Chapter 4: Psychological Features And Behavior Managment Flashcards
Common features in children:
- individuality
- fear of abandonment
- awareness of time/concept of time
- fear of the unknown
Children younger than 2-3, parents should?
Stay in the room
Up until what age are children not aware of time?
Younger than 4 years old
Behavior management is necessary to?
Gain confidence of the child
Factors affecting the child behavior?
- family’s attitude
- IQ and age
- previous experiences
- presence of parents in the dental office during treatment
- time and extension of the visit
How do we achieve effective treatments?
We don’t change an expected treatment to the detriment of health, based on the child’s behaviour
Ex: make an extraction instead of a pulpotomy due to bad behavior
how do we achieve efficient treatments?
To do the correct treatment in the shortest possible time
What does a positive attitude towards dental treatments mean?
The child wants to come back
Control behavior techniques include?
- communication techniques
- behavior modification techniques
- movement restriction techniques
- prohibited techniques
- other techniques
What is the key to direct behavior and to creat a trusting relationship with the patient?
Communication
Communication can be?
Verbal or nonverbal
Communication techniques include:
- paediatric language
- play therapy
- control of voice
- tell-show-do
Paediatric language:
- speak at the level of the child’s age without underestimating their intelligence
- never lie
- dont prepare the child TOO much
- encourage their imagination and make comparisons
- avoid silence
- few instructions at a time
- dont allow them to delay treatment
- avoid words that inspire fear
Control of voice: the authoritarian attitude aims to
Reestablish communication that has been lost
We achieve that with a sudden change of tone accompanied by a facial expression, and once we recover their attention, they’ll be praised
What is the basic method in the educational phase of the paediatric patient, and also in any teaching technique? and what does it serve
Tell-show-do
Serves to familiarise the patient with the clinical environment, should be done without any interruptions and caring language, say and do immediately
Behavior modification technique: objective?
To transform inappropriate behavior into an appropriate one
Behavior modification techniques: types?
- reinforcement
- desensitisation
- imitation
RID
Reinforcement: based on?
Pavlov’s laws: a rewarded behavior tends to appear frequently and a punished behavior tends to disappear
Reinforcement: we only apply what kind of reinforcement?
Positive
We dont use negative reinforcement (punishments)
Reinforcement: how do we deal with inappropriate behavior?
Ignore it
Ex: if the patient vomits, we clean it and continue
Reinforcements have to be?
Consistent and contingent
Consistent: given if they behave well and not given if wrong
Contingent: given immediately
Reinforcement: types? And which one works best?
- social (works best): praise, smiles
- material
- activities
Desensitisation is?
- a classical technique used by psychologist and psychiatrists
- based on reducing anxiety by relaxation and doing everything systematically
- systematically we establish a scale of difficulty of what causes anxiety and we’ll change it gradually, enter clinic-exploration-prophylaxis
- each sequence of treatment should be individualised to each patient
Movement restriction techniques: objectives?
• To protect him/her against possible injuries (prevent the child movements during anaesthesia).
• To make the treatment easier.
• To recover the child’s attention (hold the hand when distracted).
• To teach the behavior expected from him (ex: put his hand here).
• To give him/her more confidence through body contact.
• They should always be associated to behavior modification techniques and their application in
some cases is controversial.
