Situation-specific child control: A visit to the dentist

This paper describes the development of the Child Dental Control Assessment (CDCA), a situationally-specific measure of control strategies for school-age children visiting the dentist. A pilot proceeded two definitive studies. In the pilot, the instructions and a battery of items were pretested. The first study was with 180 children and gathered data in a classroom setting to establish the psychometric characteristics of the instrument. Factor analysis, accounting for over 50% of the variance, suggested five scales: Dentist-Mediated Control, Active Coping, Cognitive Withdrawal, Reassurance, and Physical Escape. Internal consistency of the scales constructed from the factors ranged from 0.5 to 0.7. The highest standardized scale scores were for Reassurance and Dentist-Mediated Control. Younger children reported a greater need for Active Coping. In the second study in a clinical setting, children completed an assessment battery and were trained to use a signalling device. Higher CDCA scores for the Active Coping scale, but not the other scales, were associated with the use by subjects of a device to signal the dentist. The proposed measure allows assessment of individual differences among children of the same age as well as developmental differences between age groupings of children.