Toothpaste

Sometimes I have a stroke of brilliance that may not seem as exciting and brilliant to your average person. And I often find myself doing things that most people never do. But sometimes there are at least a few other people who do those things and that stroke of brilliance may help them out. And at the risk of making the majority of the world wonder if I've completely lost my mind, I decide to share that idea in the hopes that it will help someone out. This is one of those things. You may think I'm totally nuts, or you may find this to be helpful (or you may think "I've been doing that for years, what's the big deal?")

Students with more severe forms of Autism Spectrum Disorders often need to work on functional, daily-living skills at school. One such skill - brushing teeth - is, I'm sure, practiced in many classrooms. The fact that my students work on brushing teeth isn't the weird part. :-)

I found that many of my students (and probably lots of typical kids, too!) squeeze WAY too much toothpaste on their toothbrush. And toothpaste (if you've ever had tablespoons of it smeared on the bathroom counter you already know this) is incredibly difficult to clean up! So I set out to find a way to keep my kids from making giant sticky blue messes while wasting several dollars worth of toothpaste each week - that would still allow them to develop independence in brushing their teeth. My first thought was - Mentadent! It comes in a pump that only dispenses a small amount per pump - pumping is more difficult than squeezing and makes it easier to control. However, I can't find it ANYWHERE except online and can't find a "kid's" version and I doubt my finicky kids would like it ... so back to the drawing board.

I decided to try travel-size containers of toothpaste - at least then they can only squeeze out so much, which limits the amount they can waste. As they used the travel-size containers, I noticed that as they got closer to emptying the tube, the amount of toothpaste they used was becoming more appropriately sized.

1. Travel-sized toothpaste tubes are expensive, when you consider how much you get in them
2. My students were more successful with almost-empty tubes

So ... I decided to buy large tubes of toothpaste and refill the small tubes - but not refill them completely! For months now I've been making my OWN giant blue sticky mess while I try to refill the small tubes ... and I was wasting quite a bit of toothpaste myself. (Here's where the weird part begins) I woke up in the middle of the night with a flash of genius. Use a syringe!! So this morning I refilled toothpaste containers without making a mess!! And it was SO easy!!  So I thought - maybe someone else out there is trying to figure out how to refill travel-size containers of toothpaste in their classroom, too. And this blog post was born. :-)

 

So here's how brushing teeth goes in my classroom. Students are eating lunch at the kitchen table. One parapro is sitting with them at the table. One adult (myself or a parapro, depending on the day) calls students one at a time as they finish eating to wash their plate and cup. After they do their dishes, the student comes to another adult (me or a para, whoever isn't doing dishes) in the bathroom to brush their teeth. Then they go to the table in the classroom for free-play time. (The para at the kitchen table moves to the classroom table when there are more kids out there than in the kitchen - in the meantime whoever is doing dishes and whoever is in the bathroom can see the kids at the classroom table)

I have this toothbrush caddy that I got from Lakeshore, each child has a toothbrush with a cap labeled with their name. They also have their own tube of toothpaste (that way, when they lick the toothpaste straight out of the tube before I can stop them ... I don't have to throw the whole thing away!) with their initial on the cap of the toothpaste. I put little 3 oz cups along the bottom of the toothpaste caddy, put the toothpaste in the cup under each kid's toothpaste. There is also a little basket of bathcloths on the counter.

Some students come in and get their own toothbrush/toothpaste/cup/cloth, for others I lay out their things by the sink. Some fix their own toothbrushes, others get some help. Some brush independently, others get assistance, etc. After they finish, they throw their cup away and put their cloth in the laundry basket. Some get their own new cup and put their toothbrush/toothpaste/cup away - others give their toothbrush/paste to me (or a para) and we get a new cup and put it all in the caddy.

Another side-note: the toothbrushes I use (and LOVE) are FireFly toothbrushes -  you squeeze the bottom and a light in the handle of the toothbrush begins to blink. It blinks for 60 seconds - visually letting my kids know how long they need to brush!

Lunch, part 2

In a continuation from the last post, as promised, here is our lunchtime routine.

• One of my parapros sits with the students at the group table while they play with sensory toys. My other parapro goes to the cafeteria with empty plates.  The cafeteria workers serve my students' lunches onto these plates instead of trays.  Mrs. Pfefferle uses one of the cafeteria carts to bring the lunch plates back to the class kitchen and puts them on the counter.  I pour drinks and put the cups at each students' place at the table.  
  
• I call students, one at a time, into the bathroom to wash their hands. 
• After washing hands, the student goes into the kitchen.  They get their plate from the counter and carry it to their seat.  Then I call the next student.
  

• We sit with the students at the table and encourage social communication.  Attainment makes some great placemats with communciation symbols on them that facilitate mealtime communication.  (Even for verbal students, the picture symbols provide reminders and cues.)
  
• We also encourage students to use their fork/spoon to eat
• We work on cutting,and pouring (refilling drinks, cutting food into bite sizes) as well
• When a student is finished eating, they carry their plate to the trash can, scrape their food into the trash, then bring their cup to the sink and pour out what's left of their drink.  We then help them wash their plate, silverware and cup, rinse them, and put them in the dish drain.  
• After finishing their dishes, the student goes back to their seat at the table so that they can continue to have conversations with their friends.  
• When everyone is finished eating and washing dishes, we pass around a soapy cloth and each student washes their part of the table. 
• The students go back to the table to play with sensory toys, one student puts the tablecloth and dishtowels in the washing machine and starts the laundry, then I call students one at a time to come back into the bathroom to brush their teeth.
  
  

Lunch

I mentioned that we work on communication intensively during snack time.  During lunch, we work on other things, mainly ADL (activities of daily living) and social skills.
I am very lucky in that my classroom has a fully equipped kitchen and a 12-seat dining room table.  We eat lunch in the class kitchen Monday through Thursday. On Friday, we eat in the cafeteria.
To avoid another super-long post, I'm going to explain why in this post and then go into more detail about what we do during lunch in the next post.


Why do we eat in the classroom?

• My students are learning how to participate in every-day activities both at home and in the community.  While functioning in the school environment is important, my main focus is on home and community - because that's where "real life" happens after they finish school. Now, at home and in the community, outside of cafeteria-style restaurants (which aren't the norm), mealtime is not similar to the school cafeteria experience.  In the classroom kitchen, we eat off of real plates, with real silverware.  We drink from cups instead of milk cartons.  We sit in chairs - with backs! 
• My students have sensory processing difficulties - the cafeteria is LOUD! 
• We work on table manners, using utensils, using a napkin, and communicating socially during lunch.  In the cafeteria (not even considering the noise that would be distracting to this instruction) this would draw attention to my students -- no one else in there has an adult sitting right next to them reminding them to use their fork (though many of them need someone there lol).

So why, you may ask, do we eat in the cafeteria? And why on Friday?

• School is part of their "real life" for the next several years.  It is important for them to have that cafeteria experience if possible (though, in my opinion, less important than learning table manners, social skills, etc)
  
• Friday at our school is always pizza day.  All nine of my students love pizza and are therefore focused on eating and less likely to engage in inappropriate behaviors.
• Pizza is supposed to be eaten with your hands! So we don't have to worry about the students sticking out by not using their fork.
  
• On Friday, several teachers have their whole class or a group of students eat in the classrooms as a reward - this makes the lunchroom a bit quieter.
• Friday is also ice cream day - which gives me a built in reinforcer to encourage appropriate lunchroom behavior - our lunch table is right next to the ice cream cooler, so it's likely they will remember to "be good" to get ice cream (makes the delayed reinforcer less abstract).