Photo source: www.kasheringyourlife.co.za, www.todaysparent.com
ABA
therapy can be used to teach/increase a variety of adaptive skills, such
as tooth brushing, toileting, hair brushing, shoe tying, making a bed, etc. My
favorite definition of an adaptive skill is anything that will have to be done for the learner, if the learner does not
learn the skill. So if I don’t teach my child how to dress him/herself, then I
will have to dress my child.
A
common concern many of my clients have around adaptive functioning is the
dreaded Morning Routine. Since my clients are usually school age, I have ample
opportunity to help families target issues that regularly pop up during that
frenzied time in the morning of trying to get the child out of the door on
time. Issues like: task refusal, off task behavior, prompt dependency, skipping
steps of the routine/completing the routine out of order, etc.
ABA
interventions should always be individualized, but some of my most effective
strategies for simplifying the morning routine include:
-
Visual supports are your friend :-)
-
Use
of auditory cues (timers)
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ORGANIZATION
With
some simple tweaks here and there and adding in more supports, the morning
routine can be less stressful, more efficient, and require less intrusive prompting
which equals more independence for your child.
Let’s
jump in:
-
Add
visuals: I say “add visuals” and not “add more visuals”, because usually what I
see is that families who struggle the most with the morning routine are not
using any visual supports. If you are regularly struggling during the morning
routine but you already have visual supports in place, then that’s a gold star
for you. You are ahead of the game. If you are new to visual supports, just
keep reading. Think of a visual support as a way to minimize prompting or
assistance. If you have to stand in the bathroom doorway, physically assist
your child, or keep giving the same demand over and over (“Make up your bed Evan
……. Evan, did you make your bed?”), then you definitely need to add some visuals.
It is much easier to fade the prompt of a visual, than to fade your voice or
your presence. Or to put it another way, do you want to have to stand in the
doorway to make sure tooth brushing happens when your child is 25? Here are
some awesome examples of visual supports, all were found on Pinterest.
-
Auditory
cues: The use of a timer can be such a helpful addition to the morning routine
because time is usually of the essence. We have to go, and we have to go now. For many of my defiant kiddos, those
with attention issues, or those with lots of escape maintained behaviors, the
simplest demand (e.g. “Put your socks on”) can take ages and ages to
actually happen. Decide on a specific amount of time for the skill to occur,
and then set a timer. If the child can beat the timer, then allow them to
contact reinforcement. Depending on the child, this could mean a treat, getting
to pick what they wear that day, 2 minutes of TV time, etc. Make the concept of
“hurry up” more concrete by helping the child understand how quickly
tasks needs to be completed.
-
Organization:
This tip is more for you than the child. Organization or proper set up for the
morning routine does not begin that morning, it begins the night before. Part
of the bedtime routine can include setting up items for the next day. This could
mean lining up the soap, facetowel, toothpaste, and toothbrush by the bathroom
sink. Or this could mean putting the backpack by the front door, so there is no
frantic search for it in the morning. How you organize will depend on the
specific issues you are having in your home. The point is to set the child up
for success. For younger children (especially if you want to increase
independence) line up needed items/materials in their correct order so your assistance
is not needed. For example, in the bedroom line up underwear, socks, pants,
shirt, and shoes. In the kitchen, line up the bowl, spoon, and cereal box. For some children you may need to put number cards on each item (e.g. put a "1" card on the underwear). Any
step you can do the night before will save precious time the next morning, and the
materials being visible helps serve as a prompt of what to do next.
*Bonus
Tip: A good way to practice the skills required for a successful morning
routine is to incorporate weekend practice. If these skills are only performed
M-F with a time crunch, then you’re setting yourself up for lots of
frustration. On the weekends, still have your child go through the morning
routine. Use this to fine- tune skills, or provide more
repetition than is possible on a Monday morning. If tooth brushing is always a
struggle, consider modifying the visuals or making them larger/more detailed. Try
removing yourself, and only checking on your child periodically. If the child
is older or needs less support, try implementing a checklist that the child
completes. As they perform each skill, they check a box. When all the boxes are
checked they bring the checklist to you for review.
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