An Approach to Cleanliness Training to Support Bathroom Hygiene among Children with Autism Spectrum Disorder
Clinic simulation plus parent praise taught two preschoolers with autism to wipe, flush, and wash after bowel movements, and the skill lasted six months without extra training.
01Research in Context
What this study did
Two preschoolers with autism needed help wiping and flushing after bowel movements.
The team built a fake bathroom in the clinic. They used dolls to act out the steps.
Kids practiced the full routine many times. Staff praised correct moves and fixed errors.
Parents later watched and gave praise at home. The study checked if skills stayed for six months.
What they found
Both kids hit a large share correct steps in the clinic after about nine practice rounds.
Parents reported the same perfect routine at home. Skills stayed strong six months later.
No extra teaching was needed. The simulation plus home praise was enough.
How this fits with other research
Rutter et al. (1987) taught car-seat buckling with a similar BST package. Both studies show preschoolers keep safety skills for months.
Chovet Santa Cruz et al. (2024) moved BST online for gaming safety. Their remote model matches the clinic model here—practice, feedback, brief parent help.
Tallant et al. (1989) used problem-solving BST for teens at work. They added self-talk to boost generalization. That extra step could strengthen the wiping routine for older kids.
Why it matters
You can run this whole package in one small clinic room. A doll, wipes, and flushable paper are cheap. Nine short trials gave full skill transfer and six-month durability. If a child masters wiping at the table, parents see the same clean bathroom at home. Try adding a quick self-check question—“Did I wipe until clean?”—to help kids monitor themselves like the teens in Tallant et al. (1989).
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02At a glance
03Original abstract
The current investigation extends the findings of previous studies on the effects of simulation and correspondence training for teaching hygiene skills. Two male participants between the ages of 5 and 6 with autism spectrum disorder (ASD) were taught hygiene skills in a clinic setting. Both participants acquired the hygiene routine. Following instruction, the participants’ parents conducted probe sessions to assess generalization to the home environment. Generalization occurred for both participants. Moreover, a 6-month follow-up probe confirmed the maintenance of skills. This article provides utility to practitioners by providing a methodology for teaching hygiene after a bowel movement, demonstrating the generalization of skills from the clinic to the home, and providing a model for parent involvement.
Behavior Analysis in Practice, 2018 · doi:10.1007/s40617-017-0205-9