Sir, we would like to highlight a new role for the mouth mirror in children with autism.

Examining a child with autism on the dental chair can pose a challenge to a dental practitioner. Autism is a pervasive developmental disability characterised by severe, complex and permanent behavioural and cognitive disabilities.1 The behavioural characteristics of autism can be categorised into five sub-clusters of disturbances:2 a) disturbances in relating to persons and things; b) disturbances in communication; c) disturbances in motility; d) disturbances of developmental rate; and e) disturbances of sensory processing and perception. The role of occupational therapy in children with autism or children with Sensory Processing Disorder (SPD) is well established.3,4 The therapist uses a sensory evaluation form to assess the sensory profile as a part of the sensory integration therapy programme. A section of the evaluation form included parameters to assess oral sensory processing. Scores are given based on the following: the child gags with certain food; has strong preference to certain food, taste and smell; mouths objects and routinely smells or chews non-food objects. Each child in the special school (Sankalp Open School and Learning Centre, Chennai) had their own oral kit which included a toothbrush, nuk brush, finger brush, vibratory brush or oral stimulator tube and teether. With the help of the occupational therapist 20 children with autism were trained to use a mouth mirror as a part their oral kit. We assessed the acceptance of the mouth mirror by these children along with the other parameters of the evaluation form. We found a marked change in the acceptance of the instrument over a period of two months. Inclusion of a mouth mirror in the oral kit had a magical effect and the examination of the oral cavity was made much easier after the mouth mirror took a new role as part of the therapy.