-Triveni Goswami Vernal
Registered Special Educator (A64010)
Activities of Daily Living or Life Skills are activities that are routinely followed by individuals, that help them be independent in life. For an individual with various challenges, these daily activities can prove to be cumbersome. And hence, they need to be broken down into small components that can be taught individually till it is mastered, before the entire activity is taught and becomes second nature to them.
Activities of Daily Living include:
1) Self-care and Hygiene: Bathing and drying themselves after a bath, Brushing Teeth, Clipping Nails, Getting dressed etc
2) Sleeping: Sleeping on their own
3) Toileting: Using the Toilet independently and cleaning up after themselves
4) Meal Times: Preparing a meal, eating independently, washing dishes etc
Mastering the various ADLs, is the end goal for almost everyone on the Autism Spectrum. The core idea is to keep working on these skills across the years, such that the individual can become independent in those skills, and not be forever dependent on caregivers, all their lives.
According to the website https://thespectrum.org.au/autism-strategy/autism-strategy-activities-daily-living/, Daily Living activities are important for the following reasons:
• “Independence: if you are able to look after yourself by undertaking these key activities of living you are more likely to be able to live safely and independently as an adult.
• Self-esteem: self-reliance helps with self-esteem, it feels good to be able to look after yourself without needing help.
• Less reliant on others: as with the above two points, it’s an excellent goal to be able to function on your own without needing assistance from other people if possible.
• Skills for life: these daily living skills are tasks that everyone needs to undertake every day throughout their life. If you can learn to undertake them yourself early, it will make life a lot easier and improve your quality of life.”
Each activity that we perform on a daily basis, is often taken for granted by us, because it takes place so naturally that we do not spend time analysing how many small components make up one particular task. For example, the activity of Brushing Teeth might seem a simple task, but when you break down the steps, you realize how complex the activity is, in reality.
In Special Education, a strategy to break down the activity into the small steps, is called Task Analysis. So, a Task Analysis of Brushing Teeth brings up the following steps:
1) Take the Toothbrush and keep it down on a surface.
2) Take the Toothpaste tube with one hand.
3) Twist the cap of the Toothpaste tube with the other hand and open it.
4) Remove the cap and keep it on a surface.
5) Squeeze the toothpaste tube, just enough to place a small amount of toothpaste on to the toothbrush.
6) Place the toothbrush on a surface.
7) Twist the cap and close the toothpaste tube. Put it back to its place.
8) Pick up the Toothbrush with the paste on its bristles.
9) Open the tap in the sink and wet the toothbrush bristles.
10) Close the tap in the sink and brush the teeth, in various motions.
11) Once done, open the tap, and clean the bristles.
12) Replace the brush back to its place.
Visual for Brushing Teeth
Source: https://blog.difflearn.com/2018/03/15/simplifying-morning-routine/
A Printable Visual for Brushing Teeth: https://www.kidsability.ca/uploads/Autism%20Services/Tooth%20Brushing%20Visual%20Schedule%20Printable%20Resource.pdf
One can choose to be as detailed or keep the steps short and concise, depending on the ability of the individual. The idea is to break the activity into small steps that are doable and can be taught in a simple and stress-free manner.
Another strategy of Special Education that can be applied while teaching the steps in a Task Analysis are BACKWARD CHAINING or FORWARD CHAINING.
Backward Chaining refers to a technique where the last step of the task is taught first, and once that is mastered, one can teach the earlier steps. So, for example, for Brushing Teeth, the individual will be first taught to do the last step, that is washing the bristles of the brush under the tap water and keeping it back in its place, while the rest of the steps will be done by the caregiver. Once that is mastered and can be done independently, the step next to last, that is brushing the teeth, will be taught.
In contrast, in Forward Chaining, the first step of the task is taught first, till it is mastered, and then one moves on to the next step. For example, in Brushing Teeth, the first step of taking the toothbrush from its place and then opening the cap of the toothpaste tube will be taught first, while the rest of the steps will be done by the caregiver, till the time the first step is mastered and then they will move on to the next step.
The strategy of Chaining (whether Forward or Backward) is adopted so that it does not overwhelm the individual who is being taught. The idea is to provide handholding and scaffolding for the individual to learn the task, at his or her own pace, without being rushed.
This was just a small example, but the idea of breaking down a task into smaller components and providing a visual for it, is very significant. Visuals help the individual remember the steps pictorially. Most individuals on the Autism Spectrum are visual learners and often struggle with Executive Function and Self- Regulation.
According to the Centre on the Developing Child, Harvard University, “Executive function and self-regulation skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. Just as an air traffic control system at a busy airport safely manages the arrivals and departures of many aircraft on multiple runways, the brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses” (https://developingchild.harvard.edu/science/key-concepts/executive-function/).
By breaking down the task into doable, small components and representing those tasks, visually, the individual is helped in planning, remembering the various steps involved, paying attention to the task at hand and implementing the various steps, to fruition.
As a caregiver, our aim is to make the process of learning more accessible and stress-free for the individual with challenges, with a final goal, towards their independence. Only if we create the right environment to facilitate their learning and engage them proactively in the learning process, can they progress towards the final goal.
Free resources on Visual schedules for various ADLs:
https://drive.google.com/file/d/1uWXSRNPOTC0p0FRKZulgEZiR2LICQHRz/view
http://www.shesalwayswrite.com/2014/05/autism-resource-potty-training-visual.html
http://autismeducators.com/browse-worktasks/free/FREE-Bathroom-Visual-Schedule-For-Boys-AutismEducators
https://www.naturalbeachliving.com/daily-visual-schedule/
https://adayinourshoes.com/free-printable-visual-schedules-for-home-and-daily-routines/
https://www.nhsggc.org.uk/kids/resources/ot-activityinformation-sheets/visual-aids-for-learning-bathing-independently-girl/
https://www.teacherspayteachers.com/Product/Bathroom-Routine-1992783
https://learningforapurpose.com/wp-content/uploads/woocommerce_uploads/2021/01/Taking-a-Shower-Toolkit-Bundle-2-rpdsnz.pdf
https://www.kidsability.ca/uploads/Autism%20Services/Dressing%20Visual%20Schedule%20Printable%20Resource.pdf
https://www.andnextcomesl.com/2018/01/free-visual-schedule-printables.html
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Author Triveni Goswami Vernal
Triveni Goswami Vernal is an Autism advocate, registered Special Educator (CRR A64010) and an Independent Researcher. Her areas of interest include Autism, Disability Rights, Gender, Art and Northeast studies. She is a mum to an 11 year old on the Autism Spectrum.
Acrylic paints and Texture paste on canvas
Creative representation for this blog is done by our extremely talented CreativeSaathi associate Kabir Vernal