Independent self-care skills such as dressing, bathing, brushing teeth, washing hands, and using the toilet are arguably the most essential and foundational skills needed for a person to lead an independent life. Increased independence in daily living skills is linked to a higher quality of life and instills a sense of responsibility and achievement in any child, but can be especially helpful in children with autism. Increasing independence with self-care can also improve a child’s motor, planning and sequencing skills.
When a child with learning difficulties is also lacking self-care skills, this can hugely narrow their world and limit their life experiences. For example, it may be difficult to go on a school trip or have a sleepover at a friend’s house if your child is not independent with eating, bathing, using the toilet or dressing.
They key to success with self-care is getting started early so that you have as much time as possible to practice.
Increasing Independence Through Self-Care:
PICK A SKILL
Increasing independence can be an overwhelming task, which is why we suggest choosing one skill to start with. To set your child up for success, try choosing a skill which your child can already do some parts of on their own. For example, perhaps your child can already pull up their trousers when getting dressed. Choosing a skill which your child can already partially do will allow you and your child to gain some momentum.
BREAK IT DOWN
Once you have chosen the skill to focus on, the next step is to break that skill down into all the necessary steps required to complete that skill. A good tip for this is to complete the skill yourself (for example, brushing your teeth) and note all the steps you completed. By breaking a skill down into smaller components, you are able to focus on learning each small step in the process. Once you have identified each of the steps, we recommend writing the steps down so you can record how your child does with each step.
Visual supports can be used to further support each small step of the task. Create a visual strip that has each step of the task represented by a picture. Place this visual strip in the location where the task is completed. For example, if you are focussing on brushing teeth, you could place the visual support beside the sink. If possible, try using photos of your child doing each step. Otherwise, try using these helpful reminder strips.
Once you’ve got your steps and visual supports ready to go, you need to have a plan for how you’re going to help your child with each step. One way to do this is by using increasing levels of help. Start with allowing your child the opportunity to complete the step on their own. If they can’t do it or do it wrong, provide them with a small amount of help. If they continue to get it wrong, provide a little more help. If we stick with the brushing teeth example, say you were working on brushing the bottom teeth, you may use the following increments of help:
- Allow the child to try on their own
- Tell the child how to do the step (e.g. “brush your bottom teeth”)
- Gently guide the child’s hand to their bottom teeth
- Provide hand-over-hand help to complete the step
The different levels of help with vary depending on the skill and needs of your child. If your child does not understand instructions, verbal help is unlikely to be successful. If your child is resistant to any physical guidance, you may want to consider modelling the step (e.g. brushing your own bottom teeth).
Perhaps the most important tip of all is to reward and provide praise for each completed step of the task. Make sure your praise is specific (for example, “Fantastic job brushing your bottom teeth!” or “Excellent work putting the toothpaste on your toothbrush!”). Rewarding your child will provide them with feedback on what they did well and will encourage them to be successful with the step next time. Rewarding your child also ensures the skill you are focusing on is a positive experience for your child. You may find you need to use a tangible reward in addition to praise. If this is the case, make sure you provide the reward immediately after the self-help skill is finished (for example, provide 5 minutes of iPad time immediately after brushing teeth is finished). Rewards lose their effectiveness with each passing minute!
PRACTICE, PRACTICE, PRACTICE!
Like any new skill, consistent practice is required to make progress. Try practicing the skill at least once a day, this will be easier if you incorporate practicing the skill into your daily routine. Routines can be very helpful, especially in children with autism or other learning disabilities. It may not be smooth sailing each time, but just remind yourself, you are setting your child up for a better quality of life in the long term!