The "Stepwise Integration" Method for Fine Motor Skills Deficits

“I need some advice on how to help my daughter with high functioning autism to dress herself. She is 6-years-old, and I still have to help her with the buttons on her sweater, tying shoes, etc. I would have thought she could be doing this on her own by now. Does anyone else have this problem?”

Stepwise integration is a good strategy to use in these circumstances. Kids with Asperger’s (AS) and High-Functioning Autism (HFA) often have difficulty with fine motor skills, which involve strength, fine motor control, and dexterity (e.g., the small muscles of the body that enable such functions as grasping small objects, writing, tying shoe laces, fastening clothing, etc.).

These skills are important in most school activities as well as in life in general. Deficits in fine motor skills can affect a youngster's ability to eat, write legibly, use a computer, turn pages in a book, and perform personal care tasks (e.g., dressing and grooming).

Dressing is a simple task for most kids, and most moms and dads expect their kids to be able to correctly dress themselves after a certain age. But for young people with AS and HFA, even the simple act of dressing is not stress-free. To help your daughter with a simple task like dressing, employ a stepwise integration method by breaking the task down while you do it for her. Then, gradually have her perform the steps by herself, giving her an extra step each time.

For instance, the first part of stepwise integration of dressing is helping your daughter get dressed while you explain every action (e.g., choose the sweater, lay it on the bed, put one arm through the hole, put the other arm through the hole, and button the sweater).

The next step (performed the next morning) is to have her choose the sweater, with you completing the remaining actions.

The following day, have her choose the sweater and lay it on the bed. Continue giving your daughter more actions until she is doing the entire process on her own.



•    Anonymous said... Break down the steps of doing buttons. You do the first couple of steps and get her to do the last step. Eg. You hold the button, you take hold of button hole, you push button half way through button hole then get your daughter to pull the button through. As her skills get better, get her to do the 2 last steps and so on and so forth until she is doing it by herself. It may take time but it will happen. Do the same for shoe laces. Get her to do the first step of crossing the laces over and pulling down, then you do the other steps and as her skills get better she can tackle the other steps. Forget about her age, it should be about showing her in steps so she can gain the skills to be independent. There are many children and adults that are still learning those skills. Believe in your daughter because she believes in you.
•    Anonymous said... I was still helping my daughter with buttons, laces etc when she was 12. She's 15 now and apart from the odd teeth brushing prompt she's fine. These things take time but your daughter will get there. Have patience and don't make a big deal out of it.
•    Anonymous said... My sons 8 and just this year starred doing buttons on his shirts but not pants. We only buy him pull on pants. Thank goodness for Velcro shoes and squiggly laces. Might as well compromise now to save yourself the stress. They will be doing buttons and laces one day.
•    Anonymous said... Same problem with my 8 year old boy.
•    Anonymous said... took a very long time for my guy to master laces, maybe age 9, and that was a skill taught in OT.
*   I have same issues with my 7 year old son. He is HFA and Aspergers. I am going to try the Step Wise Intergration method and see where I get with my little man.

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