teaching personal care skills at home
Handwashing:
Good hand hygiene is an incredibly important skill, particularly during a pandemic. Our goal is to increase tolerance of frequent handwashing as well as to help the learner become more independent with the skill.
Breaking the process down into more concrete steps will help your learner learn the process easier.
Showing them visuals (see example below) that demonstrate the process can be helpful in prompting your learner.
You can give them a fun stamp on their hands and then have them wash their hands until the stamp comes off. This will help them practice perseverance and scrubbing with handwashing.
Handwashing and Hand Sanitizer Use
Lots of Different Handwashing Posters (English & Spanish)
HandwashingPics.pdfBed Time Routine:
Having a consistent bedtime routine is important for your learner for several reasons:
Predictability helps ease anxiety around transitions
Doing the same tasks repeatedly works to increase independence with skills
Sleep (or lack thereof) can greatly affect someone's ability to function well during the day
Making a Visual: Bed Time Routine
Getting Dressed:
Learners are expected to wear and keep their clothes on while at school. Working on this skill at home can help add consistency with these school expectations. There are many benefits to working on getting dressed:
Predictability helps ease anxiety around transitions
Doing the same tasks repeatedly works to increase independence with skills
Independence with self-dressing helps protect your learner from vulnerabilities of having others nearby while they may not be clothed
Self-dressing protects their dignity
Making a Visual: Getting Dressed
Personal Hygiene:
Personal hygiene can consist of brushing teeth, fixing hair, showering, washing their face, putting on deodorant, and many more tasks. These are functional living skills that they will need to do most-likely everyday for their entire life. Working to increase independence with these skills will have the same benefits as listed above.
toilet training
Toilet training your child can be a very challenging and overwhelming process. This can be especially true if your child has physical and/or intellectual disabilities. Despite this process sometimes feeling messy, exhausting, and impossible, there is a lot of research out there that shows even individuals with these types of challenges can successfully be toilet trained or more participatory in the process.
Being toilet trained has many long-term benefits:
Better hygiene (which may lead to less medical issues such as UTIs, rashes, etc.) for the individual
Being more independent and active in their own lives
Saving money on diapers/pull-ups
Less storage space needed for diapers/pull-ups
Less exposure to having others complete hygiene routines with them
Less laundry of soiled clothes
There are also many challenges during the toilet training process:
Traditional methods may not be effective for your child and you don't know what else to do
It can be very labor intensive for adults to implement (especially if your child is resistant)
There may be frequent accidents and therefore laundry once you make the switch to wearing underwear (consider access to laundry facilities and cost of laundry)
It may require a disciplined approach using timers to increase punctuality and consistency in responses which may be unfamiliar or feel uncomfortable
Recommended Toilet Training Books for Parents:
Toilet Training Success: A Guide for Teaching Individuals with Developmental Disabilities
Elimination Disorders in Children and Adolescents
Recommended Toilet Training Videos for Parents & Learners:
Healthy Habits, Teaching Kids How to Wipe
Sesame Street: Potty Time (song)
Let's Poo in the Potty (song)
Pee and Poop #1 and #2 (explains to kids why they need to use the potty)
Recommended Toilet Training Research Articles (these are very dense and intended more for a professional audience rather than parents):
**PLEASE NOTE: The language used to describe the participants in some of these studies is outdated and may be offensive. The term "mental retardation" was accepted in the medical community and changed at the federal level to "intellectual disability" when Rosa's Law was passed in 2010.
Azrin, N.H. & Foxx, R. M. (1971). A rapid method of toilet training the institutionalized retarded. Journal of Applied Behavior Analysis, 4(2): 89-99.
This article describes the interventions used to successfully toilet train individuals with intellectual disabilities. It was one of the first articles published on this topic.
Azrin, N.H., Sneed, T.J., & Foxx, R.M. (1973). Dry bed: a rapid method of eliminating bedwetting (enuresis) of the retarded. Behavior Research and Therapy, 11(4): 427-434. (Abstract only)
This article describes the interventions used to successfully toilet train individuals with intellectual disabilities at night.
Tarbox, R.S.F., Williams, W.L., & Friman, P.C. (2004). Extended diaper wearing: effects on continence in and out of the diaper. Journal of Applied Behavior Analysis, 37(1): 97-100.
This article shows evidence that continued use of diapers leads to more accidents and less successful voids in the toilet.
Didden, R., Sikkema, S.P.E., Bosman, I.T.M., Duker, P.C., & Curfs, L.M.G. (2008). Using a modified Azrin-Foxx toilet training procedure with individuals with angelman syndrome. Journal of Applied Research in Intellectual Disabilities, 14(1): 64-70. (Abstract only)
This article describes modified Azrin & Foxx interventions used to improve toileting skills in children with intellectual disabilities and Angelman Syndrome.
Kroeger, K. & Sorensen, R. (2010). A parent training model for toilet training children with autism. Journal of Intellectual Disability Research, 54(6): 556-567. (Abstract only)
This article describes Azrin & Foxx interventions taught to parents and used in the home setting to toilet train their children.
Call, N.A., Mevers, J.L., McElhanon, B.O., & Scheithauer, M.C. (2017). A multidisciplinary treatment for encopresis in children with developmental disabilities. Journal of Applied Behavior Analysis, 50(2): 332-344. (Abstract only)
This article shows evidence of interventions leading to independent, consistent bowel movements on the toilet.
Doing Activities on Their Own
(aka Using an Independent Activity Schedule)
(aka Using an Independent Activity Schedule)
An independent activity schedule is a tool that helps give structure to kids so they can complete an activity or multiple activities in a row independently - WITHOUT YOUR HELP!
What does it look like?
Book or strip is out with activities already placed in/on it that you know they can do independently.
You tell the child "Time to do your activities" or "Time to work by yourself" and they approach the book and point to the first item listed.
Your child removes the picture from the schedule and goes to the place where the activities are. They match the picture and put the card on top of the match (which has velcro on it). They remove the activity and bring it back to the table.
Your child completes the activity independently.
Your child returns the activity to where it came from and returns to the book to see what the next task is.
When all tasks are completed, they can notify you that they're done by exchanging a picture that says "all done" and then they earn time with preferred toys/activities or a preferred food.
**You will need to teach your child how to do complete this routine by physically guiding them through it and then start fading out your prompts until they can do it 100% independently.
Recommended Independent Activity Schedule Videos for Parents:
Independent Activity Schedule - shows how to prompt through teaching
Activity Schedule Using Play Skills
Recommended Independent Activity Schedule Research Articles:
MacDuff, G.S., Krantz, P.J., & McClannahan, L.E. (1993). Teaching children with autism to use photographic activity schedules: maintenance and generalization of complex response chains. Journal of Applied Behavior Analysis, 26(1), 89-97.
This article used graduated guidance prompting to teach 4 young boys with autism how to follow a picture activity schedule independently.
Wacker, D.P., Berg, W.K., Berrie, P., & Swatta, P. (1985). Generalization and maintenance of complex skills by severely handicapped adolescents following picture prompt training. Journal of Applied Behavior Anlysis, 18(4), 329-336.
This article taught 3 disabled adolescents how to independently complete daily living skills and vocational tasks using a picture activity book.
Chan, J.M., Lambdin, L., Graham, K., Fragale, C., & Davis, T. (2014). A picture-based activity schedule intervention to teach adults with mild intellectual disability to use an ipad during a leisure activity. Journal of Behavioral Education, 23, 247-257. (Abstract only)
This article used a picture activity schedule to teach adults how to access a high preference game (Angry Birds) on the ipad "which included opening the cover of the iPad, unlocking the device, opening Angry Birds, playing the game, and putting the iPad away."