voice control: effects on children’s disruptive and affective behavior

Department of Pediatric Dentistry
Lutheran Medical Center

Name: Craig Elice Date: September 12, 2008
Article title: Dentists’ voice control: effects on children’s disruptive and affective behavior.
Author(s): Greenbaum, PE, Turner C., Cook EW., and Melamed BG.
Journal: Health Psychology
Volume (number): 9(5) 546-558
Month, Year: 1990
Major topic: Behavior Management—Voice control
Type of Article: Prospective study
Main Purpose: The study evaluated (1) whether loudness is a requirement for the use of voice control or is a normal tone equally effective, (2) if voice control reduces children’s disruptive behavior, and (3) the after treatment affect on children. Does long-term dental fear increase when punishment (voice control) is used?
Overview of method of research: Forty patients (23 male and 17 female) ages from 3.5 to 7 years scheduled for cavity restoration who were considered potential behavior problems and were treated by 3 pediatric dentists who use voice control in daily practice. Treatment was randomized into two groups, loud VC, and normal voice VC, and lastly if behavior was good, a non-experimental control. A pretreatment Children’s Fear Survey Schedule Dental subscale and a Self Assessment Mannequin test were given. Videotapes of the procedure were scored using a Behavior Profile Rating Scale to measure fear and disruptive behavior. At the end of treatment, dentists rated children’s fear and cooperation. After leaving the operatory, children again rated feelings using the SAM test.
Findings: The groups were evaluated statistically for age, gender, dentist voice modulation, pre treatment fear and pretreatment feelings. Their distributions were not significantly different. Post intervention behavior showed that the loud voice group was less disruptive then normal voice VC within two seconds after receiving loud VC, and lasting for the measured duration of 2 minutes. The SAM score measuring affect showed significantly greater pleasure and lower arousal (greater calmness) for the loud VC group. The dominance affect had no significance between groups.
Key points/Summary: VC was a highly effective punishment technique to reduce childrens disruptive behavior for ages 3.5 to 7 years of age. Although one of the components of long term dental fear is a negative experience, this form of negative reinforcement did not elicit any long-term negative sequelae as measured by the SAM scores
Assessment of article: This study was able to integrate various psychological tests to determine the effectiveness of a commonly used technique in pediatric dentistry. It further validates the use of voice control in today’s pediatric dental practice .