When we first spoke to Joe's mother, she was very worried about her son's personal hygiene. Joe was very sensitive with his head and facial area being touched since he was at a young age, and would not accept his hair being washed or his teeth being brushed, despite Mum trying her best to use various methods of maintaining his hygiene over the years. The family had tried ABA interventions previously, however, his mum found the plans impossible to carry out just by herself. As a result, whenever Joe was sat down engaged in an activity, Mum ended up “ambushing” him with a wet flannel to wipe his hair, or with baby wipes to clean his teeth.
After detailed discussions, our consultant was able to come up with an intervention that is both practical and effective. We asked Joe's mum to have something he likes with her (usually an iPad), then tell Joe to come over to the bathroom with her to use the iPad. Joe was then sat on the toilet seat, fully clothed and engaged with the iPad, so mum can take a bit more time to wipe his hair properly. As for tooth brushing, we decided to start with hiding a small tooth brush under mum's finger, then wrap it around with baby wipes, so Joe would accept it in his mouth and slowly get used to the sensation of the toothbrush.
By the end of the intervention, Joe was able to sit still in the bathroom fully clothed when Mum instructed him to, and accept a flannel hair wash for 10 minutes. He still found toothbrushing tricky, but would open his mouth briefly for a toothbrush and toothpaste to brush his teeth.
Joe's mum found the programme beneficial in the way that it provided ideas for her to make a tricky task easier to conduct.
Although it was tiny steps, this was the beginning of Joe accepting something new being done. With Mum being very persistent and creative, we are positive that one day they will reach the goal of Joe accepting his hair being washed and teeth being brushed!