Coronavirus Makes Teaching Hand Washing to Kids with Autism Even More Important

Today, I am going to be talking about the Coronavirus and how it is affecting the autism world as we speak. I’m also going to be giving some really practical tips on teaching hand washing to kids with autism.

Each week I provide you with some of my ideas about turning autism around. So if you haven’t subscribed to my YouTube channel you can do that now. Today I am sharing a bonus video I did a few years ago on handwashing and teaching hand washing to kids with autism, which is a common thing we’ve been hearing a lot lately, we just need to wash our hands. We need to not panic. So today I thought I would talk about the Coronavirus. You can’t go anywhere, you can’t look on Facebook, you can’t turn on the TV without hearing or seeing something about it.

First thing, as soon as I opened my email for today, I learned that stock prices have fallen and the markets are going into a spiral again. And I am not a Coronavirus expert, I am a registered nurse though and I’m married to a emergency medicine physician, but just a few times last week I had situations where the Coronavirus was definitely impacting the autism world. For example, the California ABA conference was scheduled to go on and an hour before preregistration, CalABA pulled the plug on the whole conference. Many of the speakers including Dr. Amanda Kelly and Dr. Mark Sundberg were both scheduled to speak at the CalABA conference and it was canceled the hour before the conference. So it is affecting us in the autism world quite a bit.

So teaching hand washing is also the bridge for how to teach other self-care skills. My book, The Verbal Behavior Approach in chapter 11 is all about potty training, but on pages 156-158, I also provide specific feedback on how to start teaching hand washing. One of the things about teaching hand washing that is so important is you want to break down the task. And we’re going to talk about this a little bit more in a second, but in my book I talk about teaching hand washing, and in my list of steps I state to grab both knobs and turn the water on. So this is my house. I have two knobs in the sink that we were going to practice on, but some of your sinks have just one handle that pushes up. Some of them have a knob that turns side to side.

So each breakdown or task analysis as we call it needs to be individualized so that you have the steps broken down. Why are we focusing on teaching hand washing as one of the first, if not the very first self-care skill to teach? It’s because by 18 months, and this is from Dr. Mark Sundberg’s self-care checklist, kids should be able to wash hands with assistance. By four years of age, children should be able to definitely wash their hands.

It’s also in the self-care checklist under toileting and it is one of the important skills to teach before potty training so that we can quickly go in from sitting on the toilet peeing and then getting up, pulling up pants, which is part of dressing, and then wash your hands. So teaching hand washing is important. It’s an important skill at home, at preschool, after pottying, before meals. The other really important reason that I like to start with teaching hand washing as opposed to starting with a dressing or wiping your bottom is because it’s easy to prompt from standing right behind the child. So if we think about wiping your bottom after a bowel movement, you can’t easily get behind the child in order to prompt that. So those are the reasons I like to start with teaching hand washing.

Now, in addition to my book, I also really like the book Self Help Skills for People with Autism, which is written by four people of which two are listed as BCBAs and the other two have doctorals. It’s a very good ABA friendly book with really good advice for all kinds of skills including potty training, hand-washing, tying shoes. There’s also a really nice what we call a task analysis sheet, which allows you to break down the information into what we call component parts.

Want to learn more about teaching self care skills to kids with autism?
Sign Up for Free Workshop

So in my task analysis sheet, as I describe in chapter 11 of my book, I have grasp both knobs and turn the water on. Put right soap on a right hand on soap pump and left hand under spout. Press pump two times. Rub hands together for five to 10 seconds. Place hands under faucet to remove soap and turn the water off. Get towel, dry both hands and place towel back on rack. Now remember I wrote my book in 2007 for those of you that know that, and in the meantime, another thing I’ve learned was that when you do task analysis and when you are giving kids directions for the different breakdown, you should really have five words or less.

This is a TAGTeach kind of rule and now we use that. For a previous client, Cody, his task analysis sheet had push up sleeves, turn water on, wet hands, gets soap, rub hands, count to five, hands underwater, turn water off, dry hands. Then we’d record the data and mark with a V for verbal prompt, G for gestural prompt, or I for independent. And we would also have whether it was a full physical prompt or partial prompt. And in the bonus video, which you can get and see the whole video of me working with Cody and his mom, you will see the need for more physical. While Cody is resistant to mom helping him pull up his sleeves, he’s really good with imitating.

So in the end we end up doing a video model of his mom actually going through the tasks herself, saying each item like push sleeves up, turn water on, as she does it. And with the use of video modeling it was really what helped Cody become fluent with washing his own hands, which has been great. So you might say, well, what about having like a visual schedule of that. And what I found is that this technique of walking through kids through prompting from behind very gently of course, if if they are resistant to physical prompts using something like a video modeling, or imitation is really much better for many kids then using a visual schedule where they’re kind of breaking the chain as they go. And so each kid might be different though.

So the key is, is that kids need to learn to wash their hands and in light of the Coronavirus they need to learn as quickly as possible how to wash their hands. And so my take is that the best way to start teaching hand washing is by breaking the task down. Like I said, for your sink, for the sink that they’re going to mainly practice on. And there may be a sink at school and a sink at home and you may be just at home with your child and you can just have it set up like the home one. He might need more assistance at school until it’s fluent. So even if you have the hand soap on the right side, but it could go either way, but at school it’s mounted to the left side. You might want to put it on the left side just to get the child to go over there so that they can generalize better to other sinks.

I mean most people just don’t think about like all the generalization that’s needed for teaching hand washing. Where are the soaps located? Whether it’s a one handle push up or knobs where you have to turn both. There’s temperature control. All these factors, whether you use foam soap versus regular liquid soap, regular liquid soap, you know, you do three or four versus foam soap. You get a totally different amount of soap. You don’t want too much. You don’t want too little. I have found that counting, really helps with teaching hand washing.

And up until now, I don’t think I have any free videos on teaching hand washing. So now I have one that’s out, which is at Marybarbera.com/handwashing. If you enjoyed this video/article, I’d love it if you would share it, and leave me a comment and for more information, how you can help kids increase talking decrease tantrums and learn about self help skills like teaching hand washing. I would love it if you would attend a free online workshop marybarbera.com/workshops and I hope to see you right here next week.

Want to learn more about teaching self care skills to kids with autism?
Sign Up for Free Workshop

Transcript

Today, I am going to be talking about the Coronavirus and how it is affecting the autism world as we speak and I’m also going to be giving some really practical tips on how to teach kids with autism to wash their hands. Hi, I’m dr Mary Barbera, autism mom board certified behavior analyst and bestselling author. Each week I provide you with some of my ideas about turning autism around. So if you haven’t subscribed to my YouTube channel you can do that. Now today I am sharing a bonus video I did a few years ago on handwashing and how to teach kids with autism to wash his or her hands, which is a common thing we’ve been hearing a lot lately is you know, we just need to wash our hands. We need to not panic. So today I thought I would talk about the Coronavirus. You can’t go anywhere, you can’t look on Facebook, you can’t turn on the TV.

First thing, as soon as I opened my email for today, I learned that stock prices have fallen and you know the markets are, are going into a spiral again all last week. And I am not a Coronavirus expert. So I’m, I am a registered nurse though and I’m married to a emergency medicine physician, but just a few times last week I had situations where the Coronavirus was definitely impacting the autism world. Also on Wednesday or Thursday, um, the California ABA conference was scheduled to go on and an hour before preregistration, uh, Cal Aba pulled the plug on the whole conference. Many of the speakers including Dr. Amanda Kelly who was on episode podcast, episode number eight I believe, and dr Mark Sundberg where they were both scheduled to speak at the Cal ABA conference and it was canceled the hour before the conference. So it is affecting us in the autism world quite a bit.

So we’re going to talk about teaching hand-washing and, and it also is the bridge for how to teach other hand-washing other self care skills. My book, the verbal behavior approach in chapter 11 is all about potty training, but on pages one 56 to one 58, I also provide, um, specific feedback on how to teach hand-washing. Um, and one of the things about hand-washing that is so important is you want to break down the task. And we’re going to talk about this a little bit more in a second, but in my book I talk about hand-washing, grab both knobs and turn the water on. So this is my house. I have two knobs in the sink that we were going to practice on, but some of the, your sinks have just one handle that pushes up. Some of them have, you know, a knob that turns side to side.

So each, um, breakdown or task analysis as we call it, um, needs to be individualized so that, uh, you have the steps broken down. Why are we focusing on hand-washing as one of the first, if not the very first self care skill to teach is because by 18 months, and this is from dr Mark Sundberg’s self care checklist, which is so important. Uh, you can get this at avbpress.com and we can also, I believe link it in the show notes. It’s under resources, VB-MAPP, supplementary materials on avbpress.com. Right. So by 18 months there should be, they should be, kids should be able to wash hands with assistance. This is by Chronicle chronological age of 18 months by uh, 30 months. They should be washing hands, uh, trying to watch hands independently and by four years of age, um, children should be able to definitely wash their hands.

Um, it’s also in the self care checklist under toileting and it is one of the important skills to teach before potty training so that we can quickly go in from sitting on the toilet peeing and then getting up, pulling up pants, which is part of dressing a self care checklist and then wash your hands. So washing hands is important. It’s an important skill at home, at preschool, after potty training, I mean after pottying, before meals. The other really important reason that I like to start with hand washing as opposed to starting with a dressing or wiping your bottom is because it’s easy to prompt from standing right behind the child. So if we think about wiping your bottom after a bowel movement, you can’t easily get behind the child in order to prompt that. So those are the reasons I like to start with hand-washing.

Now, in addition to, um, my book and chapter 11, specifically, page one 56 of the verbal behavior approach, I also really like this book self help skills for people with autism, which is um, written by four people of which two are listed as BCBAs and the other two have doctoral. So self help skills for people with autism is a very good ABA friendly book, uh, with really good advice for all kinds of skills including potty training, hand-washing, tying shoes. I also have a ton of videos, uh, on all of those things. I have potty training videos, uh, video blogs, podcasts, marybarbera.com/potty will get you a free guide that I recently wrote. Um, I have videos on shoe tying. Okay. So in the book self help skills for people with autism is a really nice what we call a task analysis sheet, which uh, allows you to break down the information into what we call component parts.

So, um, like I was saying before with my, uh, hand-washing in chapter 11 of my book, the verbal behavior approach, I said, turn the knobs and um, and the next steps in this, in my breakdown here, grasp out both knobs and turn the water on. Put right soap on a right hand on soap pump and left hand under spout. Press pump two times. Rub hands together for five to 10 seconds. Uh, place hands under faucet to remove soap and uh, turn the water off. Get towel, uh, dry both hands and place towel back on rack. Um, now remember I wrote my book in 2007 for those of you that know that, um, it in the meantime, uh, another thing I’ve learned was that when you do task analysis and when you are giving kids directions for the different breakdown, you should really have five words or less.

Um, this is uh, a tag. Teach a kind of rule and now we use that. So here is Cody’s task analysis. Push up sleeves, turn water on, wet hands, gets soap, rub hands, count to five, uh, hands underwater, turn water off dry hands. And then what you see over here is the date. And then you also see, uh, V for verbal prompt G for gestural prompt I for independent. And, um, we would also have the physical props full physical prompt or partial prompt. And in the video, which you can get and see the whole video of me working with Cody and his mom, you will see the need for more physical. So in the video, which I’m not going to be able to show you right here, but Cody is resistant to mom helping him pull up his sleeves, but he’s really good with imitating.

Um, and so in the end we end up, um, doing a video model of his mom actually going through the tasks herself, saying each item like push sleeves up, turn water on, um, as she does it. And with the use of video modeling was really what helped Cody become fluent with washing his own hands, which has been, which has been great. So you might say, well, what about, um, you know, having like a visual schedule of, of that. And what I found is that, um, this technique of walking through kids through prompting from behind very gently of course, um, if if they are resistant to physical prompts using something like a video modeling, um, or imitation is really much, uh, better for many kids then using a visual schedule where they’re kind of breaking the chain as they go. And, um, so each kid might be different though.

So the key is, is that kids need to learn to wash their hands and in light of the Coronavirus they need to learn as quickly as possible how to wash their hands. And um, so my take is that the best way to do that is by breaking the task down. Like I said, for your sink, for the sink that they’re going to mainly practice on. And there may be a sink at school and a sink at home and you may be just at home with your child and you can, uh, just have it set up like the home one. Uh, he’s might need more assistance at school until it’s fluent. Um, so even if, um, you have the hand soap on the right side, but it could go either way, but at school it’s mounted to the left side. You might want to put it on the left side just to get the child to go over there so that they can generalize better to other sinks.

I mean most people just don’t think about like all the generalization that’s needed for hand-washing. Where are the soaps located? Um, whether it’s a one handle push up or knobs where you have to turn both. There’s temperature control. All these factors, whether you use, um, foam soap versus regular liquid soap, regular liquid soap, you know, you do three or four versus foam soap. You get a totally different amount of soap. Um, you don’t want too much. You don’t want too little. Um, I have found that counting, um, really helps with hand washing. That’s kind of what I know about, uh, Coronavirus. It is affect. It’s affecting all of us. We all need to stay calm. Um, I think this 24, seven news cycle is, is making us all a little bit more anxious than we need to be. Really using the opportunity to learn online what to do I think is a, is a great thing.

And um, up until now, I don’t, don’t think I have any free videos on hand-washing. So now I have one that’s out, which is Marybarbera.com/handwashing. So if you ever can’t remember what she say the link was for potty or dressing or anything like that, just search in a Google search, mary autism plus your topic. Um, there’s, chances are very good that with weekly content coming out for the last couple of years that I probably have something and if I don’t have something, let me know and maybe I will do that topic, uh, for a live or for something that you can attend. If you enjoyed this video, I’d love it if you would share it. Leave me a comment and for more information, how you can help kids increase talking decrease tantrums and learn about self help skills like hand-washing. I would love it if you would attend a free online workshop marybarbera.com/workshops and I hope to see you right here next week.

Download the Transcript