This advice came from an autism list. The parent used videos as a reinforcer.
- Behavior Modification. Thanks to Mary Elizabeth Christian. We used a fragrance free, dye free children's(no tears shampoo). We used a large cup to rinse instead of a sprayer or dunking which she did not tolerate. We did the following over a period of days:
- We placed a TV in our bathroom and initially let her sit on the floor and watch a few minutes.
- Placed her in the tub with the TV playing but did not wash her hair.
- Washed her hair with the TV on - we allowed screaming just not trying to get away, if she tried to escape we stopped the TV and kept washing, if she sat still the TV resumed. I actually sat in the tub with her and her dad ran the remote and helped with hair washing.
- Paused the TV if screaming occurred during hair washing and used a "Count and Mand" procedure for her to request the TV and then continued hairwashing, if the screaming resumed we paused it again and so on.
- Once she was sitting and letting us wash without any problem behavior I stopped getting in the tub and washed from outside with the TV playing. We then eventually faded the amount of TV to none. Will still take it in the bathroom intermittently and let her watch while she has her hair washed and bathes.
During the procedure we always let her stay in the tub after hairwashing and play and watch the TV. Essentially, the bathtub, water and even hairwashing became conditioned reinforcers due to their association with TV and are now reinforcers. We slowly faded in demands (sitting clothed, sitting in water, sitting still, sitting quiet and still). She asks for a bath now. She still does not love hairwashing, but she is still and quiet and enjoys baths in general.
P.S. An update from Mary Elizabeth: The TV has been gone now for at least year, probably more. Now we sing through the hairwashing “this is the way we wash our hair, wash our hair, wash our hair, this is the way we wash our hair late in the evening." Great job!