River Valley Intermediate


Game of Thrones

Primary Researchers

Colleen Coudriet, Intern, Baylor University

Andra Speerbrecher, BS Ed, Mentor Teacher, River Valley Intermediate School, Midway ISD

Joseph Alford, MS Ed, Intern Supervisor, Baylor University

 

Rationale/Introduction

To encourage independence for a student with no toilet ability, training with sensory cues and a social story will be conducted. While using the toilet independently is ambitious, I would like for the student to be able to have more independence in their bathroom experience. For this student the bathroom includes changing pull-ups when necessary and redressing. The goal is that by having the student learn a concrete routine and the difference between the feeling of wet and dry, they will be able to have a shorter and more independent trip to the bathroom.

Question/Wondering

Will sensory training and social stories help increase independence in toileting, described as shorter durations, fewer prompts, and the student determining whether a change is needed?

Methodology/Results

For this study I worked with a 12-year-old, male student who wears pull-ups for his bathroom needs. We typically check him three times a day to determine whether he needs to be changed. Toileting, described as “pulling pants up/down, sitting on the toilet, [having] appropriate use of toilet paper, flushing and washing hands,” is an important developmental skill for children (2020). To gather data on his toileting experience, I timed the trips, counted the verbal and gestural prompts, and kept track of what tasks he was doing independently and with what he needed aid. After eight days the average time in the bathroom was 4.45 minutes and the average dry time was 3.48 minutes. Additionally, the average verbal prompt was 7.75 times and 2.35 time for gestural prompts during the baseline. For my intervention I created a video social story using Symbol Stix icons and my own voice, which my student watched each day of the intervention period. Video interventions have proven to reduce prompts in toileting for children diagnosed with ASD, and while my student does not have this diagnosis, his attributes parallel with those with ASD (2014). I also included an intervention where the student would learn the feeling of wet verses dry, to prepare for him to determine the state of his pullup. This was done by having symbols of wet and dry that he would touch and speak when touching a corresponding wet or dry towel. 

After 8 days of baseline data, I conducted 8 days of intervention data. The intervention included watching the social story, doing the sensory training, an alarm going off at 9:10 each morning, the student speaking “I need to use the bathroom” on his communication device, and beginning the bathroom process. The student responded well to this intervention with an average time of 2.55 minutes. Additionally, the prompts given decreased to an average of 3.13 for verbal prompts and 1.25 gestural prompts. The intervention worked well for the student and gave him more independence in the toileting experience. Towards the end of the data collection, he was responding well with fewer verbal prompts and more gestural prompts. Just pointing to the toilet or sink was enough to prompt him into the next step. Responded very well, thus making this a successful intervention.

Implications/Recommendations

The interventions have worked very well with this student. He enjoys watching the video and it has proven to increase independence in the bathroom. Furthermore, a model study I used described that the “skill was acquired to criterion after a little less than 40 training sessions,” so I would recommend the social story intervention be continued until 40-50 sessions have been reached (2014). I do think the wet verses dry can be faded to twice a week for two weeks, to once a week for two weeks, to extinction. He has acquired this skill well and I do not believe the same level of intervention is needed.

References

Drysdale, B., Lee, C. Y., Anderson, A., & Moore, D. W. (2014). Using video modeling incorporating animation to teach toileting to two children with autism spectrum disorder. Journal of Developmental and Physical Disabilities27(2), 149–165. https://doi.org/10.1007/s10882-014-9405-1

Saral, D., & Ulke-Kurkcuoglu, B. (2020). Toilet training individuals with developmental delays: A comprehensive review. International Journal of Early Childhood Special Education, 120–137. https://doi.org/10.20489/intjecse.728240