自閉症者の特性を考慮した歯科治療場面での対応

Management of patients with autistic disorder (AD) can be difficult, especially in the dental setting. AD, categorized in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) under the section of Pervasive Developmental Disorders (PDD), is characterized by repetitive and/or obsessive interests and behavior and by deficits in sociability and communication. The age at onset of AD is usually under three years. The symptoms vary widely. To be diagnosed as autistic, a patient must exhibit a specified number of symptoms, although not all of them may necessarily be present at the same time or to the same degree. Accordingly, it is important in the management of patients with AD, that the management program is carefully individualized for each patient. Systematic desensitization, operant reinforcement, and TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children) program are effective first-line management techniques for autistic patients.