This Dad created “TippyTalk,” a new app to help his nonverbal daughter find a way to communicate with them through pictures and texts.

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Most kids run away from the sight of the “terrible toothbrush.” However, for children on the autism spectrum with sensory issues, this can be even more of a challenge. There can be many different factors and reasons for a child’s aversion to toothbrushing. There may be some hypo- or hyper-sensitivity and oral defensiveness going on. With hypo-sensitivity, kids might have less awareness of what’s going on in their mouths, which can contribute to anxiety related to the mouth area (think of it as a type of oral “numbness”). On the flip side, kids who are hyper-sensitive might be overly conscious and sensitive to oral stimulation. The slightest touch can be overwhelming and be perceived as painful.

Although I am a licensed occupational therapist, the tips below are general suggestions and not an individualized therapy plan. If you have concerns, a speech-language pathologist or occupational therapist trained in oral motor therapy can offer a complete an evaluation and put together an individualized therapy plan with recommendations that take all factors into consideration.

However, for some general ideas and helpful insights that can be used in a trial-and-error type of approach, read on! Below you will find my tips that might help your child be more independent with toothbrushing and keep those pearly whites squeaky clean.

1. Some children may find the sensation of the bristles uncomfortable. Try using a brush with extremely soft bristles or silicone bristles. A baby toothbrush could be a useful transition tool to help your kiddo eventually transition to a regular brush. For example, the Banana brush is a baby training toothbrush that has short bristles made of silicone that can help to desensitize.

2. A toothbrush that can get the job done faster. For example, a three-sided toothbrush such as DenTrust cleans faster and gets all three sides with just one brush motion. The bristles are super soft to gently clean the gum tissue.

3. Experiment with different toothpastes. Some kids don’t like the taste of the mint and can perceive it to be a painful, burning sensation. Try different flavors of toothpaste, such as bubblegum, strawberry, orange, etc.

GUM Crayola Squeeze-a-Color comes in toothpastes that are all different colors and flavors (melon blast, blueberry burst, and jazzy apple). You can let your child squeeze a little from each tube to mix and match the colors and flavors and have some fun with it. Also, Banilla Bling is a vanilla ice cream flavored toothpaste.

4. If your child is sensitive, maybe flavored toothpaste isn’t the best option. Also, the foaming of the toothpaste may be the culprit, causing unpleasant sensory sensations and discomfort. Oranurse is a flavorless and non-foaming toothpaste that was initially created for children on the autism spectrum who were were sensitive to strong flavors and taste. Overall, this toothpaste doesn’t foam and has zero flavor, which may help ease your child’s comfort.

5. Focus on finding the right toothbrush. Make sure the toothbrush is the right size for little hands and has soft bristles that don’t hurt gums. An electric Spinbrush can make toothbrushing more fun because some children love the feel of the vibrations. Another fun option is a flashing timer brush (Crayola makes one that lights up for two minutes, letting children know when brushing time is up.)

6. If your child is a music lover, consider a singing toothbrush. There are lots of varieties of musical toothbrushes on the market, from ones that sing songs to ones that make animal noises.

7. If a singing toothbrush with all the fancy bells and whistles doesn’t sound too appealing to you, simply sing a song your child loves while they brush. If the brushing stops, you stop singing. You can even play a favorite song on your phone and pause it if they stop brushing.

8. Brush when your child brushes. Brush your teeth at the same time as your little one. Be enthusiastic about it, making it look appealing.

9. Take turns brushing. Let your little one brush their own teeth first before you do it for them. You can also try and give your child your brush and let them brush your teeth while you brush theirs (it can be a good distraction!).

10. Try brushing teeth while in the bathtub. You can also give your child a cup and some bath toys while you brush his/her teeth at the sink. Water play at the sink is a simple distraction.

11. Brush in front of the mirror. This might help your child feel more control of the situation. Visually being able to see the toothbrushing process can help as opposed to a situation where you’re facing your child and they cannot see what’s going on.

12. Visual supports and schedules. A visual schedule can be created by taking photographs of the steps of toothbrushing. Option 1: You can cut and laminate the photos, putting velcro on the back of each one. Arrange in chronological order on a board and as each step is completed, the corresponding picture is removed. Option 2: Print photos of the toothbrushing process, laminate the pages, and a dry-erase marker can be use to check off each step (so that the page can be reused day after day). Option 3: Snap a picture of each step of the toothbrushing process, load the pictures on to a digital picture frame and program it so that each photo is displayed for 10-second intervals. This can be used in the bathroom as they are brushing their teeth so they have a visual prompt when it is time to move on to the next step.

13. Try a timer. Sand timers or using the stopwatch on your phone are great for making how long to brush more understandable. You can start with just a few seconds and work up to a full two minutes.

14. If brushing really is a battle, it’s completely OK to start small. If your child isn’t comfortable with a regular toothbrush, or the electric toothbrush, start with brushing only one or two teeth for a couple seconds, (maybe with the baby silicone bristle toothbrush?), then stopping. A couple days later, you can “up” the amount of teeth you attempt to brush and add on a few more seconds. It’s OK to try this method and go slow. Sometimes a desensitization process is needed.

15. Consider water temperature. Have you always brushed your teeth with cold water? Is cold water what you use when brushing your child’s teeth? If so, try switching it up and using warm water. You child may be sensitive to the cold water and tolerate a warmer temperature a lot better.

Christina is an OTR/L and owner of Sensory TheraPLAY Box, LLC, the monthly sensory toy box for children with autism and/or sensory needs.

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If you ever feel a sense of panic when given verbal instructions, you’re not alone. Whenever I’m asked, “Will you please get whatever from the closet on the middle shelf to the right of whatever,” my immediate reaction is like a robot twirling around saying, “Panic alert!”

I started working as a substitute teacher’s aide two years ago. I often find myself frustrated when given verbal instructions by teachers or other aides, and I didn’t know why until I was recently diagnosed with Asperger’s syndrome (AS).

This diagnosis prompted me to wonder if my long-held habit of asking someone to repeat what has been said to me, particularly instructions, is related to my syndrome. Since my diagnosis, I have been doing research on AS and learned verbal instruction can be one of the things people with AS might find challenging. I don’t think it is so much of a lack of hearing that I ask for a repeat, but a need to be given more seconds to process what I am hearing.

An example of my trouble with verbal instruction was when I was subbing for a kindergarten class. While doing circle time, the teacher asked me to “get the phone.” I interpreted that to mean to go over to her landline phone at her desk and answer it. I was bewildered since I hadn’t heard the phone ring, but I thought, “Oh, well, my hearing isn’t what it used to be.” All I got was a dial tone.

I looked back at the teacher, who pointed at her cell phone. I took that to mean it was her cell phone that needed answering. Again, I was puzzled since it wasn’t ringing either. I should have acted on my bewilderment and asked for clarity, but I was in panic mode. I picked it up and heard nothing. 

That’s when the teacher told me her instruction of “getting the phone” was to simply go over to her cell phone, pick it up and hand it to her. Now if she had said, “Hand me the cell phone,” I would have understood what she wanted.

I was humiliated! I wondered what the teacher, 30 years shy of me, must have thought. She probably would have received her cell phone sooner if she had asked one of them to “get the phone” since the children are probably more familiar with cell phones than landline phones.

My diagnosis has explained so much of how I think, feel and act. Now when I think of that moment in the kinder class, I don’t feel so bad.

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My daughter Shea is on the autism spectrum. She is a sweet, charming, funny girl. Thanks to Steve Jobs, the iPad opened up her world several years ago like it has for so many of our kids. Because Shea doesn’t have strong leisure skills and is mostly nonverbal, she relies on her iPad 24/7. Over the past few years, she has gone through about 10 iPads by throwing them, dropping them in water, breaking them in some unknown mysterious way, etc. When one of the above happens, it’s a mad scramble to get her a new one and quick. Thankfully the $99 Apple Care generally takes care of the replacement (sorry, Apple).

Three days ago, my husband was picking up our daughter from school, which I usually do, but he’s a good pinch hitter. I discovered upon their return that she did not have her iPad. I asked him if he’d forgotten to get it from the school and he said, no, she was using it in the car and then she didn’t want to. As a veteran of these circumstances I immediately knew it meant her battery had run out, as she never “loses interest” in it. Then he said he forgot to put the child locks on the door and window and she’d kept trying to open both repeatedly, making for a dangerous situation under the best of circumstances. Oh no… this was trouble.

Long story short, it wasn’t anywhere to be found. She’d thrown it out of the car at some point along the 30-minute journey. Panic set in. We knew we were going to have to buy her a new one, however, neither of us could do it until Friday — four days away.

I woke up this morning to check my email and saw one from The Mighty. I assumed it was my regular newsletter, but I saw it was addressed to me personally. What it said shocked me.

Dear Terri,

I hope this email finds you well. I’m reaching out because we received an email from someone reaching out because they believe they found an iPad belonging to your family…

What? I couldn’t believe it, so with my permission, this editor was able to put us in touch. Questions were racing through my mind. How/where did he find it? How did he know it belonged to us? And how in the world did he find us through The Mighty?

I sent him an email, and he emailed me back with his work address and said I could pick it up anytime. I raced over and walked into a large high-tech office. I told the receptionist I was there to see the kind gentleman, and she said he was expecting me. I asked her if he told her why I was there, and she said no. I proceeded to tell her the story, and by the end we were all crying. He rounded the corner, and to my surprise he was a “kid” (to me at least because most of my kids are older than him). He had Shea’s iPad clutched in his hands and happily handed it to me. I gave him a big bear hug, and he returned with an equally firm squeeze. I’m not sure he understood why I was crying so I told him I hoped he realized this was not about getting her iPad back (although it was really great… really great), but it was about him and the lengths he must have gone to find me.

man with lost ipad

He said he was walking along the side of the road not far from his office and saw it lying in a gutter. Shea’s first and last name were written on the back with a Sharpie. It was very worn so you could barely read it. He Googled her name and came across an article I wrote for The Mighty a year or so ago, and tada!

girl with found ipad

Maybe it’s just this time of year that made this so special and me so weepy, but I was truly touched. I told him he restored my faith in humanity and the generosity of the human spirit. He probably thought, “This lady needs to get out more!” But his eyes were kind, and he said he was very happy my daughter was going to get it back. It meant a lot to all of us. Now, if that isn’t a feel-good holiday story, I don’t know what is.

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