27 March 2008; received in revised form 1 August 2008; accepted 8 October 2008. published online 23 February 2009.

Objectives

To examine the influence of a sensory adapted environment (SAE) on the behavior and arousal levels of children with developmental disability in comparison with typical children, during a stress-provoking medical situation.

Study design

Sixteen children (6-11 years old) with developmental disability and 19 age-matched typical children participated in a cross-over trial measuring behavioral and psychophysiological variables, performed during a dental intervention.

Results

Both groups performed better in the SAE compared with the regular environment (RE), by comparing: the mean duration of anxious behaviors in the SAE and RE (5.26 and 13.56 minutes; P ≤ .001); the mean electrodermal activity for arousal levels, before commencement of treatment in the SAE and RE (784 and 349 Kohms; P = .002); and the mean electrodermal activity during treatment in the SAE and RE (830 and 588 Kohms; P = .001). A significant group by environment interaction was revealed, indicating that the difference in the 2 environments was greater in children with developmental disability than typical children in all 3 measures.

Conclusions

These findings indicate the importance of environment in determining the comfort level of all children. The greater difference in the 2 environments observed in children with developmental disability suggests that this group benefits more from sensory adapted environments.

Abbreviations: EDA, Electrodermal activity, NDBC, Negative dental behavior checklist, RE, Regular environment, SAE, Sensory adapted environment

 

 The authors declare no potential conflicts of interest.

PII: S0022-3476(08)00883-4

doi:10.1016/j.jpeds.2008.10.017

The Journal of Pediatrics
Volume 154, Issue 4 , Pages 546-550, April 2009