Personal Hygiene 

Helping your child develop skills for the long-term goal of mastering personal hygiene tasks can be a struggle due to sensory issues, timing, or difficulty focusing. The long-term goal of personal hygiene is fundamental for maintaining health, wellness, social interaction, and independence. To encourage your child to make progress with the long-term goal of personal hygiene, you can help them to master the short-term goals of completing a morning hygiene routine, completing a bedtime hygiene routine, washing hands, bathing in a bathtub, showering, washing hair, brushing teeth, washing and drying face, menstruation hygiene, etc. 

Increasing your child’s ability to do tasks related to the long-term goal of personal hygiene can promote independent living and self-care mastery, can help them avoid safety issues that can arise during hygiene tasks (for example, water temperature being too hot may cause burns, getting in and out of the shower or a bath can lead to slipping due to slick surfaces), and can help to prevent bullying and stigma that arise from poor hygiene. Use positive reinforcement and praise to encourage progress with personal hygiene tasks, regardless of whether your child has successfully completed the entire task. Positive reinforcement may also come as the reward of completing a daily routine, or for completing all scheduled activities in a given day. Phase out the positive reinforcement when the skill has been sufficiently acquired. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement.

Below are some strategies for helping your child develop skills related to the long-term goal of personal hygiene.

• Use a visual schedule. Create a schedule for your child to go through each morning or evening that shows images or drawings of each step in their hygiene routine. List the steps in order and if your child has a preference for doing one task before or after another task, let that guide the schedule. For example, the visual schedule may show an image of clean clothes with words that say “Step 1: Put on clean clothes;” an image of someone washing their face with words that say “Step 2: Wash face;” an image of a toothbrush with words that say “Step 3: Brush teeth;” etc. Add steps that you would like your child to complete. You can also create a visual schedule that describes steps for one individual task by itself, such as showering (for example: Step 1: turn on water; Step 2: remove clothing; Step 3: carefully get into the shower; Step 4: wet hair and body with water, etc.). 
• Social stories. Use a social story that is appropriate for your child’s age and skill level to help them learn the importance of personal hygiene. The story should address how to do a task, why your child must do a task, and when they must do a particular task. For example, for a teenager or pre-teen, the social story may discuss the daily use of deodorant or menstruation hygiene. 
• Identify triggers. There may be particular triggers that cause your child to get upset, stressed, or even meltdown when taking care of their personal hygiene. If you can identify these triggers ahead of time, it may be possible to reduce emotions and behaviors associated with the triggers by modifying the personal hygiene experience. For example, your child may dislike showers, in which case, letting them take a bath may be more appropriate; or your child may react badly to a certain water temperature, in which case you can adjust the temperature to a level which your child prefers- keep a waterproof thermometer and read the temperature of the water so you can use the same preferred temperature for the next bath or shower time. Additionally, your child may find a certain soap scent unpleasant- offer them an alternative (scent-free).
• Choose the appropriate tools. To minimize sensory issues related to textures and touch, choose appropriate tools for your child. For example, make sure the towel and/or the sponge your child will use is soft. As another example, and because smells can trigger sensory issues, consider choosing soaps that are scent-free.
• Additional Resources:

8 Creative Ways to Teach to Your Child Good Personal Hygiene | Articles Blog (asu.edu)

Personal Hygiene (lingokids.com)

For the short-term goal of completing a morning hygiene routine, you can choose a target such as completing dry grooming tasks (e.g., hair brushing, putting on deodorant), completing wet grooming tasks (e.g., washing hands, washing face, brushing teeth, bathing or showering), etc. 

Completing a Morning Hygiene Routine

Step 1: Decide what morning hygiene routine you would like your child to complete. For example, you can choose the target of completing dry grooming tasks while working on the short-term goal of completing a morning hygiene routine. The task analysis for completing dry grooming tasks could be as follows:

1. Gather hairbrush and deodorant.
2. Place items on bathroom sink.
3. Pick up hairbrush with dominant hand.
4. Starting from top of head, push bristles into hair and pull brush in downward motion.
5. Repeat until remainder of hair has been brushed and brush can go through hair without catching on knots.
6. Pick up deodorant and remove cap.
7. If necessary, twist the knob bottom of the deodorant to produce more product.
8. Take shirt off (if necessary).
9. Pick up deodorant with either hand.
10. With top part of deodorant container (with the product) facing up, bring deodorant to the opposite underarm and swipe product onto underarm once.
11. Repeat with other hand, again, bringing hand with deodorant to opposite underarm.
12. Put cap back onto deodorant.
13. Put the hairbrush and deodorant back where they belong.

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of a hairbrush and a picture of deodorant, or a verbal SD (“Time to brush your hair and put on deodorant!” or “Dry personal hygiene time!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 5 min, 10 min, 15 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of completing dry grooming tasks), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to gather hairbrush and deodorant, brush hair from top to bottom, and apply deodorant, followed by putting back the hairbrush and deodorant where they belong).

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at completing dry grooming tasks over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of completing dry grooming tasks by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at completing dry grooming tasks over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Completing a Bedtime Hygiene Routine

Step 1: Decide what hygiene routine you would like your child to complete. For example, you can choose the target of completing a bedtime hygiene routine while working on the short-term goal of completing a hygiene routine. The task analysis for completing a bedtime hygiene routine could be as follows:

1. Gather a towel, washcloth, pajamas, shampoo, conditioner, body wash, toothbrush, and hairbrush.
2. Place cleansers and washcloth into bathtub on a ledge.
3. Place hairbrush, toothbrush, towel, and pajamas on the sink or counter.
4. Remove clothes worn during the day and place them in a hamper or in the location where dirty laundry goes.
5. Take a bath, making sure to clean the entire body and hair.
6. When done with bathing, step out of the bathtub and dry off with the towel.
7. Hang up the towel.
8. Put on pajamas.
9. Pick up the hairbrush with your dominant hand.
10. Starting from top of head, push bristles into hair and pull brush in downward motion.
11. Repeat until the remainder of the hair has been brushed.
12. Pick up the toothbrush and toothpaste.
13. Brush teeth.
14. Clean up and put away items used for bedtime hygiene routine.

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of a child in pajamas, or a verbal SD (“Time to clean ourselves up before bed!” or “Let’s get clean before bedtime!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 30 min, 45 min, 1 hour, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of completing a bedtime hygiene routine), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to gather items needed for a bedtime hygiene routing, take a bath, get dressed in pajamas, and then brush hair, followed by brushing teeth).

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at completing a bedtime hygiene routine over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of completing a bedtime hygiene routine by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at completing a bedtime hygiene routine over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Washing Hands

• Use a visual aid. In any areas where you would like your child to practice washing their hands (for example, bathrooms, the kitchen, etc.), use a simple chart that shows images of the steps involved with hand washing. Hang the chart where your child can easily see it and go through the steps.
• Start with individual steps. Many aspects of personal hygiene involve multiple steps. It may be helpful for your child to break them down and practice the steps individually before completing them in a row. For example, hand washing is a process that involves multiple steps. The approach of breaking things down into individual steps and learning the individual steps is called “chaining.” For example, for hand washing, you can start by teaching your child how to turn on the water. First, demonstrate by turning the water on yourself while telling your child “I am turning on the water.” Next, have your child turn on the water. You may say “Your turn.” If your child is able to successfully turn on the water, offer praise and positive reinforcement. After your child has mastered turning on the water, have them move on to the next step (for example, using a soap dispenser to put soap on their hands). When your child has mastered all steps, practice putting the steps together and going through the entire hand-washing process.
• Hand over hand. Show your child the steps involved with hand washing by placing your hands over your child’s hands and guiding them through the process. You may try the following steps:

• Gently guide your child’s hands to turn on the water while saying “First, we turn on the water.” Adjust to a temperature that you know your child is accustomed to and will likely not cause sensory issues.
• Next, help your child to put soap into their hands, again, with your hands gently guiding their hands. Say “Next, we put soap on our hands.”
• Gently place your child’s hands and your hands into the water, and help them to lather the soap. Say “Next, we wash our hands.” 
• Continuing to hold your child’s hands in your own, tell them “Now, we rinse the soap.” 
• Next, gently guide your child’s hand and help them to turn off the water while saying “Next, we turn off the water.”
• Guide your child’s hands to a towel and tell them “Last, we dry our hands.”

For the short-term goal of washing hands, you can choose a target such as washing hands after using the restroom, washing hands before a meal, washing hands with liquid soap, washing hands with a bar of soap, washing hands with foam soap, washing hands for 30 seconds, etc. 

Step 1: Decide what scenario related to hand washing that you would like your child to learn. For example, you can choose the target of washing hands with liquid soap while working on the short-term goal of washing hands. The task analysis for washing hands with liquid soap could be as follows:

1. Turn the hot and cold water faucets on and adjust water to a comfortable temperature.
2. Put one hand under the end of the soap dispenser pump, where the soap comes out.
3. Put your other hand on top of the soap dispenser pump and push down 2 times to get 2 pumps of soap in the hand that is under the dispenser.
4. Put your hands together with your palms touching each other.
5. Put hands under running water.
6. Rub hands together to make bubbles/lather, and maintain for about 30 seconds. You can time this by singing a relatively short song, such as Happy Birthday.
7. Run hands under water until all bubbles/lather is gone.
8. Turn off water.
9. Dry hands on a clean, dry towel. 

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of a person washing their hands, or a verbal SD (“Time to wash your hands with soap from the pump!” or “Let’s wash our hands now!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 1 min, 3 min, 5 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of washing hands with liquid soap), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to turn on the water, pump soap into palms, lather and rinse, then dry hands).

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at washing hands with liquid soap over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of washing hands with liquid soap by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at washing hands with liquid soap over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Bathing

The following strategies may help your child make progress towards mastering the short-term goal of bathing: 

• Get the timing right. Choose a time for bathing when your child is calm. Preferably, do not start bath time around other stressful or high-energy situations to avoid overstimulating your child. 
• Make bathing fun. Provide items for bathing that your child enjoys, such as sponges, soap/shampoo bottles, or other items with their favorite characters (movies, cartoons, etc.). Sing a fun song to accompany the bathing. Make funny noises during bathing or to get your child to the bathing. Associate some silliness with the bathing to encourage them to cooperate.  
• Make showering/bathing time a pleasant experience. Ensure the water temperature is warm enough and pleasant for your child. Use tear free shampoo, preferably unscented and with low suds. Use a foam visor or a dry washcloth to prevent water and soap from getting into your child’s eyes. Use a small cup to pour water over your child’s hair rather than using the shower head. When your child allows you to wash their hair using any of these methods, provide positive reinforcement and verbal praise to encourage this pattern of behavior.
• Additional resources:

Helping Your Child Take A Bath Independently - The Warren Center | Non-profit organization in Richardson, Texas

BathTimeTipSheet.PDF (aota.org)

The Bath Song | Original Kids Song | Super Simple Songs - YouTube

Taking a Shower Visual by Adrianne Kmet | TPT (teacherspayteachers.com)

For the short-term goal of bathing, you can choose a target such as bathing independently, bathing in a bathtub, showering, etc. 

Bathing in a Bathtub

Step 1: Decide what personal hygiene task related to bathing you would like your child to learn to do. For example, you can choose the target of bathing in a bathtub while working on the short-term goal of bathing. The task analysis for bathing in a bathtub could be as follows:

1. Place clean clothes/pajamas and towel on the counter or in a place where they will not get wet but are within reach when exiting the tub.
2. Gather shampoo, conditioner, body wash, soap, a loofah and/or washcloth and any toys or forms of entertainment for a comfortable bath time experience.
3. Put the plug in the drain or pull the tab to stop the water from draining.
4. Turn on the water and fill the tub with water that is a comfortable temperature.
5. When the tub is at a level where it will not overflow when you enter, turn off the water.
6. Check the temperature of the water.
   --> If the water is too hot, you can wait for it to cool down, or drain some and then add some cold water.
   --> If the water is too cold, you can drain some water and then add some hot water.
7. Take off clothes and place them in the hamper/where other worn clothes are stored before washing.
8. Place your hand on the top rim of the tub and carefully get in, making sure not to slip and fall.
9. Get your entire body wet. This can be done by submerging or using a washcloth to wet your body.
10. Wash the body one step at a time using your hands or a loofah/washcloth and body wash/soap. When you wash, you want to rub the area with soap/body wash first, and then rinse with water to remove all soap. Repeat rinsing as necessary.
    --> Wash your face.
    --> Wash your neck and then wash behind your ears.
    --> Wash your hair.
    --> Wash your belly and your chest.
    --> Wash your back. If you need assistance, ask your parent or caregiver.
    --> Wash one arm then repeat with the other arm.
    --> Wash one leg then repeat with the other leg.
    --> Wash your private areas/bottom.
11. When the whole body is washed and rinsed, stand up and carefully get out of the tub.
12. Grab the towel and begin to dry your body in the same order that you washed. Optional: use a second towel to wrap hair in after the body is dried.
13. When your body is dry, change into your new clothes/pajamas.
14. Drain the tub.
15. Put away bathtime items (shampoo, conditioner, etc.).

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of a bathtub, or a verbal SD (“Time to get in the bathtub!” or “Let’s bathe in the bathtub!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 25 min, 30 min, 45 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of bathing in a bathtub), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to undress and put the worn clothes away, then stepping into the tub and washing up, followed by getting out and drying off). For example, you can use a stuffed toy or doll to bathe to show your child how to complete a bathing routine.

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at bathing in a bathtub over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of bathing in a bathtub by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at bathing in a bathtub over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Showering

Step 1: Decide what personal hygiene task related to washing up you would like your child to learn. For example, you can choose the target of showering while working on the short-term goal of bathing. The task analysis for showering could be as follows:

1. Place clean clothes/pajamas and towel on the counter or in a place where they will not get wet but are within reach when exiting the shower.
2. Gather shampoo, conditioner, body wash, soap, a loofah and/or washcloth and any toys or forms of entertainment for a comfortable shower time experience and place items in shower on a ledge or another area that they are out of the stream of water.
3. Take off clothes and place them in the hamper/where other worn clothes are stored before washing.
4. Turn the shower handle to turn on the water and adjust to desired temperature.
5. Carefully get in the shower, making sure not to slip and fall.
6. Get your entire body wet by stepping under the shower spray.
7. Wet washcloth and put a squeeze of body soap approximately the size of a quarter into the wet washcloth.
8. Wash the body one step at a time using your hands or a loofah/washcloth and body wash/soap. When you wash, step out from under the water and rub the area with soap/body wash first, and then rinse with water when the whole area is covered in soap.
   --> Wash your face.
   --> Wash your neck and then wash behind your ears.
   --> Wash your hair.
   --> Wash your belly and your chest.
   --> Wash your back. If you need assistance, ask your parent or caregiver.
   --> Wash one arm then repeat with the other arm.
   --> Wash one leg then repeat with the other leg.
   --> Wash your private areas/bottom.
9. When the whole body is washed and rinsed, turn off the water.
10. Carefully get out of the shower.
11. Grab the towel and dry your body in the same order that you washed. Optional: use a second towel to wrap hair in after the body is dried.
12. When your body is dry, change into your new clothes/pajamas.
13. Put away bathtime items (shampoo, conditioner, etc.).

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of a shower, or a verbal SD (“Time to shower!” or “Let’s clean up in the shower!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 15 min, 30 min, 45 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of showering), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to undress and put the worn clothes away, then step into the shower and wash up, followed by getting out and drying off). For example, you can use a stuffed toy or doll to shower to show your child how to complete a showering routine.

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at showering over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of showering by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at showering over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Washing Hair

Children with ASD can find the short-term goal of washing hair to be difficult. This may be the result of sensory processing difficulties, such as those that arise from unpleasant smells (scented washing products), the temperature of the water (such as water being too cold or too hot), or the type of soap (which may irritate eyes during hair washing, for example). The inability to consistently wash hair can lead to health and wellness issues, as well as bullying and stigma. By helping your child identify methods and products to master the short-term goal of washing hair consistently, you can improve cleanliness, confidence, and potentially reduce the chances of your child being bullied. 

The following strategies may help to increase your child’s cooperation with showering and bathing time, such as washing their hair:

• Discuss washing hair steps with your child ahead of time so they know what to expect. Let your child know what to expect from hair washing before starting. Offer a reward for cooperating with hair washing, and give your child the reward if they do not fight you to prevent the washing of their hair (even if they cry during the washing). Use positive reinforcement and praise to encourage progress with hair washing, regardless of whether your child has successfully completed the entire task. Positive reinforcement may also come as the reward of completing a daily routine, or for completing all scheduled activities in a given day. Phase out the positive reinforcement when the skill has been sufficiently acquired. Ideally, you want your child’s positive behaviors to be supported solely by social reinforcement.
• Make a routine for hair washing. Create a routine that your child will find engaging for hair washing. This can include the steps of getting to the bathroom, undressing, and getting in the tub or shower. Consider washing your child’s hair at the sink. Find some steps that your child can help with, perhaps help turn the water on, find a good water temperature, or choose between two types of shampoo. You may choose to use positive reinforcement upon completion of the hair washing task to encourage them to repeat that level of cooperation or build on it: offer a piece of candy, extra play time, etc. Phase out the positive reinforcement when the skill has been sufficiently acquired. Ideally, you want your child’s positive behaviors to be supported solely by social reinforcement.

In order to master the short-term goal of washing hair, you can choose a target such as identifying all items needed to wash and dry hair (shampoo, conditioner, towel, etc.), washing hair in the bathtub, washing hair in the shower, etc.

Step 1: Decide what activity related to washing hair you would like your child to learn. For example, you can choose the target of washing hair in the shower while working on the short-term goal of washing hair. The task analysis for washing hair in the shower could be as follows:

1. Gather shampoo and (optionally) conditioner and place into the shower where they are accessible (without water running).
2. Move the handle to turn on water and adjust to a comfortable temperature.
3. Carefully step into the shower.
4. Whichever way you are comfortable (facing the showerhead or away from the showerhead), tilt your head into the water and soak hair.
5. Remove head from water.
6. Put a squirt of shampoo that is approximately the size of a quarter into your palm.
7. Put your palm into your hair and rub your hair all over to lather shampoo.
8. Tilt head under water and rinse until there is no more shampoo in hair.
9. Repeat previous steps with conditioner, if desired. 

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a bottle of shampoo, or a verbal SD (“Time to wash your hair in the shower!” or “Let’s take a shower and wash your hair!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 5 min, 10 min, 15 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of washing hair in the shower), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to gather shampoo and conditioner, then turn on the water and get into the shower, followed by washing and rinsing hair). For example, you can use a stuffed toy or doll to show your child how to complete a hair washing routine.

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at washing hair in the shower over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of washing hair in the shower by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at washing hair in the shower over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Brushing Teeth

Children with ASD often find the short-term goal of brushing their teeth unpleasant due to sensitivity issues, where the process can be overstimulating and anxiety-inducing. Daily teeth brushing prevents the occurrence of tooth decay. Brushing teeth can be done independently or with your assistance, depending on your child’s level of independence and skill with this goal. 

The following strategies may help to increase your child’s ability to achieve the short-term goal of brushing their teeth, which in turn can improve their oral and general health:

• Practice with your child. Demonstrate to your child how to correctly brush their teeth by gently guiding their hand over each section of their mouth. Stand in front of a mirror with your child. You can stand behind your child so that you are able to guide them. Place a pea-sized amount of toothpaste on the brush and help your child go over each section of their mouth as you narrate. For example, you can say “top front teeth” while you guide your child to brush all surfaces on their top front teeth. Sing a song to make it fun!
• Take turns. To show your child how to correctly brush their teeth and encourage them to improve the skill of independently brushing, take turns showing your child how to brush and then allow them to repeat brushing the same teeth without your help. You can gently guide their hand to brush a section of their teeth, then say “Your turn!” and encourage them to brush that same section. 
• Find the correct toothbrush and toothpaste for your child. Children with ASD prefer softer bristles, so look for a toothbrush with soft or silicone bristles. Finding a toothbrush design that your child likes can help with their desire to brush their teeth. For the toothpaste, the typical flavored taste of the toothpaste can sometimes provide a sensory overload. If your child appears to dislike flavored toothpaste, try unflavored. Alternatively, consider a chewable toothbrush, provided your pediatrician or dentist thinks it could benefit your child. Consider having your child floss, as flossing also leads to improved dental hygiene. This can be done independently of tooth brushing, even if tooth brushing is not happening as often as it should. When your child successfully engages in any of these oral care processes, provide positive reinforcement and encouragement, for example, offer verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement.
• Have your child brush their teeth in the room they are most comfortable with (as opposed to the bathroom). Brushing teeth in the bathroom can cause anxiety for some children with ASD. Work with your child to determine where they are least anxious to brush their teeth. Use positive reinforcement to encourage them to brush their teeth regularly: offer an age and effort appropriate reward: a cool sticker, a piece of candy, a small toy, an extra bedtime story, extra videogame time, etc. The positive reinforcement may also come as the reward of completing a morning routine, a bedtime routine, or for completing all scheduled activities in a given day. Phase out the positive reinforcement when the skill has been sufficiently acquired. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement.

In order to master the short-term goal of brushing teeth, you can choose a target such as brushing teeth with toothpaste, dry brushing teeth without toothpaste, brushing teeth for 2 minutes, etc.

Step 1: Decide what activity related to brushing teeth that you would like your child to learn. For example, you can choose the target of brushing teeth for 2 minutes while working on the short-term goal of brushing teeth. The task analysis for brushing teeth for 2 minutes could be as follows:

1. Gather toothpaste and toothbrush and set on bathroom sink.
2. Turn on water. 
3. Pick up toothbrush and run under the water to wet brush head.
4. Turn off water.
5. Put toothpaste on toothbrush head.
6. Set a timer for 2 minutes.
7. Start timer.
8. Brush teeth, making sure to brush all areas (front of teeth, back of teeth, top of teeth).
9. When timer goes off, stop brushing.
10.  Turn on water and spit toothpaste into the sink.
11.  Rinse your mouth with water or mouthwash.
12.  Rinse toothbrush.
13.  Rinse the toothpaste down the sink.
14.  Dry outside of mouth, if necessary.

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of a child brushing teeth, or a verbal SD (“Time to brush your teeth!” or “Let’s brush your teeth!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 3 min, 5 min, 7 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of brushing teeth for 2 minutes), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to get out toothbrush and toothpaste, put toothpaste on the brush, followed by brushing teeth and rinsing mouth).

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at brushing teeth for 2 minutes over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of brushing teeth for 2 minutes by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at brushing teeth for 2 minutes over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

‍Washing and Drying Face

In order to master the short-term goal of washing and drying your face, you can choose a target such as washing face using a washcloth, washing and drying face independently after waking up, washing and drying face independently before bedtime, washing face using pre-moistened cleansing wipes, washing face in the shower, washing face in the bathtub, etc.

Step 1: Decide how and/or when you would like your child to learn to wash their face. For example, you can choose the target of washing face using a washcloth while working on the short-term goal of washing and drying their face. The task analysis for washing face using a washcloth could be as follows:

1. In the bathroom, gather a clean, dry washcloth and facial cleanser and set on the counter.
2. Put a nickel size amount of cleanser in the palm of one hand.
3. Turn on water and adjust to a comfortable temperature.
4. Wet hands.
5. Use one hand to turn off water.
6. Rub palms together to create a lather.
7. Carefully rub hands on face to cover face with the lather, avoiding eyes, nostrils, and mouth.
8. Turn the water on and adjust to a comfortable temperature.
9. Wet the washcloth and squeeze it to get out excess water.
10.  Use washcloth to wipe soap from face. 
11.  Rinse washcloth and repeat wiping soap until there is no more soap on face.
12.  Using two hands, hold a clean, dry towel and pat your face dry.

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of a person washing their face with a washcloth, or a verbal SD (“Time to get your face washed!” or “Let’s go wash your face!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 5 min, 10 min, 15 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of washing face using a washcloth), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to get the washcloth and cleanser, lather soap and put on face, rinse, and dry face.).

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at washing face using a washcloth over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of washing face using a washcloth  by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at washing face using a washcloth over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

The following steps may help your child make progress towards meeting the target of washing face using pre-moistened cleansing wipes.

Step 1: Decide how and/or when you would like your child to learn to wash their face. For example, you can choose the target of washing face using pre-moistened cleansing wipes while working on the short-term goal of washing and drying their face. The task analysis for washing face using pre-moistened cleansing wipes could be as follows:

1. Gather facial cleansing wipes and a dry towel.
2. Stand in front of a mirror.
3. Open the package of cleansing wipes and remove one.
4. Close the package of cleansing wipes.
5. Grasping the wipe with one or both hands, rub wipe over your entire face, avoiding eyes, nostrils, and mouth and using the mirror to ensure that you have washed your entire face.
6. Throw the cleansing wipe into the trash can.
7. Using two hands, hold a clean, dry towel and pat your face dry.

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of a person washing their face with a cleansing wipe, or a verbal SD (“Time to get your face washed!” or “Let’s go wash your face!”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 5 min, 10 min, 15 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of washing face using pre-moistened cleansing wipes), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to get the cleansing wipes, use a mirror to wipe entire face clean, dry face, and discard cleansing wipe).

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at washing face using pre-moistened cleansing wipes over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of washing face using pre-moistened cleansing wipes by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at washing face using pre-moistened cleansing wipes over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Completing Menstruation Hygiene 

The time in which a female experiences puberty and begins menstruation encompasses many physical and emotional changes. This period of time can be accompanied by a range of feelings, from stress, to excitement, to fear. This may make the short-term goal of menstruation hygiene difficult for an individual with ASD to master, as the experience can trigger sensory issues and feelings of embarrassment among peers. 

The following strategies can help your child master the short-term goal of completing menstruation hygiene:

• Use a visual guide. Create a visual guide for your child that they can use at home or school. This visual guide can note set times of the day for your child to visit the restroom and check their sanitary napkin to see if it needs to be changed as well as pictures of how to put on the sanitary pad (you can cut this out from the back of the box!).
• Start with sanitary napkins. For many adolescent girls, it may be easier to start with sanitary napkins when menstruation begins. Purchase a range of sizes and styles, and show your child each one to determine which they prefer.
• Practice early. As your child is approaching adolescence and before they begin menstruation, discuss menstruation to prepare them. You can simulate what menstruation looks like using a pair of old underwear and beet juice and practice using sanitary napkins.
• Other Resources:

How to Manage my Period Social Story by Aimee Ross | TPT (teacherspayteachers.com)

Getting My Period - social story for girls in early puberty by Bloom Wellbeing (teacherspayteachers.com)

In order to master the short-term goal of menstruation hygiene, you can choose a target such as putting a sanitary napkin with wings into a clean pair of underwear, putting a sanitary napkin without wings into a clean pair of underwear, disposing of a sanitary napkin worn overnight, cleansing self before putting on a new sanitary napkin, etc.

Step 1: Decide what menstruation hygiene practice you would like your child to learn. For example, you can choose the target of identifying and changing a soiled sanitary napkin while working on the short-term goal of completing menstruation hygiene. The task analysis for identifying and changing a sanitary napkin when it is soiled could be as follows:

1. In the bathroom, pull down pants and underwear. 
2. Sit on the toilet.
3. Visually inspect the sanitary napkin for menstrual blood. 
4. If there is blood in the sanitary napkin, grasp one end of the sanitary napkin and pull upward until it is no longer stuck to underwear.
5. Roll or fold sanitary napkin and wrap in toilet paper.
6. Put spent sanitary napkin into trash can.
   Caution: Do not dispose of the sanitary napkin into the toilet, as it may interfere with or clog the plumbing system. If you accidentally drop the sanitary napkin in the toilet or flush it, let a parent or caregiver know.
7. Wipe vulva from front to back, using fresh squares of toilet paper when necessary, until the toilet paper no longer has menstrual blood on it.
8. Open a new sanitary napkin and throw away wrapper.
9. Peel paper backing off sanitary napkin and throw into trash can.
10.  With the sticky side down, put the sanitary napkin into your underwear, such that when your underwear is pulled up the napkin covers your private areas.
11.  Stand and pull up underwear.
12.  Pull up pants.
13.  Flush toilet.
14.  Wash and dry hands.

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of sanitary napkins, or a verbal SD (“Time to check your sanitary napkin to see if it needs to be changed.” or “Let’s see if it’s time to change your sanitary napkin.”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 5 min, 10 min, 15 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of identifying and changing a soiled sanitary napkin), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to sit on the toilet and visually inspect the sanitary napkin, replace it with a clean sanitary napkin, followed by washing hands). For example, you can use a stuffed toy or doll to show your child how to complete changing a spent sanitary napkin (which you can stain with a red dye such as beet juice).

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at identifying and changing a soiled sanitary napkin over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of  identifying and changing a soiled sanitary napkin by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at identifying and changing a soiled sanitary napkin over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

The following steps may help your child make progress towards meeting the target of cleansing self before putting on a new sanitary napkin.

Step 1: Decide what menstruation hygiene practice you would like your child to learn. For example, you can choose the target of cleansing self before putting on a new sanitary napkin while working on the short-term goal of completing menstruation hygiene. The task analysis for cleansing self before putting on a new sanitary napkin could be as follows:

1. Gather flushable cleansing wipes and a new sanitary napkin, and set items on bathroom sink.
2. While standing, remove pants followed by removing underwear.
3. Remove spent sanitary napkin and wrap in toilet paper.
4. Throw spent sanitary napkin into trash can.
   Caution: Do not dispose of the sanitary napkin into the toilet, as it may interfere with or clog the plumbing system. If you accidentally drop the sanitary napkin in the toilet or flush it, let a parent or caregiver know.
5. Open the container of flushable cleansing wipes and remove one wipe.
6. Sit down on toilet.
7. Grasp the wipe with dominant hand and wipe starting with vulva from front to behind.
8. Put wipe in the toilet. 
9. Repeat as needed until no menstrual blood is seen on the wipe.
10. Repeat with 3 squares of toilet paper to dry vulva and bottom. 
11.  Pick up new sanitary napkin and open, throwing wrapper into trash can.
12.  Peel paper backing off sanitary napkin and throw into trash can.
13.  With the sticky side down, put the sanitary napkin into your underwear, such that when your underwear is pulled up the napkin covers your private areas.
14.  Stand and pull up underwear.
15.  Pull up pants.
16.  Flush toilet.
17.  Wash and dry hands.

Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as a picture of sanitary napkins, or a verbal SD (“Time to clean up!” or “Let’s go get you clean and get a clean sanitary napkin.”).

Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete the entire task analysis independently during a set amount of time (e.g., 5 min, 10 min, 15 min, etc.).

Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of cleansing self before putting on a new sanitary napkin), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to gather sanitary napkin and cleansing wipes, clean and dry vulva and bottom, put on a clean sanitary napkin). For example, you can use a stuffed toy or doll to show your child how to cleanse self before putting on a new sanitary napkin.

Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Decide if you want to utilize forwards or backwards chaining to teach the steps that your child may struggle to complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at cleansing self before putting on a new sanitary napkin over a certain number of sessions. 

Step 6: Track how your child makes progress to meet the target of cleansing self before putting on a new sanitary napkin by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at cleansing self before putting on a new sanitary napkin over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.