DENTAL EXAMS, MEDICAL EXAMS, HAIRCUTTING

ABA WAYS TO PREPARE

(From Marcia's Friend)

Dental Exams

Medical Exams

Haircutting

My 7 year old son is a slow learner, & gets easily upset by anything he hasn't been taught to tolerate. At age 4, he required dental rehab under general anesthesia to fill 9 cavities. After that, we started an intense ABA based dental program to teach him acceptance of tooth brushing, flossing, & exams/ cleaning at the dentist. We taught everything first at the drill table, using ABA to break everything down to the least intrusive step & rewarding with the most powerful reinforcers. Interplaq tooth brush helps to simulate the vibration & noise. We also bought a dental mirror, etc at the local drug store. Don't forget to ADD THE LATEX GLOVES. After he tolerated everything at the drill table, we generalized it to a bed, then propped up on a couch , then contacted the dental office to "practice" during their lunch break. He tolerates cleanings well & hasn't had a cavity since. We also got a dental X-ray film to put in his mouth to practice doing dental X-rays. We used a heavy winter coat draped over his shoulders & across his chest to simulate the lead apron. Initially we used a small cup to simulate the X-ray machine. Then we thought of using a black toy telescope that looked even more like the real thing. One of us pretended to be the dental technician—"Hold still now!" and left the room, as the other person counted slowly to 10. When we told the dentist we were ready to have X-rays done, his comment was "well, I don’t know if we’re likely to get anything to see". What he got were perfect films.

MD EXAM was done the same way. Start out as simple as "Lift shirt" (or do as motor imitation). Big reward. Eventually, add stethoscope for 1 sec, etc. Break it down as much as you need & add time by the second if necessary. Each part of the physical exam needed to be trained for Jon. Heart/lungs/ears/belly, etc. It helped Jon to count along slowly up to 10 for the ear exam so he would know when it was finished. Don't do this for heart & lungs because MD won't be able to hear anything. After learning at drill table, generalize to having other people "play doctor", & practice in different rooms. DON'T FORGET THE PAPER COVERING THE EXAM TABLE, like I did the first time. And don't forget to tell the MD how to approach your child so as to best mimic how you have done the training.

HAIR CUTTING--we started this with one snip of the scissors 2 feet away from his head. Reward. etc. Eventually make the situation as close to the real thing as possible. Remove shirt, cover with towel, get child used to water spritzer, etc. Unfortuantely, we didn't maintain this very well, so now I just cut his hair in the shower. (Our hairdresser taught me how to do it)