Promoting Independence in Daily Living Skills

Are you trying to help your child become more independent in their daily living skills, such as brushing their teeth, putting on their clothes, and washing their hands? Instead of just doing it for them, let’s encourage some independence by planning a time when you are not rushed to teach them how to do it! The visual above shows the prompt levels that can guide you on their path to independence.

Anticipated Outcomes and Proper Usage Instructions!

Most-to-least prompting starts with the most invasive prompt, such as hand-over-hand (full physical prompt), and fades back with the next least invasive prompt (partial physical prompt) as they become more independent at the task. Tapping gently or guiding the child’s hand to pick up the toothbrush are examples of partial physical prompts. It is important not to over-prompt during this phase. Remember, you are promoting independence, not dependence.

Once you see more independence using the partial physical prompt, maybe try modeling the expectation by brushing your teeth with them at each step of the process. Some steps may need more support than others, but as needed, go back to the prompt level until independent, and then move on to the next step.

Keep in mind that not all steps require the same prompt level. For example, they may not be able to unscrew the top of the toothpaste, so they may need a full physical prompt, whereas they may only need modeling for squeezing the toothpaste out. If they are doing really well with modeling, maybe next time try using the gestural prompt by pointing to each step as they move through the task. If you notice they are not skipping any steps and are doing really well (maybe some steps they are doing it without gestures), then fade back to verbal direction with the steps they may be forgetting, not doing long enough, or need some correction. If you notice that verbal prompts are not helping, you may have to go back a prompt level to correct them for that step to teach them the right way before moving on. When you see the correct response at the prompt level you had to correct them on, then you know what type of prompt to give them next time.

Two big benefits of using Most-to-Least prompting tasks are preventing errors from being made and completing tasks more efficiently. However, like anything, there are some disadvantages to this direction of prompting, which include needing to assess the prompt levels on a daily basis to ensure they are being used correctly, and the Most-to-Least prompting strategy takes longer for the child to reach mastery levels.

If you are looking for more opportunities for independence and initiative, then use the Least-to-Most strategy by starting with the least invasive prompts for each step to see where their skill levels are and then increase the prompt level as needed. Be aware that this strategy is time-consuming and allows more opportunities for errors. However, to help avoid frequent errors, you can always strengthen and weaken the reinforcement given by maybe not being so excited about it when using more invasive prompts. It’s also important to remember to avoid accidentally reinforcing errors since you are giving them more independence and to give them time (5 seconds) to respond to each step on their own before prompting. For example, if they have the toothbrush in their hand but rather than rinsing it off first, they put it in their mouth without toothpaste on it, give the direction “time to brush teeth” after 5 seconds. If there is no response or an incorrect response, then point to the toothbrush, wait 5 seconds - if there is no response or an incorrect response, then model the correct response, and so forth down the prompt line until they complete the step. Restart the prompt level back to the least intrusive prompt for every step.

Go ahead and set a goal with their name in it and place it where they can see it. For example, “____ (name of child) will independently ____ (name of task) ___ (# of times) times in a row and then _____ (name of child) will get _____(reward)” to motivate them to reach the mastery level. I don’t recommend making the reward too out of the ordinary (new toy) because you don’t want them to think they will get that same reward every time they brush their teeth independently. Maybe a sticker or token (generalized reinforcer) that can be used to save up for that (big prize) to maintain the motivation and correct responses over time.

Side note, did you know that chain restaurants such as Dunkin' or Chick-fil-A use the same strategy to increase the rate of customers spending money on merchandise? For example, you can scan the QR code from their app and earn a certain amount of points depending on how much money you spent. Then, after accumulating a certain number of points, you can get something for free. The more expensive the product, the more points it requires, meaning you will spend more money to earn the points needed to get the preferred item for free. This is called a token economy, also known as a rewards system, which keeps the motivation for desired behaviors to be maintained or increased over time. Token economies are very useful and effective for teaching skills as such. For more information on token economies and how they can be used, stay tuned for QBC's next blog.

Keep This in Mind

• We want them to learn the correct way so we don’t have to unlearn incorrect habits. To ensure this, keep your corrections immediate and only praise the correct responses even if it is prompted.

• Each step completed correctly still needs reinforcement to maintain the correct response and motivation to do it the correct way in the future.

• Be direct and specific with your compliments. For example: "Way to remember rinsing the sink out", "Good job closing the toothpaste", "I like how you brushed the back of your teeth".

• Reinforcement is always given after the entire task is completed, whether it be a token, a hug, high five, praise, or a special treat, no matter how independent they are. Over time, the amount of praise or other types of reinforcement can be faded back so the correct response isn’t so dependent on this, but not too soon or too fast to avoid regression in progress.

• Always promote independence over doing it for them. Life goes by quickly, so be sure they have the skills they need when they need them the most.

If you have questions or need help on ensuring the techniques are implemented correctly, reach out to one of our behavior consultants directly. We are always happy to help. Our behavior consultants are highly trained professionals with years of experience in behavior analysis and modification. They specialize in providing personalized guidance and support to individuals seeking to improve their understanding and application of behavioral techniques. By contacting our consultants, you can benefit from tailored advice, practical tips, and effective strategies to address specific challenges and achieve desired outcomes. Whether you are a novice looking to learn the basics or an experienced practitioner seeking advanced insights, our consultants are dedicated to assisting you every step of the way. Don't hesitate to get in touch with us for expert assistance and guidance tailored to your unique needs and goals.