Does your child with autism resort to crying, screaming, clamping their mouth shut, or turning their head sideways during brushing? Do you constantly face this daily struggle with your child? If yes, read on, as here are some ideas to make this task more easier for your child and yourself.
It helps when you understand the cause to a problem. Children with autism cope better when they understand the whole picture and not a part of it. For this task, brushing is the “whole” whereas toothbrush, toothpaste, sink, tap, water, and opening mouth are all “parts” to the process of brushing. Thus your child may fail to understand how all these parts “fit together” to end in “brushing teeth”. Also your child may not be clear about the idea “clean and dirty teeth”. The issues pertaining to sensation (of brush, taste of toothpaste, movement of brush along gums and teeth) is another probable cause for difficulty in brushing.
Preparing your child:
- Teaching the parts that form the whole: Introduce each object as something which is necessary for the act of brushing teeth. You can have pictures made and put up near the sink identifying each object and linked to the act of brushing. Model on yourself and show your child the step by step action of brushing, while introducing the various parts necessary for brushing. This also helps your child to feel less threatened by brushing the next time
- Social stories: Create a song or story about brushing, the need of brushing and process of brushing. Use these stories as you brush your teeth and repeat while brushing your child’s teeth. Encourage your child to brush your teeth and that of their dolls before brushing theirs as it gives them confidence and helps to accept brushing.
Explore various sensations related to brushing. Use your child’s hands to give pressure around the mouth, gums and teeth. Chewing and eating foods of different textures also helps.
- Opening the mouth is vital to brushing. Play a game with your child making faces in front of the mirror eg: “opening mouth, saying AH, grimacing, rubbing your tongue over your teeth” so that it prepares the child in opening their mouth for brushing.
- First Steps: As children have better control over what they put in their mouth, it is better to initiate with child himself. Encourage the child to taste the flavored toothpaste by placing it on his finger. Once the child likes the taste, put a small dab on the toothbrush and encourage them to place the brush in the mouth (or do so manually). The most common response is for the child to suck / chew on the bristles, so repeat the task for 3-4 days. Next put a little of toothpaste on his index finger and let him gently apply it over his teeth. If your child shows no signs of discomfort, proceed to the next stage by letting him rub it in a front and back motion and also up and down the teeth. This reduces the aversion towards having the paste rubbed on to the teeth and proceed with the brush. Teach the act of spitting and rinsing his mouth. Reward the child for each step completed successfully . Over the weeks, gradually increase the length of time you brush.
To reduce the issues related to toothbrush and paste:
- Toothbrush: Use soft / ultra soft toothbrushes. Allow your child to select the color and the type (as the handles of some may have the pictures of their favorite cartoon characters). The bristles should be end rounded i.e: a polishing machine is used to round the rough cut ends of the bristles. Brushes with thicker handles allow your child to have a better grip. Also available are brushes with angled heads so that it is easier to reach the deeper parts of the mouth
- Toothpaste: There are various flavored toothpaste available, purchase one according to your child’s preference. Initially use only a pea sized amount of toothpaste as it prevents excessive foam in the mouth. As your child gets better at brushing eventually fade in with the more conventional toothpaste.
Create a routine:
Your child will cooperate better if brushing is always done at a fixed time, and in a particular way. Create a routine while brushing. Start from one end of the mouth and proceed to the other, the bottom teeth first followed by the top teeth. You can also count teeth as you brush so that your child knows when the task will end. Similarly brushing songs will help the child to remember if he has missed any part of the task eg : forgot to brush the bottom teeth. This will help in remembering the sequence of the task.
Go ahead, try out these ideas and hope you have a sparkling time!