- For tasks that involve using the sink, make sure your child has a stable stool to stand on that raises him/her to a comfortable
- Toothbrushing and hand washing are multi-step tasks. Use consistent words or short phrases to prompt them through each step
one at a time.
- Pair verbal prompting with visual cues, such as the picture sequences described above, for better learning and retention
- The first few times, practice brushing teeth without toothpaste on the brush
- Removing and replacing the toothpaste cap may be challenging, so practice just this skill when you can. For additional fine motor
support, work on the activities listed in Thumb Opposition.
- Use hand-over-hand guidance to teach putting toothpaste on the toothbrush. This way, the child will be able to feel the amount of
pressure you are exerting to squeeze.
- Many children are not used to minty flavored food, so use a child-friendly flavored toothpaste
- If your child initially dislikes using toothpaste, make it into a game: "Try to paint all the teeth in your mouth" for example. Use a
Q-tip to "paint" the teeth if they won't allow a toothbrush in
- Some children have aversions to having certain things or textures in their mouths, such as rough toothbrush bristles. Here are
some ways to prepare the mouth for brushing:
- have your child hold a vibrating toy (with gentle vibration) against his/mouth and cheeks for a few minutes. Then try a
toothbrush inside the mouth.
- use a vibrating teething toy: let child bite and chew on it with the vibration on and also move it around the cheeks
- let child chew on thick, crunchy or chewy food prior to brushing. Examples: Dutch pretzel, bagel, dough pretzel, twizzler
- talk to your therapist about using a Nuk brush (a modified toothbrush) and for other sensory strategies
- To encourage brushing teeth for a reasonable duration, create a song or poem to sing while doing it. As an example: "This is the
way we brush our teeth, brush our teeth, brush our teeth; This is the way we brush our teeth, so early in the morning".
- Teach how to turn on the faucet and using one finger to test the temperature. Start with turning on the cold water first. If
using a single knob for hot and cold, make sure the knob is in the cold position before your child turns it on. Always supervise
closely and test the water yourself when your child is first learning about temperature control.
- Use a picture sequence strip if necessary to teach the steps in the process: "turn on water, test temperature, wet hands, use
soap, rinse hands, turn off water, dry hands"
- To encourage washing hands for a reasonable duration, create a song or poem to sing while doing it. As an example: "This is the
way we wash our hands, wash our hands, wash our hands; This is the way we wash our hands, so early in the morning".
- Starting at the age of 2, most children are able to learn this skill on their own by imitating adults. If not, try these strategies:
- Start with learning to blow things with the mouth: blow bubbles or blow out candles. Have contests blowing cotton balls or ping
pong balls across a table while blowing through a straw.
- Once blowing by mouth is mastered, hold a tissue loosely over the nose and mouth and challenge the child to blow the tissue up in
the air by blowing only through the nose.
- Blow against a window or a mirror so that the child can see the mist that he/she creates by blowing through the nose
- Teach nose blowing in front of the mirror to pair the visual with the action: this reinforces learning. It will also help in cleaning
the nasal area thoroughly
- Cup drinking is best taught by first using a 2 handled cup with a top, then progressing to a covered cup without handles to
eventually an open cup that is filled half full
- Drinking through a straw: start with a short straw as the child may not have the suck strength or attention to suck liquid all the
way up through a long straw
- Teach eating with utensils starting with spoon feeding. Eventually progress to the more challenging skill of using a fork.
- Some children have difficulty planning the motor movements involved in getting food onto a spoon or fork and then into the
mouth. Use a hand-over-hand approach to create a "motor memory" for the desired motion. Much hand-over-hand repetition may
- Grasping utensils correctly: additional fine motor support may be needed to develop a non-fisted grip on eating utensils. Review
suggested activities listed in Pincer Grasp