Therapist’s Overview

ACTIVITIES OF DAILY LIVING PROGRAM

GOALS OF THE EXERCISE

1. Function at an appropriate level of independence in the home setting.
2. Increase participation in family responsibilities.
3. Improve personal hygiene and self-help skills.
4. Increase parents’ praise and positive reinforcement of client for assuming responsibilities and
becoming more involved in activities at home.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST

USEFUL
• Academic Underachievement
• Autism/Pervasive Developmental Disorder
• Depression
• Oppositional Defiant

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

This intervention utilizes principles of positive reinforcement to reward the child for assuming basic
activities of daily living at home. First, it is important to assess the client’s overall intelligence,
social/emotional maturity, and level of adaptive functioning before implementing the program.
Obtain reports of any recent psychoeducational evaluations to gain insight into the child’s level of
functioning. Conduct or refer the client for a thorough psychoeducational evaluation, if this has not
been completed within the past 3 years. Knowledge of the child’s level of capabilities will help the
parents, child, and you select tasks that are appropriate for this program. After the assessment has
been conducted, meet with the parents and client to identify specific activities or tasks of daily living
that the client can assume on a regular or daily basis. Next, select the rewards that will be used to
reinforce the child for completing the daily tasks. Include the client in the discussions about the
specific tasks and rewards so that he/she feels that he/she is a part of the program. This program
differs from the homework assignment, “You Belong Here,” because it has been designed for
children who have been diagnosed with Severe and Moderate Mental Retardation. The program can
also be used with clients with Mild Mental Retardation who are resistant to performing basic
activities of daily living.
 EXERCISE XXI.A

ACTIVITIES OF DAILY LIVING PROGRAM

PARENTS’ INSTRUCTIONS

This program seeks to increase your child’s level of responsibility and independence in the home by
allowing the child to assume basic activities of daily living. The program is designed to improve your
child’s personal hygiene, increase his/her self-help skills, or help him/her become more responsible
around the home.

1. First, meet with your therapist and son/daughter to develop a potential list of activities of daily
living that your son/daughter can perform on a daily or regular basis. Include your son/daughter
in many of the discussions about this program, particularly when it comes to making any final
decisions or explaining the program to him/her. However, there may be times when you need to
talk privately with your therapist about the nature of the task or responsibility. In choosing the
basic activities of daily living, it is important to consider your son/daughter’s intellectual
capabilities, social/emotional maturity, and overall level of adaptive functioning. Select tasks
that your son/daughter can perform independently. Hopefully your son/daughter can perform the
tasks without a lot of supervision or monitoring, although some children may need greater
supervision or guidance in the beginning phases of the program. Likewise, some children with
severe limitations may need more supervision throughout the entire program. Talk with your
therapist about how much supervision you are to provide for your son/daughter.
Expect your child to perform three to five basic activities of daily living. Here again, the
number of these basic activities or tasks can be adjusted to meet the needs of your child. For
some children, you may want to begin the program by focusing on one specific task or activity.
You can add other tasks or activities later as the child becomes more proficient in performing
the initial task.
Following is a list of tasks or responsibilities that you may want to address in this program.
This list is offered as a guide to help you select appropriate tasks. Feel free to select other tasks
that you feel are more appropriate for your son/daughter.
• Comb hair • Dust furniture
• Brush teeth • Vacuum carpet
• Wash hands or hair • Wash dishes
• Take a bath • Pick up toys
• Dress self in preselected clothes • Pick up sticks in the yard
• Select own clothes appropriately • Take out trash
 • Make bed • Sweep the floor
• Load the dishwasher • Set the table
• Get cereal in the morning • Chew with mouth closed
2. Use a reward system to positively reinforce your son/daughter for assuming the activities of
daily living. Rewards can help maintain your son/daughter’s interest and motivation in fulfilling
the tasks. Following is a list of tangible rewards that you can use to reinforce your son/daughter.
Remember, the most powerful reinforcer or reward may be the spoken word, praise, or an
affectionate touch or hug. Praise your son/daughter often in addition to using more tangible
rewards, such as:
• Tokens or stickers that can be traded in to purchase larger toys, prizes, or
privileges
• Money
• Snacks
• Extended bedtime
• Rent or go see a movie
• Read a book together
• One-on-one time with child in an agreed upon activity
• Small toys
• Allow child to invite a friend over to the house to play
• Extra television time
• Extra time to play video games or use computer
• Coloring books
• Colorful stickers
3. Keep a record of how often your son/daughter successfully completes a task. Use the following
Activities of Daily Living sheet to record when your son/daughter performs the task. The
Activities of Daily Living sheet will help remind you to reward your son/daughter. Post the
Activities of Daily Living sheet in a visible place (such as the refrigerator or a bulletin board in
the child’s room).
4. Have your son/daughter sign a formal contract if he/she is reading at a third-grade level or
above. Use the Activities of Daily Living Contract form to formalize the agreement. Regardless
of whether a formal contract is used, it is important to clearly spell out the terms of this program
to your son/daughter in advance. Your son/daughter should be aware of how often he/she needs
to perform his/her activities of daily living before he/she receives the reward. Post the contract
in a visible place.
 ACTIVITIES OF DAILY LIVING CONTRACT

If    (Name of child)    performs the following task(s):

   (Frequency)    per    (Day or week)   , then     (Name of child)    

will receive the following reward:

Signature of Child Signature of Parent

Signature of Parent Signature of Teacher or Therapist

 ACTIVITIES OF DAILY LIVING SHEET

DAY OF THE WEEK

Activity Sun. Mon. Tues. Weds. Thurs. Fri. Sat.

1.

2.

3.

4.
5.

6.

7.

8.

Place a check (√) mark in the appropriate box when the child performs the task on that specific
date.