Development and validation of a social story for preschool children: Seeing a dentist

Abstract

Objectives: To develop and validate a social story for establishing regular dental-visit habit among preschool children with special education needs (SEN). Methods: The importance of regular dental check-up, as well as the routine procedures and common instruments had been demonstrated by a social story. This story was designed by five registered dental surgeons. Face and content validity were assessed by a panel of specialists in Pediatric Dentistry, parents, and staff from the special child care centers (SCCCs) in Hong Kong. The social story was sent to 156 children with SEN. Children’s dental-visit experiences had been collected at baseline and 12-month follow-up. Questionnaires regarding children’s changing behaviors towards dental visit were rated by parents, with a higher score indicating a higher level of challenging behaviors. Construct validity was assessed by correlating children’s behaviors with their willingness to visit a dentist. Empirical validity was assessed by comparing children’s dental-visit experience before and after reading the social stories. Results: The panel agreed that the social story illustrated the main steps of routine dental visit in a child-friendly way, and it was easy to be understood. A total of 129 children were followed for 12 months (response rate 82.7%). Construct validity was supported by a positive correlation between children’s challenging behaviors and their willingness to visit a dentist (r = 0.87, p < 0.001). At baseline, 19.2% children had dental visit experience, while after reading the social story, more children (32.6%) had visited a dentist during the 12-month follow-up (p = 0.044). Conclusions: The main findings indicated that the dental-visit social story could be used to help young children with SEN establish dental-visit habit.