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5494 Perseverance, Patience & Possibility: Teaching Intimate Self-care Skills

Saturday, July 9, 2011: 3:15 PM-4:30 PM
Tallahassee 123 (Gaylord Palms Resort and Convention Center)
Home-based occupational therapy services to clients with autism spectrum disorders represent a facet of intervention that essentially involves the entire family system when teaching intimate self-help skills, such as dressing, showering, and toileting. Use of assistive devices need gradual introduction, sensory considerations need to be addressed, and family routines have to be understood for success of the client's independent functioning within the family system. THIS case study will describe the 2 year process of teaching a young teenaged boy with Autism how to independently perform a showering routine which included washing hair, putting on deoderant, and dressing routines. His use of the Dynavox for communication was utilized to create a sequential pictoral and word display of the steps involved: over 35 steps from start to finish! The considerations in this intervention, performed in the home, included: sensory (tactile defensiveness), communication (both receptive and experessive), motor planning difficulties, fine motor skills, and familial routines.

Particpants will learn from this example how patience and careful pre-planning are necessary when providing an intimate, self-help skill within the home environment to a person with Autism Spectrum disorder. The development of the intervention was a collaboration between the school personnel who provided swimming pool activities and the members of the entire family who might be supervising the showering routine on a rotating, daily basis with this client. Understanding when to introduce assistive devices, account for sensory defensiveness, and establish self-care routines within the family dynamic is necessary to implementation and success, with creativity and flexibility being the traits most needed in the OT provider.

Due to the potential increase in numbers of teens transitioning into community settings when graduating high school, acheiving independence this showering task (as well as toileting and dressing skills) can mean the difference between a one-on-one assistant or use of minimal verbal and physical cues to assist the client in performing selfcare tasks independently.  Having an attitude of 'patience and possibility" on the part of the OT can convey to the team providers that working for several years during their early years can have an enormous pay-off for the client and the family/caregivers who will be involved for the client's lifetime.

Learning Objectives:

  • Participants will learn how to analyze a self-help skill and teach the steps using multiple learning strategies.
  • Participants will appreciate the intricacy and time-involvement when teaching independence in a complex self-help taks.
  • Participants will understand the familial considerations when home-based occupational therapists teach intimate, self-care skills.

Content Area: Life with Autism


Margo Ruth Gross, Ed.D., OTR/L, LMFT
Assistant Professor of Occupational Therapy
Sacred Heart University

Ms. Gross has worked in pediatric and psychiatric OT practice settings and has maintained a private practice providing consultation to schools and families for clients on the autism spectrum and other realted disorders for over 30 years. She also teaches full time in a graduate OT program in CT.