Young children with disabilities often demonstrate delays in multiple areas of development. Because of these delays, they may need additional help with skills that other children acquire easily and naturally (Baker & Brightman, 1997). With typically developing children, teachers tend to focus on language and self-help skills. Children with delays, however, receive adequate language instruction, but their self-help skills are often overlooked or ignored. In order for children to receive acceptance and acquire independence in the classroom, it is important that self-help skills be a focus during the preschool years.
The following guidelines, which form the acronym “SELF-HELP,” can assist teachers in being more successful when promoting self-help skills in children with disabilities.
S- Select appropriate prompts. While teaching a child to eat with a spoon, for example, the teacher can move from full physical assistance to assisting the child only when moving the spoon directly into his mouth. You may need to use hand-over-hand assistance, but this support needs to be faded as the child becomes more independent.
E- Establish a routine. Routines pay a critical role in the formation of self-help skills. For example, putting on a jacket before going outside to play is a self-help skill that is routinely done prior to outdoor play. Brushing teeth after lunch is another self-help skill that is part of the daily schedule.
L- Learning, rather than time, should be the focus. The ultimate goal is for self-help skills to be performed independently, however, it may take longer for a child with a disability to master these skills. Persistence is the key to success!
F- Find appropriate rewards. Researched-based rewards are individualized, age-appropriate, and naturally occurring in the environment. A naturally occurring reward for drinking from a cup is relieving thirst. When the child first begins to learn to use a cup, say, “Look at you! You can drink from a cup!”
H- Help from related professionals is critical. Teachers should seek more information about specialized
techniques and adaptive equipment that may be useful. Occupational therapists and special educators are great
resources for learning more about assistive technology and specialized
E- Expect positive outcomes. Sometimes teachers do not attempt to teach self-help skills to children with cognitive disabilities because they have low expectations. If educators expect children to succeed, there is a higher probability that they will.
L- Learning should be embedded in the curriculum. Integrating opportunities to promote self-help skills throughout the day and during play will provide needed practice for successful mastery of targeted skills. Having dress-up clothes in the housekeeping center, for example, provides an excellent opportunity to reinforce buttoning, zipping, snapping, and tying.
P- Parent involvement is the foundation for success. Research shows that children are better able to transfer newly acquired skills when parents are actively involved in reinforcing the skills learned at school in the home setting.
SELF-HELP in the Classroom
The toilet training example described below uses the SELF-HELP guiding principles.
Children with mild disabilities are typically toilet trained using traditional methods. For students with mental retardation and other significant disabilities, it may take considerably longer for the child to become toilet trained. Because it will take longer, it is important to begin toilet training during the preschool years. The only prerequisites to begin toilet training are: 1) a stable pattern of elimination, 2) daily periods of one to two hours of dryness, and 3) a chronological age of two years or older (Farlow & Snell, 2006). If toilet training is delayed until the child is older, it may result in placement in a more restrictive setting away from their peers and friends.
When beginning toilet training, it is important to consider clothing (Christiansen & Matuska, 2004). Teachers should suggest to parents that children wear pants with elastic, rather than overalls with suspenders that are difficult to remove. Training pants, as opposed to diapers, make it easier for the child to be aware of wetness. When teaching the children to pull up their pants, it may be necessary to use hand-over-hand techniques; gradually fade the assistance as children begin to perform the task on their own.
In addition, it is very important for the child to be able to use a comfortable potty chair where her feet touch the floor. Occupational therapists may have additional recommendations such as seating the child on the toilet facing the tank. This position provides more stability and allows the child to see what happens when she urinates in the toilet. Teachers should be aware that toilet training takes time and the child may lose instructional time during toilet training. Toileting programs for children with disabilities often involve extra drinks of water before taking the child to the restroom. About five or ten minutes after the child drinks a glass of water, she is taken to the restroom to sit on the potty for ten minutes. This process is repeated several times each morning and afternoon. For children with seizure disorders, be sure to check with the child’s physician before giving extra water during the day since it may interfere with anticonvulsant medication.
Rewards should be used judiciously. When the child has toileting successes, affirm him by smiling, clapping, and telling him what a big boy he is. You also can provide treats that he really likes. For rewards to be effective in maintaining skills, the child must be weaned from treats and verbal affirmation gradually. The ultimate reward for the child is staying comfortable and dry, and avoiding embarrassment with classmates (Schaefer & DiGeronimo, 1997).
During toilet training, materials and activities should be included in the classroom. By placing a doll-sized potty chair, baby dolls with panties, and toilet paper in the house center, children will have the opportunities to practice and recall the steps in toileting during play. Books such as Once Upon a Potty can be read during circle time or placed in the library center.
It is essential for children with disabilities to be taught self-help skills in order to be successful both at school and in life. The early childhood years constitute a critical window of opportunity for children to learn these skills along with typically developing playmates. Teachers are often challenged by this task. However, they should not be afraid to try to teach these skills. Following the “SELF-HELP” principles discussed here will enable teachers to remain focused and be effective in their instruction.
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