Worries over the future are one of the most common concerns we hear for parents. Thankfully, we have a few predictors we can look toward to give us some clue about potential outcomes. Note that we say "predictors" and this is not a guarantee one way or another!
One of these predictors is the child’s ability to engage in independent living skills. Children on the autism spectrum often need to be taught these skills more explicitly than other children. This is important and sometimes over looked, particularly for higher-functioning children, as professionals and parents focus on academics or other skills. However, research indicates that deficits in adaptive functioning skills are often present regardless of level of cognitive functioning. Given the importance of emphasizing daily living skill development, I think it could be helpful to review strategies for increasing independence.
Before starting, it can be helpful to develop a plan. Make a list of independent living skills that may be more difficult for your child (but that other kids the same age are often able to do). Don’t let this list overwhelm you but use it as a guide. Only focus on one or two skills at a time.
One barrier to skill development is language understanding. If children do not understand what is said to them, they cannot adequately benefit from their parents’ teaching. Therefore, it is important in these situations to supplement verbal communication with the use of visual supports. One type of visual support that can be particularly useful is a visual schedule. In this case, a visual schedule shows a child the different steps involved in completing a particular skill. For example, when teaching a child to brush their teeth, you might break this down into steps involving picking up the toothbrush, putting toothpaste on, wetting the toothbrush, brushing the top teeth, brushing the bottom teeth, spitting, rinsing their mouth, rinsing the brush, and putting away their toothbrush. Then, as you practice this skill with them, you point to each step as you complete it. This provides the child with a better understanding of the steps and, over time, they will be able to use the visual supports to complete the task more independently.
It is important not to expect a child to learn or begin implementing a new skill immediately. Lasting behavior change and skill development don’t happen over night. Instead, we have to gradually shape behavior. This means that we have to set goals right above where an individual is currently functioning. Then, we reinforce meeting these goals. Once the individual is able to meet this goal more than 80% of the time, then the goal can be gradually increased. If we initially set the goal too high, then the individual is likely to become overly frustrated and give up. If the goal is set too low, then it is too easy and we do not see additional development. Keeping data regarding the frequency of meeting goals is very important to determining progress and when to increase demands.
When teaching daily living skills, it is often apparent that other skill deficits or sensory sensitivities may act as a barrier to a child’s ability to learn and use the skill. It is important to consider other therapies that may be necessary. For example, some children fall behind in their ability to dress themselves independently because of fine motor deficits interfering with their ability to zip or button. Children may also refuse taking a bath/ shower or brushing their teeth due to sensory sensitivities. These children would likely benefit from occupational therapy services to address these symptoms.
Whenever a skill or behavior is reinforced, it will happen more frequently. Therefore, whenever you are teaching a child to perform a new skill, it is important that any progress is reinforced. Reinforcement can take many forms from praise (particularly labeled praise – naming the behavior that pleases you) to earning privileges that the child finds reinforcing. Reinforcement is most effective when it occurs as close in time to the behavior as possible and is used consistently.
It is important that skills are practiced across different environments in order to increase generalization of skills developed. It is often best to initially practice in a comfortable environment. However, as your child masters the skill in that environment, it should be practiced in new less familiar environments to increase the child’s ability to generalize the skill to new situations.
Steps to Independence: Teaching Everyday Skills to Children with Special Needs by Bruce L. Baker and Alan J.Brightman
https://www.amazon.com/Steps-Independence-Teaching-Everyday-Children/dp/1557666970
The Center for Autism Research (CAR) Autism Roadmap has a section dedicated to tips for developing daily living skills from toileting, showering, hair care, and brushing teeth
https://www.carautismroadmap.org/category/home-family/
Taking Care of Myself by Mary Wrobel
https://www.amazon.com/Taking-Care-Myself-Personal-Curriculum/dp/1885477945
The Autism Speaks website lays out a good example of a morning checklist to increase independent functioning:
https://www.autismspeaks.org/teaching-important-life-skills-start-early-possible
They also have a section related to tips for developing life skills that includes a link to a community-based skills assessment to help with planning:
https://www.autismspeaks.org/life-skills-and-autism
For more information regarding research indicating the importance of focusing on daily living skill development:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398153/
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Licensed Clinical Psychologist