Effects of a video modeling intervention to improve hand washing independence in children with disabilities.

Research Objectives: To create and implement a video modeling intervention for children to improve performance in handwashing.

Design: One group, pre/post test

Setting: United States outpatient pediatric facility with structured therapeutic preschool and kindergarten program.

Participants: 10 children (4 female), ages 4.0 to 6.7 with autism spectrum disorder and 1 with down syndrome. Additional comorbid conditions present.

Interventions: Point-of-view video modeling of a hand washing skill incorporated during 12 to 18 consecutive therapy sessions. Videos demonstrated nine steps of handwashing: turn on water, wet hands, get soap, scrub, rinse, turn off water, get towel, dry hands, dispose of towel.

Main Outcome Measures: Ordinal measure for level of independence in 9 steps of a hand washing task (refusal/full physical assist, partial physical, modeling, gesture, verbal, independent) measured at baseline, 3rd, 6th, 9th and final sessions. Average of number of independent steps of hand washing skill compared baseline to final (paired t-test). Level of assist compared baseline to final (related samples Wilcoxon signed-rank test).

Results: Participants significantly increased number of steps completed independently from baseline (3±2.2) to final (6±1.8) p < 0.001. Level of independence increased significantly from baseline to final for the steps “turn on water”, “wet hands,” “get soap,” and “dry hands.” Results of the related samples Wilcoxon signed-rank test indicate that a statistically significant decrease in prompt level (baseline to final session) was observed for the steps “turn on water” (p=0.048), “wet hands” (p=0.005), “get soap” (p=0.022), and “dry hands” (p=0.002).

Conclusions: Point of view video modeling can improve young children with disabilities ability to independently complete a handwashing task.

Author(s) Disclosures: Occupational Therapy Doctorate Student Capstone Project.