Melanie Nelson Instructional Program of Tooth Brushing Name of Student: Travis Initiator: Melanie Nelson Context for Instruction:

Instruction for tooth brushing will occur between 7:45 and 8:15 on Wednesdays, Thursdays, and Fridays. Student T will brush his teeth in the Mens bathroom of the Young Adult Program House. He will finish copying his schedule and filling out his last night paper and then begin his daily hygiene. Tooth brushing is the first step in daily hygiene. Student T will need a toothbrush, toothpaste, a sink, and the tooth brushing procedure. This is an individual activity done with me in the morning. Program Objective: During daily hygiene, Student T will perform 100% of the steps of the tooth brushing task analysis for ten consecutive school days. Generalization: Student T will generalize the skill to brushing his teeth at home. There are only two places that Student T will regularly brush his teeth: at home and at school. I can send home a sample data sheet for his parents to assess if he has generalized the skill in a new setting. Rationale:

Everything done at the young adult program is to help the students be more independent for their futures outside of school. Independence in some or all areas will help the students be more successful in life. Teaching Student T how to brush his teeth is very important because it is part of his daily hygiene. He will use this skill daily, if not multiple times a day. He has already had some signs of declining dental health, and knowing how to brush his teeth properly and independently will hopefully help to prevent further issues. Assessment Procedures: I will assess Student T during his daily hygiene routine. Here are the steps of the assessment procedure: Walk to Mens bathroom Check to see if there is anyone occupying the bathroom If open, walk into the bathroom Point to the daily hygiene schedule on the wall Point to tooth brushing and say Time to brush your teeth, Travis. Take data as he completes each of the steps of the task analysis Tooth brushing task analysis should be posted on the wall for his reference o Record if he utilizes this procedure With fading, gradually fade out steps of the task analysis until independent. Assess with materials used during instructional period

To take data: Record with a + next to the step on the task analysis if the task was done independently. Record with a - next to the step on the task analysis if the student needs a prompt.

Example Task Analysis for Data Collection:

Brushing Teeth 1 2 3 4 5 6 7 8 9 10 11 12 13 Get out toothbrush and toothpaste Wet toothbrush Put toothpaste on toothbrush Brush teeth on bottom left side (10) Brush teeth on bottom right side (10) Brush teeth in bottom middle (10) Spit in sink Brush teeth on top left side (10) Brush teeth on top right side (10) Brush teeth on top middle (10) Spit in sink Rinse toothbrush Put toothbrush and toothpaste away

+ or -

Assessment Schedule: The student was assessed for three days during baseline. Student T receives instruction three days a week. He will be assessed every other Friday. This means, Student T will be assessed after five consecutive days of instruction. Assessment Schedule can vary as needed if the student is absent or if there are days off of school. Instructional Procedures: To instruct, I have a copy of the steps of tooth brushing above. After Student T does his morning routine of copying his schedule and filling out his last night paper, we will read the

task analysis together. He will read the steps aloud. When getting to the part where he begins to brush the bottom left side, I will model for him by pointing to where that would be in my mouth. I will show him on his face where the bottom left side of his teeth would be. I will continue modeling this for the bottom middle, bottom right, top left, top middle, and top right. This will help Student T to know where to brush. After we read the task analysis together, we will go to the bathroom to do his hygiene. I will prompt him by verbally saying, Time for your hygiene. What do you do first? I will be pointing to the sign in the bathroom that says to brush his teeth first. He will get out his toothbrush and toothpaste and begin to follow the task analysis (above). While actually brushing his teeth, he will count to 10 each time before moving on to the next step and the next area of his mouth. I will prompt him by reading the next step to him as he completes a step. To fade prompting, I will use most-to-least prompting. I will prompt Student T with verbal prompts for all of the steps of tooth brushing. With probes, I will begin to fade the verbal prompts to just pointing to the step of the visual procedure. After he becomes independent with that, I will begin taking away steps from the visual procedure until he is completely independent with brushing his teeth. Reinforcement (type and schedule): Beginning instruction, Student T will be reinforced after each completed step of the tooth brushing procedure. He will get a verbal praise such as Good! or Nice work. He will also receive praise after total completion of brushing his teeth. The verbal praise will be Great job brushing your teeth today, Student T! As Student T becomes more independent, I will fade the reinforcement for only steps for which he is not independent. As independence progresses, he

will only receive the end verbal praise. Finally, he will brush his teeth independently without reinforcement. Maintenance: After Student T has reached independence, I will probe once a week at the end of each week to check for maintenance. I will probe each week to make sure he is still independent for four weeks. If he does not complete the steps of the task analysis, I will begin instruction again. Monthly probes throughout the rest of the school year should occur to ensure Student T is maintaining his skill level. Research Rationale: In the article, Effectiveness and Efficiency of Constant Time Delay and Most-to-Least Prompt Procedures in Teaching Daily Living Skills to Children with Intellectual Disabilities, it explored the use of time delay when teaching daily living skills. This is relevant to my instructional program because I am teaching my student the daily living skill of brushing his own teeth. In the research, most-to-least prompting helped with generalization and maintenance of the skill. I will use this prompting procedure to teach Student T to brush his teeth with hopes that he can generalize to brushing his teeth at home and making this an independent skill that he can do on his own after he graduates from the program. The second article I read, Effects of Task Analysis and Self Monitoring for Children with Autism in Multiple Social Settings, dealt with using task analyses and self monitoring charts for students with Autism to use in social settings. They performed better than students without and were able to generalize and fade out the task analysis. Although my instructional program does

not deal with social settings, it does use a task analysis self-monitoring system. This should help Student T remember each step of the tooth brushing process while performing the task.

Skill Sequence:

Get toothbrush and toothpaste

Put toothbrush and toothpaste away

Put toothpaste on toothbrush

Wet toothbrush

Spitting in the sink

Brush bottom back left and right set of teeth

Brush top back left and right set of teeth

Brushing front middle set of teeth

References: Aykut, Cigi. Effectiveness and Efficiency of Constant Time Delay and Most-to-Least Prompt Procedures in Teaching Daily Living Skills to Children with Intellectual Disabilities. Educational Sciences: Theory and Practice, 366-373. Retrieved from web.ebscohost.com Kamps, Debra & Parker, Daniel. Effects of Task Analysis and Self Monitoring for Children with Autism in Multiple Social Settings. Focus on Autism and Other Developmental Disabilities, 131-142. Retrieved from web.ebscohost.com