ENvironmental Adaptations for Better heaLthcare Experiences (ENABLE)
Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩ Cluster: Health Services and Health Equity ⟩ Cluster: Work, Health, and Occupational Engagement ⟩
The ENvironmental Adaptations for Better heaLthcare Experiences (ENABLE) Lab focuses on the broad-ranging effects of environmental factors on stress, well-being, and activity engagement during challenging healthcare encounters, and the efficacy of tailored environmental modification interventions to alleviate these challenges.
Using a variety of quantitative, qualitative, and mixed methods research, the ENABLE Lab features highly interdisciplinary team science, bringing together collaborators from a diverse array of fields such as occupational therapy, dentistry, primary care, oncology, and engineering. Research in our lab focuses on the:
- identification of environmental barriers and facilitators to positive healthcare encounters; and
- development and evaluation of evidence-based ENABLE interventions to improve healthcare experiences for consumers and healthcare providers.
Current ENABLE Lab studies include the examination of healthcare encounters in children during dental care (those with autism, Down syndrome, and/or dental fear and anxiety), autistic adults at primary care visits, children with cancer during chemotherapy infusions, and children receiving treatment in the Emergency Department.
Previously called Tailored Environmental Modifications (TEM).
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Active projects
Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩ Cluster: Health Services and Health Equity ⟩ Cluster: Work, Health, and Occupational Engagement ⟩
The goal of the project is to expand equitable access to oral health care for individuals with developmental disabilities by training providers about sensory processing, how sensory processing challenges may impact dental care, and identifying/implementing sensory-based modifications to improve…
Period: Jan 2026 – Jan 2028
Private Funding
$266,667
Cluster: Work, Health, and Occupational Engagement ⟩ Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩
Dental fear and anxiety (DFA) characterizes up to 42% of the pediatric population and predicts negative behaviors in the dental clinic, irregular appointment attendance, need for general anesthesia, and poor oral health. Sensory over-responsivity (SOR), which occurs in up to 33% of the pediatric…
Period: Apr 2022 – Mar 2029
Federal Funding
$5,538,460 (anticipated)
Completed projects
Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩ Cluster: Work, Health, and Occupational Engagement ⟩
To identify environmental barriers and facilitators during healthcare encounters, develop evidence-based interventions tailored environmental modification interventions to improve care experiences for consumers and healthcare providers, and examine the efficacy and effectiveness of these…
Period: Sep 2017 – Aug 2022
Federal Funding
$250,076
Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩ Cluster: Health Services and Health Equity ⟩ Cluster: Work, Health, and Occupational Engagement ⟩
The SADE-2 study is a randomized clinical trial of 184 ethnically diverse children with autism spectrum disorder (ASD). We are investigating the efficacy of a sensory adapted dental environment (SADE) compared to a regular dental environment (RDE) to decrease children’s physiological anxiety,…
Period: May 2015 – Apr 2022
Federal Funding
$3,783,021
Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩ Cluster: Work, Health, and Occupational Engagement ⟩
To identify environmental barriers and facilitators during primary care health encounters for adults with autism spectrum disorder.
Period: Sep 2017 – Mar 2019
Private Funding
$49,946
Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩ Cluster: Work, Health, and Occupational Engagement ⟩
To identify environmental factors that influence the experience of stress during outpatient chemotherapy infusions by interviewing children with cancer, their parents, and their healthcare providers.
Period: Jul 2015 – Dec 2017
Private Funding
$188,773
Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩ Cluster: Work, Health, and Occupational Engagement ⟩
Children undergoing cancer treatment are at risk for adverse mental and physical health consequences due to repeated exposures to physical and/or psychological stressors. Although it is well documented that cancer therapies are stressful, there is a lack of data regarding the stress response during…
Period: Jul 2016 – Nov 2017
Intramural Funding
$29,400
Cluster: Autism, Sensory Processing, and Neurodevelopment ⟩ Cluster: Health Services and Health Equity ⟩ Cluster: Work, Health, and Occupational Engagement ⟩
Abstract The goal of this research project is to collect information that will support a later clinical trial on the effectiveness of a specially adapted dental environment for children who have difficulty tolerating oral care in the dental clinic. Within this project, two groups of children will be…
Period: Sep 2011 – Aug 2015
Federal Funding
$531,376
In Chan News
November 25, 2024
Study led by Leah Stein Duker in partnership with Children's Hospital Los Angeles extends Sensory Adapted Dental Environment research line begun in 2011.
June 2, 2023
Results of USC–CHLA study of 162 autistic children show that safe and feasible adaptations to the clinic environment created more relaxed, less anxious dental care experiences.
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