Research in Autism Spectrum Disorders 79 (2020) 101679 Available online 4 November 2020 1750-9467/© 2020 Elsevier Ltd. All rights reserved. Brief Report Brief report: At-home oral care experiences and challenges among children with Autism Spectrum Disorder Abdulmonem A. Alshihri a , Mansour H. Al-Askar b , Mohammed S. Aldossary c, * a Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia b Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia c General Directorate of Dentistry, Ministry of Health, Riyadh, 11176, Saudi Arabia A R T I C L E INFO Keywords: Autism Spectrum Disorder Oral hygiene Toothbrushing Child ABSTRACT Background: The aims of this study were to investigate parental challenges, toward at-home oral healthcare of their children with Autism Spectrum Disorder (ASD), as well as parental experience in supervising teeth brushing. Method: 27-item questionnaires were completed by 142 mothers of children with ASD. The questionnaire addressed information on socio-demographics, at-home oral hygiene practice, medical history, and the habits of children with ASD. It also included parents’ experiences with oral care at-home and what diffculties were encountered. Statistical analysis was done using descriptive statistics, and several tests for statistical comparisons and associations were per- formed. The signifcance level was set to be P < 0.05. Results: 16.9 % of children do not brush their teeth at all, 35.9 % brush less than once a day, 35.2 % brush once a day, and 12 % brush twice or more daily. Among the children who brush their teeth (n = 118), 21.2 % brush their teeth themselves, for 64.4 %, their mothers brush their teeth, and for 14.4 %, a family member does that. Regarding if the child allows brushing supervision, 10.2 % do not allow brushing supervision, 39 % sometimes allow, and 50.8 % allow brushing supervision. Results indicated that there is a signifcant positive association between brushing frequency and allowing brushing supervision (P < 0.001). No signifcant association between children’s age, gender, or autism severity, and allowing brushing supervision. Conclusion: At-home dental care is challenging for children with ASD and their parents. Children with ASD showed improper oral hygiene practices and exhibited damaging oral habits, necessi- tating the urgent need for effective prevention programs, including parental education. 1. Introduction Autism Spectrum Disorder (ASD) is a complex neuro-developmental condition that causes signifcant social, communication and behavioral impairments in children and adolescents (Lord, Elsabbagh, Baird, & Veenstra-Vanderweele, 2018). The abnormalities that characterize ASD include developmental impairment of social interaction, restricted activities and interests, restricted or repetitive behavior, and defciency in verbal and nonverbal communication skills (Bhat, Acharya, Adeli, Bairy, & Adeli, 2014). There is evidence that children with ASD had poor oral hygiene, elevated plaque levels, and a higher prevalence of periodontitis, * Corresponding author. E-mail addresses: monem.alshihri@post.harvard.edu (A.A. Alshihri), malaskar@ksu.edu.sa (M.H. Al-Askar), msaldossary@moh.gov.sa (M.S. Aldossary). Contents lists available at ScienceDirect Research in Autism Spectrum Disorders journal homepage: www.elsevier.com/locate/rasd https://doi.org/10.1016/j.rasd.2020.101679 Received 22 May 2020; Received in revised form 17 September 2020; Accepted 2 October 2020