The long-term objective of this study is to initiate investigations into the behavior of abused children when they encounter a situation that normally elicits anxiety. Dental treatment is a necessary event that frequently causes this response in many child patients. The careful observation of this child-dentist interaction should enable the investigators to characterize the responses(s) of the abused child to fear- producing situations and subsequently begin to develop behavior management strategies that are effective in promoting the delivery of treatment yet do not reinforce the concept of the dentist as a threatening authoritarian.
The specific aims of this project will be to determine if abused children: 1) demonstrate more problem behaviors and self-reported anxiety then nonabused control children as measured by parent report, 2) demonstrate significantly more externalizing behaviors than internalizing behavior when compared to control children, 3) exhibit significantly more disruptive behavior, noncompliance, and fear during dental treatment when compared to control children, 4) exhibit more physiological anxiety before and during dental treatment when compared to control children. The study will consist of 60 abused children (age 5-9) and demographically comparable a control group of 60 nonabused children. Each subject will receive a dental exam, prophylaxis, and fluoride treatment. The procedure will be standardized and the following data will be collected to evaluate patient behavior during dental treatment: 1. Behavior Profile Rating Scale (BPRS), a standardized measure of fear- related behavior (from video-tape) 2. Command Response evaluation , a measure of the ability to respond to verbal commands (from video-tape) 3. Continuous pulse rate data to measure physiologic response. The following general measures of adjustment will be obtained prior to treatment: 1. Achenbach Child Behavior Checklist (CBCL), a battery for assessing problem behaviors in children 2. Revised children's Manifest Anxiety Scale (RCMAS), a self-report measure of general anxiety across a range of situations. 3. Child Bearing Practices Questionnaire, a parent-report measure designed to measure factors related to child-rearing practices.
