One of my clients is a 12-year-old boy who has Autistic Spectrum Disorder (ASD). His mum has up until this point assisted with all self-care tasks, including toileting.
As a school camp was coming up, we decided to dedicate one therapy session to helping this child learn the steps involved in toileting independently - in particular wiping. First we discussed why it was time to learn this skill and reassured him that Mum would be close by to assist when needed. Kids with ASD find change to routine challenging and it's important to introduce change slowly, and with as much information as possible. Children with ASD respond well to visual cues and step-by-step instructions, so this was the method employed for this boy.
After discussing the steps involved, we role-played going to the toilet. If you ever had any illusions that OT was a glamorous career choice, they will be shattered forthwith!
I grabbed a role of toilet paper and we sat on our chairs. I explained that we are pretending to have just been to the toilet. I showed my client how we wrap the toilet paper around our hand and then wipe ourselves clean. We discussed how we knew when we were clean and what to do with the paper once finished. Mum and I explained why it was important to be clean for hygiene reasons and because we don't want to smell!
The 12-year-old was able to copy my actions and respond to my verbal instructions. After a few goes, he was better at pulling the paper off the role and wrapping it around his hand. We felt that he was ready to try this by himself at home in the lead up to school camp.
Following this session, I was really satisfied by what we had achieved and excited by the prospect of this child learning such an important life skill.
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