Self-care skills such as brushing teeth, washing hands, and dressing are important for children to learn as they affect their everyday lives. For children diagnosed with Autism, they often experience delays in learning these skills and may need a different way of teaching to acquire them. Using some behavior analytic techniques, these skills can be taught in an appropriate way suitable for your child to be successful.
Is your child ready to perform self-care skills?
- Component skills: In order to ensure success with the desired self-care skill, make sure that your child can perform the basic skills necessary for the task. For example, for the skill of brushing teeth, this may include: pincer grasps, holding a toothbrush, moving a toothbrush in a back and forth motion, spitting out toothpaste, squeezing toothpaste tube, gargling water.
- Attending: Can your child pay attention and tolerate the duration of the skill?
- Complexity of composite skill: Can your child put together the component skills to perform parts of the desired task?
If your child is unable to perform the component skills, attend to the desired self-care task, or combine component skills, work on building up this repertoire before moving forward. Providing help and lots of positive reinforcement with these tasks will make learning the desired skill easier!
Now that your child is ready, how can you teach your child to perform self-care skills?
- Chaining: This strategy involves breaking down the steps of the skill into multiple pieces. Once the steps are broken up, teaching can occur by linking steps together.
- The steps can be linked together from the beginning of the skill. For example, brushing teeth can begin with allowing the child to put toothpaste on the tooth brush and run the tooth brush under the water. The rest of the steps of the skill can be prompted by an adult. As the child becomes more independent with the first few steps, more steps can be added for him or her to perform independently as a chain.
- Steps can also be linked from the end of the skill. For example, for hand washing, you can have the child wipe his or her hands independently on the towel. As the child becomes more independent with that skills, you can also introduce turning off the water to the chain of steps. All the steps prior to those mentioned steps can be prompted by an adult.
- Social Stories: These stories outline the appropriate way to engage in the desired task. Each page can describe the steps and how to complete the skill. They can be in the form of videos, audio, or written (with pictures). Each child may respond better to one form over another.
What supports can you use with these strategies?
- Visuals: You can provide visuals of each step of the task posted in the location that the skill will occur in. For example, with hand washing, some pictures can include turning on the sink, hands under the soap dispenser, or rubbing hands with soap. Modeling the skill before the child engages in the skill may also help the child learn by imitating your actions.
- Physical prompts: You can physically guide your child with your hands on top of theirs to allow them to get used to the motion of the task. Then, you can reduce your physical prompts (e.g., move your hands to their elbows or moving farther away and pointing to the correct step) until they can complete the skill independently.
- Vocal prompts: You can vocally instruct the child to perform each step as they are performing the skill. Then, you can fade your prompts until they can do the skill independently.
Working on the component skills independently until the child can easily and reliably perform them can greatly increase their success with putting those steps together. A combination of different supports listed above can provide a way for you to teach your child how to engage in complex self-care skills. Providing and fading your physical and vocal prompts can take some practice. It may be beneficial to work with a BCBA to ensure the success of your approach and the acquisition of these skills.