Self Help skills (continued)
    on.  This won't be necessary as they become more competent at sequencing the task.  
  • If they are having difficulty learning the sequence, you can prompt them by telling them a step
    and then asking "What comes next?"
  • For additional support, make a picture sequence of the activity on a strip of paper and leave it
    within view.  You can photograph your own child during the activity for picture prompts, find clip
    art on the internet or draw the steps yourself.  Point to each picture as each step comes up.
Therapy Street for Kids

blow/wipe nose
Grooming supports:
  • 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

    brushing teeth
  • 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".

    hand washing
  • 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".

    nose blowing
  • 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

Feeding supports
  • 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
    be needed.
  • 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
General tips:
  • You can make self help tasks easier for children by breaking the job
    down into smaller steps.  For example, rather than saying  "start
    brushing your teeth", tell the child what to do first, then second and so
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