5.3 Basic Behavior Guidance Techniques

Communicative Guidance

Note: Much of the information in this section was adapted, with permission, from American Academy of Pediatric Dentistry, Council on Clinical Affairs—Committee on Behavior Guidance. In press. Guideline on behavior guidance for the pediatric dental patient [revised 2006]. http://www.aapd.org/media/policies_guidelines/g_behavguide.pdf.2

Communicative guidance is used universally in dentistry with both cooperative and uncooperative children. It is the most fundamental form of behavior guidance.

Communicative guidance includes a host of communication techniques, including parental presence or absence, voice control, nonverbal communication, tell-show-do, and positive reinforcement, and distraction. Since these comprise the elements of usual and customary communication, they are appropriate for all children and have few contraindications. No specific consent or documentation is necessary.

Communicative —Guidance—Parental Presence or Absence

Description:
This technique involves using the presence or absence of the parent during oral health procedures to gain the child’s cooperation. Health professionals’ philosophies and parents’ attitudes about this issue vary widely. Children’s responses to their parents’ presence or absence vary as well. Each oral health professional must be aware of his own skills, the abilities of the particular child, and the desires and skills of the specific parent in evaluating the usefulness of this technique.

Parents can be a valuable resource in the operatory. Parameters of their involvement should be discussed ahead of time. It is important that one person serves as primary communicator with the child; otherwise mixed messages may be transmitted, and the child may become confused. Particularly for children with communication disorders, parents may be the most effective communicators.