Acceptability Of Methods Of Behaviour Control For Dentally Anxious Children

Objectives: To determine the perceived acceptability of three specific techniques of behaviour control for dentally anxious children Methods: A series of case vignettes were devised describing the treatment of a 13 year old child who was dentally anxious. The vignettes varied systematically on three variables: the intervention used to control the child's behaviour (Hand Over Mouth technique vs. the Papoose Board vs behaviour management using rewards); the outcome of treatment (good outcome vs. poor outcome); the child's level of intellectual functioning (average IQ vs. mild mental retardation). The vignettes were rated by 348 respondents using a standardised measure of treatment acceptability (the Treatment Evaluation Index, Kazdin et al 1983). The results were analysed using univariate MANOVA techniques. Results: There was a significant main effect of treatment outcome. Where the outcome was good the treatment was perceived as more acceptable (F1,336=327.99 p<0.001). There was also a significant main effect of intervention type (F2,336=12.29, p<0.001), behaviour management using rewards was perceived as more acceptable than either Hand Over Mouth or the Papoose Board. The interaction of intervention type and outcome was significant (F2,336=7.70, p<0.001). Graphical representation of the interaction suggested that the impact of a good outcome was attenuated when the intervention was the Papoose Board. Conclusions: The outcome of methods of behaviour control has a strong effect on the perceived acceptability of the treatment. The public perceive effective treatments to be acceptable. There is also an effect of treatment type on ratings of acceptability - treatments which involve restraint are perceived as less effective than techniques based on rewarding non-anxious behaviour.