Safety_2 View

This is good to teach her to prevent possible safety or sexual abuse.

Have the client wear a bathing suit while teaching the steps

Personal care with her menstrual cycle

Showering independently reduces risk of being sexually abused

Task analysis and then forward chaining or total task

Dressing self

This would provide autonomy as well as safety from potential abuse.

Forward chaining to generalization. Use video modeling, and shaping.

Dressing, and shampooing her hair, along with grooming skills can be included. A shower schedule per week can be used with phone or calendar.

Learning to shower independently enhances self-esteem and reduces the risk for physical and sexual abuse.

Forward chaining after a task analysis. The steps can be visually represented.

Dressing themselves, brushing teeth, toileting, menstrual care etc.

Decreases vulnerability

total task chaining with a TA

how to wash hair and body. Dry oneself, get dressed

Create a safe condition

Reviewing step by step instructions

Avoid taking shower when she is alone at home

Not needing assistance during a vulnerable time of being naked means less risk

Task analysis and chaining

Shaving if wanted, or getting dressed

Learning to shower independently is directly related to Tina’s health, hygiene, and dignity. It helps her prevent skin infections, odors, and illness, and supports social inclusion by keeping her clean and comfortable. Additionally, learning safe showering practices (like water temperature awareness or using non-slip mats) reduces the risk of accidents like burns or falls. Encouraging this skill also boosts her confidence and independence, which may protect her from being over-reliant on others or vulnerable to mistreatment.

An effective approach could involve a task analysis with backward chaining — especially useful when the final step (like drying off or turning off the water) is the most reinforcing for Tina.

Here’s how you could do it:

Break the showering routine into small steps (e.g., gather supplies, turn on water, adjust temp, undress, wash body parts, rinse, dry off, dress).

Start by teaching the last step first, so Tina experiences success and independence right away.

Use modeling, physical prompts, and visual supports (like picture schedules or a checklist).

Reinforce each successful step with positive praise or a preferred item/activity.

Track her progress and fade assistance as she masters each new step.

Water safety (checking temperature to avoid burns)

Using a non-slip mat or grab bars

Washing and drying hair safely

Dressing independently after showering

Not leaving water running

Appropriate privacy and modesty

Recognizing when a shower is needed (e.g., after sweating or accidents)

Laundry or managing clean towels and clothes

Learning to shower independently is closely tied to personal hygiene and health safety. For Tina:

Physical safety: She’ll need to navigate wet surfaces, manage water temperature, and handle soap/shampoo safely.

Health-related safety: Regular, effective showering reduces the risk of infections, skin issues, and body odor, which can also impact social interactions.

Autonomy and dignity: Independence in showering reduces reliance on others for intimate care, promoting dignity and reducing the potential for vulnerability to abuse.

A good intervention would blend task analysis, prompt fading, and positive reinforcement. Here's how that could look:

Task analysis: Break down the entire showering process into manageable steps (e.g., turning on water, testing temperature, wetting body, applying soap, rinsing, drying).

Visual supports or a checklist: Use pictures or laminated guides to support sequencing.

Modeling and video modeling: Demonstrate or show videos of the steps.

Prompt hierarchy: Start with more intrusive prompts (e.g., physical guidance), then gradually fade to verbal, then to independence.

Reinforcement: Reinforce each successful attempt or step completed with praise, tokens, or a preferred item.

Practice in a safe, supervised environment to address any immediate safety risks (slips, burns).

Here are some related targets that build on Tina’s goal of increased self-care and safety:

Water temperature safety: Teaching Tina to test water temperature to avoid burns.

Non-slip skills: Using non-slip mats, shower chairs, and how to safely enter/exit the tub.

Emergency skills: What to do if she falls or gets stuck (e.g., calling for help, using a waterproof emergency button).

Dressing skills post-shower: Including drying off properly and putting on clean clothes.

Menstrual hygiene (if applicable).

Medication safety: If she eventually takes meds post-shower, learning to identify and take them safely.

Reduces the chances of abuse of the client
Increases independent skills
Improves quality of life

Assess Tina's skills with a pre-assessment
Create a task analysis that is appropriate for Tina
Use a forward chaining method to teach

Bathtub safety precautions like installing grab bars, using a shower seat, non-slip surfaces in and out of the tub, hand held shower head, etc.

being able to keep oneself clean, ensuring it can be done independently and not becoming vulnerable to other people.

forward task training, TAs

washing hair, brushing and blow drying hair, any shaving needs (if desired).

cleanliness

chaining

use

Tina is more vulnerable to abuse if someone else has to shower her.

Total task chaining with clothes on to learn steps to acquire the skills needed to complete the shower independently.

Learn about privacy and autonomy as well as what to do if that is violated.