Innovative oral hygiene strategies for children with autism spectrum disorder: a gamified app-based intervention

Yerkibayeva Z. Yermukhanova G. Saduakasova K. Menchisheva Y. Rakhimov K. Abu Z. Abdukalikova D. Bainazarova N. Abutalipova A.
February 2026 Springer Science and Business Media Deutschland GmbH

European Archives of Paediatric Dentistry
2026 #27 Issue 1 125 - 134 pp.

Purpose: This study aimed to evaluate the effectiveness of the “Marzhan Tis” mobile application in improving oral hygiene practices among children with autism spectrum disorder (ASD) and to examine its usability and correlation with learning success. Methods: A prospective, non-randomized cohort study was conducted with 90 children aged 3–18 years diagnosed with Level 1 ASD from rehabilitation centers in Almaty, Kazakhstan. Participants were divided into an intervention group (IG), which used the app for 1 month, and a control group (CG), which received standard oral hygiene instructions. Oral hygiene was assessed using the Simplified Oral Hygiene Index (OHI-S), approximal plaque index (API), and papillary–marginal–alveolar index (PMA). Adherence was measured using the modified Oral Hygiene Assessment Scale (OHAS-10), and a structured 15-item caregiver questionnaire evaluated behavioral changes and app usability. Statistical analysis included the Shapiro–Wilk test for normality, Mann-Whitney U and Wilcoxon signed-rank tests for between and within-group comparisons, Chi-square tests for categorical variables, and Pearson correlation for usability–learning associations. Results: Significant improvements were observed in the IG for all oral hygiene indices (OHI-S reduction: 28–52%; API and PMA improvement > 50%, p < 0.05). Oral hygiene adherence increased by 18.8% (p = 0.001). Independence in brushing improved in 85% of IG children (χ² = 28.7, p = 0.001). A strong correlation was found between app usability and learning outcomes (r = 0.65, p = 0.01). Conclusion: The “Marzhan Tis” mobile app effectively improved oral hygiene skills and independence in children with ASD Level 1. Its usability and gamified features support its integration into pediatric oral health interventions.

Autism spectrum disorder , Child development , Educational technology , Hygiene , Mobile applications , Mobile health

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Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Al-Farabi Kazakh National University, Almaty, Kazakhstan
King’s College London, London, United Kingdom
Kazakhstan Medical University, Almaty, Kazakhstan
Kazakh-Russian Medical University, Almaty, Kazakhstan

Asfendiyarov Kazakh National Medical University
Al-Farabi Kazakh National University
King’s College London
Kazakhstan Medical University
Kazakh-Russian Medical University

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Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026