Using self‐management strategies to improve toothbrushing for adults in supported community living

Miak et al. (2024) worked with three adults in a group home. All had intellectual or developmental disabilities.

The team gave each adult a small checklist. It listed every toothbrushing step: pick up brush, add paste, brush top teeth, and so on. The adults marked each step themselves after they did it.

Once the checklist was in place, all three adults brushed more often and did a better job. Staff still watched, but the adults ran the routine on their own.

The gains held steady across the whole study. No extra rewards were needed.

Older papers used toothbrushing as a punishment. Singh et al. (1982) and Migan-Gandonou et al. (2020) stopped rumination by having adults rinse and brush right after each episode. That worked, but the brush was a consequence, not a skill.

Miak flips the script. The same tool—an oral routine—now builds independence instead of stopping problem behavior.

McGonigle et al. (1982) also raised brushing skill, but they used a classroom team game for kids. Miak shows a solo checklist works for adults in residential care.

If you support adults in group homes, swap the prompt card for a self-check list. Let the resident mark off each step. You still supervise, but the resident owns the routine. Expect more complete brushing and less staff time per resident.