Many kids hate brushing their teeth. It’s actually quite common for young children to scream and squirm during this routine hygienic event. Or perhaps even worse, they clamp their teeth together and refuse to open their mouth! But children with autism may take tantrums to a whole new level, due to a unique mix of sensory and motivational issues, and difficulty with coordination or following instructions. Applied Behavior Analysis (ABA) is considered to be the most effective method of teaching various life skills to children with autism and other special needs. So if you are a parent or caregiver struggling with getting your child to brush his teeth, the following ABA strategies should help!
Social stories are a popular teaching method used by behavior analysts, special education teachers, and other professionals that work with children with special needs. A social story is a short story that is designed to introduce and prepare a child for what’s going to happen. You can find books about teeth brushing or create your own! Look online for sample social stories.
Teach in Small Steps
Children with autism benefit from being exposed to tasks in small steps. Sure, for us grownups, brushing teeth is not exactly complicated, but for children with autism, it can be overwhelming! Think about all of the steps involved: the child must walk to the bathroom and locate the toothbrush and toothpaste. Then rinse the toothbrush. Then open his mouth and brush each section. The list goes on and actually, the steps I have already listed can be divided into even smaller steps! So in ABA, we break tasks down into small steps (how small depends on the level of the child) and we teach each step one by one, rewarding the child along the way.
It may be that your child is so terrified of the toothbrush that you have to start with simply teaching and rewarding your child for simply opening his mouth.
Here’s an example:
Dad: “Say ahh!”
Child: opens mouth and says, “ahh!”
Dad: “Wow! You are awesome! Great job!” (Dad tickles child.)
As a next step you can brush just one section of your child’s teeth while counting to three. Work your way up, with your child brushing independently as the end goal. It can be a long road, but it’s worth it in the long run and will be easier the earlier you start.
Take a few deep breaths and put on your happy face! Make up a brushing teeth song. Dance! Let your child see you happily brushing your teeth. Try your best to convey to your child that brushing is fun! Also, make sure she has something fun to look forward to after brushing her teeth, such as a bedtime story, or a piggy back ride.
Don’t forget to tackle any sensory issues your child has. Most kids, if they know what to do and the reward is good enough, will have no problem at least attempting to brush their teeth. But some kids have sensory issues leading them to avoid brushing their teeth at all costs. If this is the case then you need to take steps to desensitize your child to the feeling of bristles on their teeth and gums. Some strategies include allowing the child to chew on the brush and gently brushing their cheeks and lips. You can also try using an electric toothbrush. Believe it or not some kids really like the sensation of an electric toothbrush (and their teeth will probably end up a lot cleaner)! Also, try using different kinds/flavors of toothpaste. Or forgo toothpaste altogether in the beginning stages.
I hope these strategies will make brushing teeth a little less scary for your child. Teach this skill patiently and systematically; and make it part of your child’s daily routine.