The effects of systematic desensitization and video self-modelling on acute stress levels of children with autism spectrum disorder during dental treatment

Purpose Children with Autism Spectrum Disorder (ASD) often experience increased stress in unfamiliar environments like dental clinics. Both video self-modelling (VSM) and systemic desensitization are approaches to reduce stress. The aim of the study was to use salivary cortisol levels to compare between systematic desensitization and video self-modelling (VSM) on the acute stress levels of children with ASD during dental treatment. Methods This exploratory study evaluated 30 children (28 males, 2 females) aged 6–12 years diagnosed with ASD (mean age 9.2 years, SD+/- 2.1 years). Participants were age-matched and assigned randomly to either Group I (systematic desensitization, n = 15) or Group II (VSM n = 15). Early morning salivary cortisol and behaviour at the dental office were estimated pre and post-intervention. Results Both VSM (p = 0.020) and systematic desensitization (p = 0.001) significantly improved behaviour in children with ASD, the latter showing greater effectiveness (Mann-Whitney U = 40.5, p = 0.002). Both VSM (p < 0.001) and systematic desensitization (p < 0.001) groups demonstrated significant cortisol reduction, with significant differences between the two techniques. A significant negative correlation was found (r=–0.594, p = 0.001), between behaviour and cortisol levels in the systematic desensitization group but not in the VSM group. Conclusion VSM can significantly reduce acute stress in children with ASD during dental treatment at levels comparable to systematic desensitization. Clinical Trial Registration The study protocol was pre-registered before participant enrolment with Clinical Trial Registration-India (CTRI/2023/06/054026) dated 16/06/2023.