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Original Research

Open Access

Picture exchange communication system as a behavior modification technique for oral health assessment in autistic children

  • P Renuka1,*,
  • Subash Singh2
  • Monika Rathore2

1Department of Pediatric and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh-249203, Uttarakhand, India

2Department of Pediatric and Preventive Dentistry, Babu Banarasi Das College Of Dental Sciences, Uttar Pradesh, India

DOI: 10.22514/jocpd.2022.020 Vol.46,Issue 6,November 2022 pp.11-16

Published: 01 November 2022

*Corresponding Author(s): P Renuka E-mail:


Objective: The aim of this study was to establish a modality for behavioral intervention for dental management in autistic children using Picture Exchange Communication System (PECS). Study Design: A prospective interventional study was carried out on 30 autistic children in the age range of 4–18 years diagnosed with mild to moderate grades of autism to evaluate the effectiveness of PECS in improving oral health over a period of 6 months. Results: PECS Phases showed a gradual rise from first to third visit, which was statistically highly significant (p < 0.001). Oral Hygiene Index-Simplified (OHI-S) scores improved significantly from first visit and second visit. Definitely substantial correlation was seen between PECS and OHI-S. Conclusion: Gradual decrease was observed in OHI-S scores over a period of 6 months, indicating an improvement in the oral hygiene status of autistic children. Gradual progress in Phases of PECS proved to increase cognitive ability of autistic children towards understanding the dental setup related PECS cards.


Autism spectrum disorder; Picture exchange communication system (PECS); Simplified; Oral Hygiene Index; Miglani’s modification; Tooth-brushing

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P Renuka,Subash Singh,Monika Rathore. Picture exchange communication system as a behavior modification technique for oral health assessment in autistic children. Journal of Clinical Pediatric Dentistry. 2022. 46(6);11-16.


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