Abstract
BACKGROUND: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition affecting social interaction, communication, and behavior. Mothers of children with ASD often experience chronic stress, leading to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and low cortisol levels. Salivary cortisol, a non-invasive biomarker, reflects physiological stress responses. Effective behavior guidance in pediatric dentistry can improve the dental experience for children with ASD and reduce maternal stress. Video self-modeling (VSM) is a promising intervention to enhance cooperation in children with ASD during dental procedures. AIM: This study aimed to estimate the salivary cortisol levels in the mothers of children with ASD following the application of VSM as a behavior guidance technique for their children during dental procedures. MATERIALS AND METHODS: Twenty-two mothers of children with ASD (aged 6-12 years) participated. Salivary cortisol samples were collected at baseline and two weeks post-intervention. Cortisol levels were measured using enzyme-linked immunosorbent assay (ELISA), and a paired t-test compared pre- and post-intervention levels. RESULTS: Pre-intervention cortisol levels ranged from 13.35 ng/ml to 63.35 ng/ml (mean 33.2 ± 15.8 ng/ml). Post-intervention levels increased, ranging from 13.35 ng/ml to 55.52 ng/ml and difference was statistically significant (mean 44.2 ± 10.1 ng/ml; t = -2.53, p = 0.019). CONCLUSION: This study highlights the bidirectional relationship between child behavior and maternal stress. VSM improved cooperation in children with ASD during dental procedures and positively impacted maternal stress, as shown by increased salivary cortisol, thus emphasizing the need for behavior interventions benefiting both children and their families.