This document discusses the importance of teaching activities of daily living (ADL) skills to individuals with autism at an early age. It describes several key ADL skills including toilet training, eating habits, bathing, and dressing/undressing. For each skill, it provides strategies for breaking down tasks, addressing sensory issues, using visual supports and reinforcement, and gradually fading prompts. The goal is to promote independence by properly organizing instruction of essential life skills.

1. Activities of Daily LivingActivities of Daily Living
Autism Spectrum DisordersAutism Spectrum Disorders

2. Importance of ADL TrainingImportance of ADL Training
 Needs to be done at the earliestNeeds to be done at the earliest
 Child must never acquire an inappropriateChild must never acquire an inappropriate
behavior that is later difficult to unlearn.behavior that is later difficult to unlearn.
 A family can lead a very comfortable life, travel,A family can lead a very comfortable life, travel,
socialize .socialize .
 Danger of abuse if the person depends onDanger of abuse if the person depends on
others for ADL activities like toileting, dressing,others for ADL activities like toileting, dressing,
bathing etcbathing etc
 AA MUSTMUST for the respect and honor of anyfor the respect and honor of any
personperson

4. PRACTICAL DIFFICULTIESPRACTICAL DIFFICULTIES
 Sequencing steps of tasksSequencing steps of tasks
 Not understanding concept of finish.Not understanding concept of finish.
 Over or under sensitive –touch/ smells/Over or under sensitive –touch/ smells/
sounds/tastes/ sightsounds/tastes/ sight
 Motor planning issuesMotor planning issues
 Limited exposure to perform independently.Limited exposure to perform independently.
 Developmental delays / lack of basic skillsDevelopmental delays / lack of basic skills

6. OrganizationOrganization

7. Toilet trainingToilet training
 Skills neededSkills needed
1.1. Body awarenessBody awareness
2.2. CommunicationCommunication
3.3. Social understandingSocial understanding
4.4. Motor skillsMotor skills
5.5. Planning and organizing skillsPlanning and organizing skills

8. Why does my child take longer toWhy does my child take longer to
be trained ?be trained ?
 Poor self awarenessPoor self awareness
 Sensory issuesSensory issues
 Do not have the understanding of privacyDo not have the understanding of privacy
 Find difficult to communicate need forFind difficult to communicate need for
toilettoilet
 Dressing undressing difficultiesDressing undressing difficulties
 Fascinations- water/ tiles/ drains/taps etcFascinations- water/ tiles/ drains/taps etc

9. TrainingTraining
 Break the training into stepsBreak the training into steps
 Steps-Steps-
1.1. Put the child on a toilet schedule or a toiletPut the child on a toilet schedule or a toilet
time table/ toilet routinetime table/ toilet routine
• Use very simple words- “Toilet time”/ “toiletUse very simple words- “Toilet time”/ “toilet
chalo.”chalo.”
• First place – a convenient oneFirst place – a convenient one
• Praise /reinforce sitting or eliminationPraise /reinforce sitting or elimination
• Ignore accidentsIgnore accidents

10. Next stepNext step
 Move from the convenient pot to real toiletMove from the convenient pot to real toilet
seat.seat.
 Structure/ modify the toilet according toStructure/ modify the toilet according to
needneed

11. AdaptationsAdaptations
 Support for balanceSupport for balance
 Cover holeCover hole
 Eliminate smellsEliminate smells
 Dry areaDry area
 Reinforcing environment- music/stressReinforcing environment- music/stress
less timeless time

12. WashingWashing
Backward ChainingBackward Chaining
1.1. CleaningCleaning
2.2. Pour water+ cleanPour water+ clean
3.3. Fill water- pour water+ cleanFill water- pour water+ clean
 FlushFlush
 adaptationsadaptations

13. CleaningCleaning
 The adult pours water for the child .The adult pours water for the child .
 Gives physical and verbal prompts toGives physical and verbal prompts to
clean. Instructions need to be specific-clean. Instructions need to be specific-
up / down.up / down.
 Gradual withdrawal of prompts.Gradual withdrawal of prompts.

14. PouringPouring
 The adult fills the water.The adult fills the water.
 The child can now use one hand forThe child can now use one hand for
cleaning.cleaning.
 The adult prompts the child physically toThe adult prompts the child physically to
pour water .pour water .
 Specific instruction- pour waterSpecific instruction- pour water
 Gradually the prompts are faded.Gradually the prompts are faded.

15. Filling waterFilling water
 Once the earlier activities are masteredOnce the earlier activities are mastered
the adult prompts the child to fill mug fromthe adult prompts the child to fill mug from
a bucket and pour.a bucket and pour.
 Jets and other modern equipment isJets and other modern equipment is
useful.useful.
 Use hose pipes/jets forUse hose pipes/jets for
convenience,.convenience,.

16. Express toilet needsExpress toilet needs
 Catch signalsCatch signals
 Single wordsSingle words
 SignSign
 Picture exchange-Picture exchange-
 Knocking the doorKnocking the door

17. Eating HabitsEating Habits
WE WANT-WE WANT-
 Eat while sitting in a placeEat while sitting in a place
 Eat neatlyEat neatly
 Eat a varietyEat a variety
 Eat at a desired speedEat at a desired speed
 Avoid overeating/ eat enoughAvoid overeating/ eat enough

18. Eating -sitting at a placeEating -sitting at a place
 If the child does not sit and runs aroundIf the child does not sit and runs around
while eating-while eating-
 Serve food after he/ she has sat.Serve food after he/ she has sat.
 Have a designated area for eating.Have a designated area for eating.
 Use visual cues.Use visual cues.
 Take away food if the child gets up.Take away food if the child gets up.
 Serve small amounts of preferred food .Serve small amounts of preferred food .

19. Eating neatlyEating neatly
 Serve rice and curry mixed in a bowl.Serve rice and curry mixed in a bowl.
 Make rice and dal ballsMake rice and dal balls
 Chair close to table.Chair close to table.
 Serve small amounts of food.Serve small amounts of food.
 Instruct to extend or bend head forwardInstruct to extend or bend head forward
while taking in spoon to mouth or hand towhile taking in spoon to mouth or hand to
mouth.mouth.
 Aprons and hand towelsAprons and hand towels

20. Eat variety of foodEat variety of food
 Check whether any sensory problem.Check whether any sensory problem.
 Give small amounts of new food.Give small amounts of new food.
 Reward eating of the small amount of new foodReward eating of the small amount of new food
with a preferred reinforcer.with a preferred reinforcer.
 Select a new food that is somewhat similar toSelect a new food that is somewhat similar to
the old onethe old one
 Dosa- bason cheela- idli-pohas.Dosa- bason cheela- idli-pohas.
 Bread- rusks- stuffed chapati- chapatti and curryBread- rusks- stuffed chapati- chapatti and curry

21.  Allow the child to touch/ small/ see theAllow the child to touch/ small/ see the
new item .new item .
 NEVER FORCE TO EAT.NEVER FORCE TO EAT.

22. OVER EATINGOVER EATING
 It is often a way of passing time.It is often a way of passing time.
 Plan the activities for the childPlan the activities for the child
 Meal times need to be visually presented.Meal times need to be visually presented.
 Structure the environment.Structure the environment.
 Do not have any junk food available.Do not have any junk food available.
 Family will need to be disciplined reg meal timesFamily will need to be disciplined reg meal times
 Never allow the child to eat from others’ plates.Never allow the child to eat from others’ plates.

23. Bath timeBath time
 Sensory issues need to be ruled out.Sensory issues need to be ruled out.
 Pour waterPour water
 Applying soapApplying soap
 Cleaning selfCleaning self
 Pour waterPour water
 Use towelUse towel
 Instructions / id of body partsInstructions / id of body parts

24. Teach the stepsTeach the steps

25. Task AnalysisTask Analysis
 Go to the bathroomGo to the bathroom
 Remove clothesRemove clothes
 Pour waterPour water
 Pick soapPick soap
 Apply soapApply soap
 ScrubScrub
 Pour waterPour water
 Wipe with towelWipe with towel
 Wear clothesWear clothes

26.  Try different kinds of soaps, lotions, sponges,Try different kinds of soaps, lotions, sponges,
brushes.brushes.
 Bath with mug vs. shower If the child wants so.Bath with mug vs. shower If the child wants so.
 After bath, wrap in soft towel or linenAfter bath, wrap in soft towel or linen
 Pat dry if the child avoids rubs.Pat dry if the child avoids rubs.
 Try to figure out what bothers the child- head bath,Try to figure out what bothers the child- head bath,
rubbing towel or soap?rubbing towel or soap?
 It could also be a wet floor that bothers him.It could also be a wet floor that bothers him.
BATHING

27.  Find out if there is anything that bothersFind out if there is anything that bothers
the childthe child
Example-sound of filling water, touch, theExample-sound of filling water, touch, the
bathroom structure.bathroom structure.
 Use sponge/ fill water in advance/ prepareUse sponge/ fill water in advance/ prepare
the child for contact/ stand in front/ givethe child for contact/ stand in front/ give
gentle prompts/ pass string through thegentle prompts/ pass string through the
soap and put around the child’s necksoap and put around the child’s neck

28.  If child does not like wearing someIf child does not like wearing some
colors and textures, respect hiscolors and textures, respect his
decision.decision.
 Child does not like wearing woolens, heChild does not like wearing woolens, he
can wear several loose layers ofcan wear several loose layers of
clothing, wind cheater or jacket.clothing, wind cheater or jacket.
 Do not let your own desire of makingDo not let your own desire of making
the child look smart bother him in anythe child look smart bother him in any
way.way.
DRESSING

29. Dressing UndressingDressing Undressing
 BACKWARD CHAININGBACKWARD CHAINING
 ExampleExample
 Adult puts pants for the child and pulls just up toAdult puts pants for the child and pulls just up to
thighs. Child pulls it upthighs. Child pulls it up
 Slowly the adult pulls the pant up less and theSlowly the adult pulls the pant up less and the
child pulls at a longer length.child pulls at a longer length.
 Child sits on a chair with adult at lower levelChild sits on a chair with adult at lower level
child extends leg and the adult puts in one leg .child extends leg and the adult puts in one leg .
 The child starts putting in one leg independentlyThe child starts putting in one leg independently

30.  The child puts in both the legs one by oneThe child puts in both the legs one by one
with the adult holding the pant and thewith the adult holding the pant and the
child then pulls it up.child then pulls it up.
 Provide physical and verbal promptsProvide physical and verbal prompts
 Fade physical prompts first.Fade physical prompts first.
 Let the garments be loose duringLet the garments be loose during
 the training.the training.

31. Concept of privacyConcept of privacy
 During toilet training, changing clothes orDuring toilet training, changing clothes or
bathing the door needs to be closed.bathing the door needs to be closed.
 Adults should remember the same.Adults should remember the same.

32. BrushingBrushing
 Try brushes of different kids of textures.Try brushes of different kids of textures.
 Soak the new tooth brush in water beforeSoak the new tooth brush in water before
use.use.
 Vibrating tooth brushes may be tried.Vibrating tooth brushes may be tried.
 Massage gums at other times.Massage gums at other times.
 Try toothpaste, powders, gels of differentTry toothpaste, powders, gels of different
flavorsflavors

33. BRUSHING-contdBRUSHING-contd
 Instead of toothbrush, fingerInstead of toothbrush, finger
may be used.may be used.
 Traditional methods:Traditional methods:
Datoon, Mustard oil andDatoon, Mustard oil and
Salt can be usedSalt can be used
 Make the child drink plentyMake the child drink plenty
of water.of water.
 Avoid colas and chocolates.Avoid colas and chocolates.

34. Task Analysis for BrushingTask Analysis for Brushing
TeethTeeth
1.1. Get your toothbrush.Get your toothbrush.
2.2. Take out toothpaste.Take out toothpaste.
3.3. Unscrew toothpaste cap.Unscrew toothpaste cap.
4.4. Lay cap on countertop.Lay cap on countertop.
5.5. Turn on cold water.Turn on cold water.

35.  Take out your toothbrush.Take out your toothbrush.
 Wet bristles of toothbrush.Wet bristles of toothbrush.
 Put toothpaste on toothbrush.Put toothpaste on toothbrush.
 Lay toothpaste tube on countertop.Lay toothpaste tube on countertop.
 Bring toothbrush with paste up to mouth.Bring toothbrush with paste up to mouth.

36.  Begin brushing teeth.Begin brushing teeth.
 Left back: top – outside then inside LeftLeft back: top – outside then inside Left
back: bottom – outside then insideback: bottom – outside then inside
 Then front: top – outside then insideThen front: top – outside then inside
 Then front: bottom – outside then insideThen front: bottom – outside then inside
Then right back: top – outside then insideThen right back: top – outside then inside
Then right back: bottom – outside thenThen right back: bottom – outside then
insideinside
 Instruction- “do this”- modelingInstruction- “do this”- modeling

37.  Spit toothpaste into sinkSpit toothpaste into sink
 Rinse toothbrush under water stream.Rinse toothbrush under water stream.
 Shake water out of brush.Shake water out of brush.

38. Specific activitiesSpecific activities
 Nail cuttingNail cutting
1.1. Cut nails after bathCut nails after bath
2.2. Massage handsMassage hands
3.3. Turn taking with sibling or parentsTurn taking with sibling or parents
4.4. Cut one nail per dayCut one nail per day
5.5. Cut nails while sleepingCut nails while sleeping

39. Hair cuttingHair cutting
 See what bothers the childSee what bothers the child
 Sound of scissors/spray of waterSound of scissors/spray of water
 Touch or the falling hairTouch or the falling hair
 Prepare the childPrepare the child
 Eliminate distractionsEliminate distractions
 Use structure/ social storiesUse structure/ social stories

40. ShavingShaving
Backward chaining or forward chainingBackward chaining or forward chaining
stepssteps
1.1. Pick shaving creamPick shaving cream
2.2. Apply shaving creamApply shaving cream
3.3. Use the razorUse the razor
4.4. Movements of razorsMovements of razors
5.5. Wash faceWash face

41. Other issues for independentOther issues for independent
FunctioningFunctioning
 Mainly preparing for long term –adult lifeMainly preparing for long term –adult life
 Prepare a snackPrepare a snack
 Move independentlyMove independently
 Follow routinesFollow routines
 Take care of belongingsTake care of belongings
 Carry messagesCarry messages
 ShoppingShopping
 Prepare own bed/ wash clothes/ utensils/ fillPrepare own bed/ wash clothes/ utensils/ fill
water for drinkingwater for drinking
 Leisure skillsLeisure skills

42.  Follow survival signsFollow survival signs
 Attend to phone callsAttend to phone calls
 Self information.Self information.