Success Story: Helping Aidan Overcome His Toothbrushing Resistance

Something as familiar as brushing your teeth can involve unfamiliar sensations, changes in routine, sounds, textures, or feelings that make the activity difficult to accept, and for some children with autism it can feel overwhelming. 

For one ABLE client, whom we will call Aidan to protect his privacy, toothbrushing had become a significant challenge. What started as resistance to brushing had become a daily struggle for Aidan and his family.

With the help of his ABA therapy team, Aidan worked step by step toward accepting toothbrushing as part of his daily routine. His story is a wonderful example of how individualized ABA therapy can help children with autism develop important self-care skills.

When Toothbrushing Becomes a Challenge

Aidan strongly resisted having his teeth brushed. When it was time to brush, he would avoid the toothbrush and become upset when his family tried to help him.

For Aidan, the toothbrush was not simply a tool for keeping his teeth clean. The experience itself could be uncomfortable and difficult to tolerate.

This created a challenge for his family because toothbrushing is an important part of maintaining good oral health. The American Academy of Pediatric Dentistry recommends daily toothbrushing as an important way to help prevent tooth decay and promote healthy teeth and gums.

For children who have sensory or behavioral challenges, establishing a consistent oral hygiene routine can sometimes require additional support and individualized strategies.

Aidan’s family wanted him to become more comfortable with brushing, but they also wanted the process to be positive and manageable for him.

That is where his ABA therapy team stepped in.

Understanding Why Aidan Was Resisting

Instead of simply telling Aidan that he needed to brush his teeth, his ABA team looked at what was happening before, during, and after toothbrushing.

The goal was to understand the reason behind the resistance and determine what could make the routine easier for him.

His team considered things such as:     b 

• How Aidan responded when the toothbrush was presented
• The sensory experience of the toothbrush and toothpaste
• How long he was expected to brush
• What happened immediately before brushing
• What motivated Aidan to participate
• Which steps of the routine he could already complete independently

This allowed his team to create a plan specifically for Aidan, rather than expecting him to follow a routine that was not yet comfortable for him.

Breaking the Routine Into Small Steps

One of the most important parts of Aidan’s progress was understanding that he did not have to go from refusing the toothbrush to immediately completing the entire routine independently.

His ABA team broke toothbrushing into smaller, more manageable steps.

For example, the routine could involve:

1. Going to the bathroom.
2. Getting the toothbrush.
3. Putting toothpaste on the toothbrush.
4. Bringing the toothbrush toward his mouth.
5. Allowing the toothbrush to touch his teeth.
6. Brushing for a short amount of time.
7. Gradually increasing the amount of time he brushed.
8. Finishing the routine and putting the toothbrush away.

Each step gave Aidan another opportunity to experience success.

This type of gradual approach can be especially helpful when a child has difficulty tolerating a new sensation or activity. Pediatric dental guidance also recognizes strategies such as gradual exposure, modeling, positive reinforcement, and desensitization as useful approaches for helping children become more comfortable with challenging dental-related experiences.

Making Toothbrushing a Positive Experience

The goal was to make the experience predictable, encouraging, and rewarding.

Positive reinforcement was an important part of the process. When Aidan participated in a step of the routine, his effort was recognized and reinforced. Over time, the toothbrush became less associated with frustration and more associated with a predictable part of his daily routine.

His BCBA and RBT focused on consistency. Practicing the routine regularly helped Aidan understand what to expect and gave him repeated opportunities to build confidence.

From Resistance to Routine

Little by little, Aidan began making progress. He became more comfortable with the toothbrush and began accepting more steps of the routine, and eventually, toothbrushing became part of his daily self-care routine.

This was about much more than brushing his teeth, because Aidan was learning how to tolerate an uncomfortable or unfamiliar experience, follow a sequence of steps, respond to expectations, and participate in an important activity that supports his health and independence.

These are meaningful skills that can carry over into many other areas of everyday life.

Why Self-Care Skills Matter in ABA Therapy

ABA therapy is not only about reducing challenging behaviors. It can also help children develop practical skills that support greater independence in their everyday lives.

Self-care routines can include:

• Brushing teeth
• Washing hands
• Getting dressed
• Using the bathroom
• Eating independently
• Bathing
• Cleaning up
• Following morning and bedtime routines

Every child has different strengths, needs, and goals. That is why ABA therapy should be individualized to the child.

For Aidan, toothbrushing was the skill that needed extra support. His therapy team met him where he was, broke the task into manageable steps, and helped him build confidence along the way.

A Small Routine Can Be a Big Victory

To someone else, brushing their teeth may seem like a small part of the day, but for Aidan and his family, being able to participate in this routine was a meaningful accomplishment.

Success in ABA therapy does not always look like a huge milestone. Sometimes, success looks like a child trying something they once avoided, tolerating something that used to feel overwhelming, or becoming just a little more independent.

Aidan’s story reminds us that progress can happen one small step at a time.

At ABLE, our ABA therapy teams work with children and families to develop individualized skills that can support communication, social development, daily living, self-care, and greater independence.

ABLE provides ABA therapy for children with autism at our clinic locations in Lakeland, Tampa, Brandon, Plant City, and Clearwater, Florida.

If your child is struggling with an everyday routine or self-care skill, you do not have to navigate it alone.

Ready to Take the Next Step?

If your child has received an autism diagnosis and you are looking for individualized ABA therapy, we would love to learn more about your family.

Click here to fill out our online intake form to get started with ABLE or contact us via phone: (863) 619 2809 email: intake@applied-behavioral.com

Every child deserves the opportunity to learn, grow, and become more independent in their own way.