Structured teaching to promote hygiene skill development in children with autism: a multi-context case study

Objectives: This case study examined the effectiveness of an 8-week structured teaching intervention designed to improve hygiene skills among first-grade boys with moderate-to-high functioning Autism Spectrum Disorder (ASD) and evaluate cross-setting generalization. Methods: Eight first-grade boys with ASD in a specialized classroom in Israel participated in a structured intervention emphasizing task analysis, visual supports, and coordinated school-home implementation. Pre- and post-intervention ratings assessed hygiene independence across five domains: dental hygiene, post-toileting handwashing, pre-prandial handwashing, eating habits, and shower self-care. Three focal cases were analyzed in-depth to illustrate diverse developmental trajectories. Results: All participants demonstrated improvements across hygiene domains. Gains were observed not only in school-based routines but also in shower activities practiced exclusively at home, suggesting cross-setting generalization. Parent-teacher collaboration was integral to ensuring consistency and skill transfer across environments. Conclusions: These findings support the effectiveness of structured, collaborative interventions in promoting hygiene independence for children with ASD. The intervention’s emphasis on visual supports, task analysis, and coordinated home-school strategies facilitated both skill acquisition and generalization across settings.