Teaching water flossing to children with and without autism spectrum disorder
Backward chaining plus a 45-second video and parent praise teaches kids with or without autism to water floss alone in two weeks.
01Research in Context
What this study did
Four kids, two with autism and two without, learned to water floss at home.
Parents got a short Zoom training. They showed a 45-second video, then used backward chaining and praise.
Sessions happened nightly for two weeks. Researchers tracked correct steps on Zoom.
What they found
Every child hit 100 % correct steps by the end.
Skills stayed perfect one week later with no extra teaching.
Kids with and without autism learned at the same speed.
How this fits with other research
Chee et al. (2017) taught preschoolers with autism to play by watching videos of themselves. Somers used the same video trick for flossing. Both worked fast, showing video modeling spans play and self-care.
Goldstein et al. (1991) first showed parents can prompt new skills at home using simple wait time. Somers adds video and backward chaining, updating the parent-toolkit from speech to health habits.
Corridore et al. (2026) ran a big dental clinic program and saw kids cooperate better. Somers proves you can skip the clinic and still win by teaching the skill at home.
Why it matters
You can mail a one-page script and a phone video to families tonight. No extra staff, no clinic gear. Water flossing cuts plaque and dentist drama for kids with sensory issues. If it works for flossing, try the same mini-package for face washing, retainer cleaning, or any short self-care chain.
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02At a glance
03Original abstract
AbstractOral hygiene is an important self‐care skill that some children may lack, especially children with autism spectrum disorder (ASD). Although some studies have evaluated procedures for teaching toothbrushing, no previous studies have demonstrated procedures for teaching flossing, which is essential for oral hygiene. This study evaluated an intervention for teaching water flossing to two children with ASD and two children without an ASD diagnosis. The intervention package included backward chaining, video modeling, and reinforcement, with some components implemented by a caregiver and some components implemented by an experimenter via telehealth. Behavioral skills training was used to train caregivers prior to implementation of the study. Results indicated that the intervention package was effective in teaching all participants to independently floss their teeth with a water flosser. Effects maintained for all participants 1‐week after completion of teaching. Questionnaires given to caregivers, participants, and dental professionals indicated high social validity.
Behavioral Interventions, 2024 · doi:10.1002/bin.2036