Efficacy of a Modified Audio-Tactile Performance Technique with Braille (ATPb) on the Oral Hygiene Status of Visually-Impaired Children

Objective: We assessed the effectiveness of a modified audio-tactile performance (ATP) technique with braille (ATPb) on the oral health statuses of visually-impaired children. Study design: Ninety visually-impaired institutionalized children received oral hygiene instructions using audio (AM), ATP or ATPb techniques. Plaque scores were assessed at baseline and after reinforcement and non-reinforcement periods. Results: In the totally visually-impaired, mean reductions in plaque scores in the ATPb, ATP and AM groups during the reinforcement period were 1.119 ± 0.260, 0.654 ± 0.239 and 0.237 ± 0.255, respectively (p <0.001), worsening to 0.107 ± 0.160, 0.083 ± 0.193 and −0.208 ± 0.267 during the non-reinforcement period (p <0.001), before culminating at 6 months at 1.227 ± 0.261, 0.737 ± 0.317 and 0.029 ± 0.108 (p <0.001). In partially visually-impaired children, reductions during the reinforcement period were 0.934 ± 0.279, 0.762 ± 0.270 and 0.118 ± 0.237, respectively, dropping to 0.176 ± 0.166, 0.083 ± 0.169 and −0.128 ± 0.114 without reinforcement and culminating at 1.109 ± 0.258, 0.845 ± 0.292 and −0.010 ± 0.226 (p <0.001). There were significant inter-group differences during the three periods (p <0.001), except in the ATP and ATPb groups during the non-reinforcement period for totally impaired (p = 0.157) and during reinforcement (p = 0.155) and non-reinforcement (p = 0.051) periods for partially impaired children. Conclusions: All three techniques were successful when reinforced periodically. However, only ATP and ATPb were successful during periods without reinforcement. The modified audio-tactile performance technique with braille (ATPb) was most effective, allowing visually-impaired children to retain oral hygiene information without intervention.