Effect of PECS in Improving Oral Hygiene Status Among Preschool Chidren

Background: Oral health is an important part of overall health of the children and precisely it is additionally imperative for children who need out of the ordinary or special health care. Children with autism spectrum disorder normally face trouble in maintenance of good oral hygiene due to their incapacity to communicate and interact socially and are one such group lacking sufficient oral health knowledge to sustain their oral health owing to communication barriers. Objective: To assess and compare the effect of Picture Exchange Communication System (PECS) intervention on oral hygiene status of preschool children (aged 4 to 6 years old) with Autism Spectrum Disorder (ASD) over a period of three months. Methods: Children with confirmed diagnosis of autism will be randomly divided into two groups. All the participants of both the groups, intervention (Group I) and control (Group II) will receive conventional oral hygiene instructions in presence of their parents. These instructions will be given on model, showing each surface to be cleaned properly. Tooth brushing with the Horizontal Scrub Technique will be promoted and performance of brushing twice daily for 2 minutes. Moreover, instruction to avoid sugary diet will also be given. Additionally, the intervention participants (Group I) will be provided a set of 10 picture cards depicting brushing sequences and techniques by animated character for PECS intervention. The plaque scores will be recorded in the two groups by using PI index by Silness \& Loe (1964), GI scores will also be recorded by using GI index Loe \& Silness (1963) using a periodontal probe at baseline. Following the initial examination, oral health education will be given on model to both groups, in addition to this (Group I) will be demonstrated to use PECS intervention. After three months follow up visit will be conducted in which plaque and gingival scores will be recorded again in both groups to assess the impact of PECS intervention on oral