“I want my own apartment, I want to move out!”
At 29 years old, my sister still requires supervision when brushing her teeth. In my head, it is on the list of things she still needs to learn to do independently if living with minimal supervision in a group setting is going to work.
“I wish I had someone like you to guide me and push me to promote independence earlier on,” my mom says.
Brushing your teeth seems like a skill that can wait in line behind the endless list of social communication skills, play skills, and all other areas related to the core symptoms of autism.
So why address it now in early childhood?
For individuals with special needs, those who acquire independence in simple daily living skills, like brushing teeth, will have a better shot early in life at success, in both domestic and vocational settings (Pierce & Schreibman, 1994).
When should you start to work on brushing teeth?
As soon as your child sprouts a tooth! By the time your child has a full set of teeth, if you are abiding by the recommendation of brushing those pearly whites two times a day that is 730 opportunities to practice a year!
Here is the kicker. To control plaque build-up, not only does the American Dental Association (ADA) suggest brushing twice a day, they specify that brushing effectively is needed to maintain oral health (Blount et al., 1989).
So what are we shooting for?
According to the ADA by 6 or 7 years old children should be able to brush independently with supervision and by 10 or 11 without supervision (ADA, 2005).
Ok, where do we start?
Here are eight easy tips on getting started:
1. Let’s start with the easy stuff, let’s go shopping! Choice is powerful for some children. A Buzz or Elsa toothbrush can be so much cooler than the generic one color number. Same is true for toothpaste flavors, the options are incredible nowadays. Don’t stop at the toothbrush and toothpaste, a fun toothbrush holder and stool are probably in order.
2. How should we teach brushing teeth? That’s a loaded question. If your child is getting services, try and coordinate with your providers to come up with a plan that is tailored for your child and your family to increase chance of success! If you aren’t, then here are some things that have been successful and consistent across studies on teaching individuals with special needs to brush their teeth (Poche et al., 1982).
3. Break down the steps of brushing teeth. Depending on your child’s age, you may want to include what you do before and after the actual brushing, such as reaching for the toothbrush across the counter, opening the cap on the toothpaste bottle and so on. Instead of focusing on all the steps of brushing teeth, you can focus on helping your child to acquire one step at a time before moving on to the next, this can make the goal more manageable for your child and you.
4. Tell your child how to brush their teeth. This will need to be tailored for your child. Verbally explaining the steps of tooth brushing might be an option for some, where other children might respond better to a visual, a book, or a video.
5. Model it. Grab your toothbrush and model it for your child, and if you are anything like me, this will serve double duty because who has the time to brush when you are a parent on the go!
6. Now practice. With a minimum of two times a day to practice you will be well on your way to teaching to independence. Not enough? No worries, some children need to practice more. Work with your children’s other providers to work this into other times of the day.
7. Give feedback. Provide descriptive praise for your child during and after practice. “Good angle!” “Nice back and forth Ellie!” My own little one sometimes is all about the tone of my voice when I provide praise, I do try and channel my inner princess voice – she loves it, but sometimes it isn’t enough. When teaching a new step or skill, provide feedback that is meaningful to your child. You can provide immediate tangibles that your child enjoys; a favorite storybook after brushing teeth, a matchbox car, blowing some bubbles. The bottom line is individualizing based on your child’s current likes is the way to go.
8. Promote independence. Is your child doing pretty well at that step or all the steps? Start fading back the rewards every time and change up who supervises brushing teeth, this will ensure they really got it!
Want to learn more online? Check out our downloadable guides for autism service providers, dental professionals and families/caregivers.
Want to learn more in-person? Email us and RSVP to attend an upcoming dental health training for families and providers presented by Dr. Amy Kenzer, SARRC Clinical Director on Friday, Feburary 13, 2015 3:00PM-4:30PM.
We want to see your kids brushing their teeth, so be sure to tag your pics on Instagram and Facebook with #SARRC
High five! You got this.
Authored by Alex Boglio, licensed Behavior Analyst & Clinical Manager for SARRC's Education, Training and Consultation program. Contact Alex by email at [email protected]