Brush Your Teeth! Helping Kids with Autism Learn Self-care

2/17/2019 By Samantha Davis, BCBA

Getting children to brush their teeth, take a bath or get dressed seems to be an uphill battle for all parents. Most children become more independent as they get older. Children with autism, however, may not naturally pick up these habits. As children get older, the feeling of being clean and the fear of being outcast by peers is typically enough to get them to complete their own personal hygiene routines. To children with autism, though, this may not be enough.

What can I do to get my child with autism to take care of themselves?

1. Avoid nagging.

For many parents, one way to get your child to do something is to tell them or show them over and over until it gets done. And, believe me, this isn’t only annoying for you, but also to your child. Nagging may make both you and the task at hand more aversive than it originally was to your child. Nagging also leads to “prompt dependence,” meaning that your child may not learn to brush his teeth without you telling him 15 times.

Instead of telling your child what to do, try setting up a chart with picture representations of the steps of a typical hygiene routine in the place where that routine is performed. This can serve as a reminder of what is expected and lead to an independent routine without constantly having to be told.

2. Provide visual supports.

It’s important to stay away from constant vocal prompts. Visual supports can be helpful to make sure a child has the tools to complete their hygiene routine well. A timer while brushing teeth or a diagram of how to appropriately brush teeth (making sure to brush outside, inside, top and bottom and tongue) in the bathroom can be helpful. Teeth brushing tablets can also help demonstrate quality tooth brushing, and are available on Amazon for less than $10.

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3. Set up a rewards system.

Like I mentioned before, the natural reinforcement of feeling clean may not be enough for a child with autism to independently take showers, brush their teeth, etc. Setting up a rewards system may give children the extra motivation to take care of themselves. A behavior contract can be helpful in these situations. This is a simple contract that you and your child sign that states specific behavior that is required to earn a certain reward and when that reward will be delivered. For instance, your child may have to complete at least 80% of a given hygiene routine independently every morning for a week to be able to go to the movies on Saturday.

4. Fade out prompting and reinforce independence.

As the child begins to demonstrate success with their hygiene routine, start to slowly remove the extra prompts that have been put into place. For example, removing a few of the smaller steps in the teeth brushing diagram or signing a new contract with more conditions.

It is also important to provide higher quality rewards (what we call “reinforcement”) for independence. While your child should still be rewarded for completing their routine with a few prompts (verbal or visual), they should earn more valuable rewards or a larger amount of the same reward for completing it independently.

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