Publications [#378516] of Timothy J. Strauman

Journal Articles

1. Bocklage, C; Selden, R; Tumsuden, O; Nanney, E; Sawicki, C; Rapolla, A; Cass, K; Lee, J; Ginnis, J; Strauman, T; Graves, C; Divaris, K; Hodges, E; Jacox, LA (2025). A software-based observational coding approach for evaluating paediatric dental pain, anxiety, and fear.. International journal of paediatric dentistry, 35(2), 241-258. [doi]
   (last updated on 2025/06/16)

   Abstract:
   

   Background

   Dental practitioners desire non-pharmacological methods to alleviate anxiety, fear, and pain in children receiving dental care; high-quality evidence, however, is required to evaluate methods' efficacy.

   Aim

   This study aimed to develop and validate an observation-based coding approach (paediatric dental pain, anxiety, and fear coding approach [PAFCA]) to evaluate non-pharmacological behavior management techniques for anxiety, fear, and pain.

   Design

   Objective (video-based) and subjective (self-reported) anxiety, fear, and pain data were collected from a pilot clinical trial evaluating animal-assisted therapy (AAT) in paediatric dentistry, in which 37 children aged 7-14 were assigned to AAT or control before dental treatment (restorations or extractions). A coding approach utilizing a codebook, a gold standard calibration video, and a user training guide was developed. Trained examiners coded the gold standard video for inter-rater agreement, and masked, calibrated examiners analyzed videos using the Noldus Observer XT software.

   Results

   A novel, software-based coding approach was developed, with moderately high inter-rater agreement. Using PAFCA, we found children reporting higher levels of pain, fear, and anxiety exhibited treatment-interfering behaviors, including crying/moaning, attempts to dislodge instruments, and more upper and lower body movements.

   Conclusion

   PAFCA shows promise as a reliable tool for assessing anxiety, pain, and fear in behavioral research for paediatric dentistry.