The experience and understanding of learning disability and autism of orthodontic practitioners in the United Kingdom: A national survey

OBJECTIVE: To explore the experience, knowledge and confidence of orthodontic practitioners in the United Kingdom in managing patients with learning disability or autism. DESIGN: National online survey. SETTING: British Orthodontic Society membership. METHODS: A novel questionnaire was developed and distributed online to orthodontic practitioners within the British Orthodontic Society. It included questions on the participants' prior training, experience in treating patients with learning disability or autism, knowledge levels using the Learning Disability Knowledge Questionnaire and Autism Knowledge Survey, and self-efficacy in managing these patients. RESULTS: A total of 171 responses were received with participation from various practitioner groups: orthodontic consultants, specialists, postgraduates, therapists and dentists with special interest. The median score for the Learning Disability Knowledge Questionnaire was 73% (interquartile range [IQR] = 20). The median score for the Autism Knowledge Survey was 93% (IQR = 6.7). The percentage of respondents who reported feeling confident in patient management varied across the self-efficacy domains: (1) treating patients with learning disability (51%) and autism (64%); (2) making reasonable adjustments for patients with learning disability (54%) and autism (61%); (3) recognising the signs of learning disability (38%) and autism (48%); and (4) signposting patients with learning disability (27%) and autism (30%) to the relevant local care pathways or services. The participants employed a range of techniques and resources when managing these patients. These included tailoring communication to individuals, adapting to sensory needs, involving parents/carers in treatment planning, adjusting the pace of care, and building trust through behavioural and acclimatisation strategies. CONCLUSION: Having a good knowledge of learning disability or autism does not always translate to greater confidence in patient management. Improving access to orthodontic-specific learning disability and autism training, national guidance and communication aids could enhance the confidence of orthodontic practitioners in managing these patient groups.