Teaching Self-Care Skills to Aspergers and HFA Kids

"How can I teach my 5-year-old daughter with High-Functioning Autism some basic self-care skills like brushing her teeth, taking a bath, getting dressed for school, etc.? Currently she insists that I help her with everything. Help!"

There are two main ways to teach self-care skills:

1. Backward chaining: This starts at the last step and works through the activity to the first step. For example, once your daughter has brushed her teeth with your help, move backwards through each step slowly (“You just brushed and rinsed your teeth. Before that, we turned on the water. Before that, we put toothpaste on your toothbrush. Before that, we got your toothbrush and toothpaste from the drawer.”).

2. Forward chaining: This teaches a skill in small steps from the first step of the activity through to the last step. For example, “To get dressed in the morning, first you put on your underwear and socks, then put on your pants, then your shirt, then…” (and so on).

Whichever you decide to use for your daughter, make sure the activity is broken down into the smallest steps possible.

You may also want to use prompts to help your daughter learn self-care skills. For example, if you are trying to teach her to wash her hands, you could use theses prompts in the following order:
  • Gestural: mime washing your hands next to your daughter while she washes her own hands
  • Physical: hold her hands and wash your hands together
  • Verbal: say "wash your hands" or show her a ‘wash hands’ symbol, which you can leave above the sink as a prompt for next time

It is important to remove the prompts as quickly as possible, which can be more easily done by providing rewards when your daughter does a step correctly (e.g., when she washes her hands when prompted, she gets a small reward immediately afterwards). Give your daughter the reward directly after the desired behavior so that she makes the connection between the two – and make sure the reward is meaningful to her.

You may find that you need to leave physical reminders (e.g., symbols, written lists) of each activity in the appropriate room. For example, describe all the different steps for brushing teeth in the bathroom – and the same thing for getting dressed in the bedroom. You can download free symbols from www.do2learn.com.


•    Anonymous said… Don't just brush it off. Mine is a tween and is still learning to brush her hair. For things that cause extra sensory issues for her .. Brushing hair & teeth, washing her hair, bathing and changing daily (or when socks are wet). Don't just relax and let it slide all of the time .. Believe me. Puberty is starting for us.. and if they don't have these skills by time that starts... It's gross. I am a bit of a germaphobe and some days I wish I had done more when she was younger because I feel like there are some things she should be able to do. If she doesn't pick up after herself in the bathroom before she hits puberty, she won't instantly start when she does.
•    Anonymous said… Great questions, because kids do need to learn to be as capable as possible and not overly dependent on parents or others, even though our first instinct is sometime to protect and "help". Dr. Temple Grandin and I just wrote "The Loving Push: How Parents and Professionals can Help Spectrum Kids Become Successful Adults". It introduces readers to 8 real individuals (and their families) on the spectrum and uses actual examples from their lives of how to put successful strategies in place to maximize a sense of hope and mastery in our kids. We also discuss how to avoid common obstacles such as lack of motivation, anxiety, lack of confidence, and (particularly in boys) vulnerability to becoming stuck in endless online games. Teaching skills to kids on the spectrum often requires customized approaches that work well with their unique ways of processing information and "lovingly push" and stretch them without overwhelming them. Our hope is it helps families with just the kinds of questions you are raising. Best wishes to you and your family.
•    Anonymous said… I have a 15 year old just sits in shower and will not brush teeth. Also has to wear what we call sponge Bob's at night. My 8 year old is following his footsteps. Need to find some way to entice them to care about hygiene.
•    Anonymous said… I have the exact same issue. We use a basic chart with everything he needs to do. Obviously i still need to help however it's not a fight to get him to do it. Our psychologist actually made one for him at the age of 4. We have high functioning ASD too. The best way to look at it is some need it like we need a calander and eventually they get it. You can get apps aswell which are great but we have issues with over stimulation on the ipad. Our hand made visual charts work best. Hope you work something out.
•    Anonymous said… It will come slowly but surely, o.t helped my little boy learn to dress and undress with clothes the correct way around etc, he.was.7 then, it was better a third party for this one with different ideas and not the pressure of rushing in the mornings. Cleaning teeth... he is now 9 and still gags if he tries to do this himself but little steps we will get there. Botty wipes help with toilet time. But he is off the scale reading, has finished the whole school reading scheme, learnt to read music with ease in 12 weeks. Good luck and don't worry too much it will come at some point! X
•    Anonymous said… She's 5!!!!! Autism or not kids need help sometimes and they say you should help kids brush their teeth till around 7/8
•    Anonymous said… Time and patience. It took my daughter until she was 11 to be able to do it all herself and now I don't have any interactions with her on it unless she asks for assistance which is rare we worked on it tho constantly from the usual ages 3,5,7,8 etc... We never stopped but eventually she took over and hasn't stopped amazing me since

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Anonymous said...

Seriously? You think that is autism related? I had to help my NT kid with those things until at least 5.

Anonymous said...

sorry & I h8 to break it to you, but my 11yr old aspie still requires help with those things.... Especially if i want to ensure hair and teeth are done to a reasonable standard, without him missing the morning school bus..!!

Anonymous said...

teach the skills one at a time. Social storys help. My ten year old requires help sometimes. Mostly when he is tired. He wont have a bath because that means sitting in your germs and dirt. Having a shower is a nightmare cause he has SPD as well so it can be painful. Cleaning teeth means moving arm for a period of time which tires out those silly joints. Reward reward reward.
9 hours ago · Like

Anonymous said...

let go of expectation. 4 is a little young to be doing these things anyway.

Anonymous said...

Agree with all comments here. My NT daughter needed help with those things until about aged 6 or 7 and she is now 17. My aspie son is 7 and needs prompting to wash in the bath, hates the feel of toothbrushes, he can dress but not to a smart standard or coordinate his clothes so we choose for him and doesnt care at all how his hair looks. We still have to make sure his bottom is clean after toilet. I cant see this changing anytime soon but are proud of all he has achieved so far considering the sensory and social problems he encounters everyday. Don't sweat the small stuff I say, there are bigger hurdles yet to come :D xx

Anonymous said...

I agree as well. My 9 year old son has asperger's and still requires constant reminders and attention when preforming tasks such as getting dressed (making sure he puts on clean underwear and weather appropriate clothing), brushing teeth, bathroom time and in the bath; while my 6 year old daughter has no trouble with any of these skills. No trouble to see the issues when you have one child with ASD and one without.

Anonymous said...

My 15 year old Aspie still has major issues with this stuff. He doesnt understand the importance of brushing teeth and showering - WITH shampoo and soap, not just a trickle of water. This is an ongoing battle. It is not about teaching the task..he knows HOW to do it...he just doesnt WANT to do it.

Anonymous said...

Anyone know where to get free printable social stories for slef help skills? My daughter is 6 and needs help with everything from getting dressed to toileting.

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