Prompt Hierarchy Examples for Daily Routines: Handwashing, Dressing, Teeth, and Shoes

The clearest prompt hierarchy examples come from routines you already do every day: handwashing, putting on a shirt, brushing teeth, putting on shoes. Each one below is written out as a task analysis (the routine broken into its steps), using the step lists from my Resource Kit's Daily Living Skills sheets, with the prompt level you'd realistically expect in the first week for a young child new to the skill, and the level you're fading toward. The codes are the kit's: I for independent, V for verbal, G for gestural (pointing or demonstrating), VP for visual prompt, PP for partial physical, FP for full physical.

If you've read the prompt hierarchy post, you know the rules: wait five seconds before prompting, prompt at the current level, fade one level at a time after a few consistent days. This is what those rules look like on an actual Tuesday.

Why examples beat definitions

The hierarchy is easy to understand and hard to apply, because the hard part is deciding what counts as a step. "Wash your hands" feels like one instruction to an adult. To a two-year-old with motor-planning differences, it's a dozen separate movements, each of which can need a different level of help. My book's advice for life skills is to scaffold the task into two or three micro-steps at a time rather than giving the whole instruction, and the examples below are that advice carried all the way through.

A task analysis is the technical name for the broken-down list (Cooper, Heron & Heward, 2020). Writing one takes ten minutes, and it changes how you see the routine: instead of "she can't wash her hands," you see "she's independent on four steps, needs a gesture on three, and needs my hands on one," which is a plan.

Example 1: handwashing

The kit's handwashing task analysis (pp. 156-158) runs to twelve steps, with a challenges-and-solutions table and a weekly tracking grid; it's the deliverable at the bottom of this post. Here are the kit's steps with the levels I'd expect.

Notice that the hardest steps, the scrubbing ones, start at the top of the hierarchy and have fade targets that stop short of independence for now. That's realistic. Rubbing the backs of the hands is a bimanual coordination task, and bimanual coordination is one of the fine motor differences commonly seen in young children with autism (Lloyd, MacDonald & Lord, 2013). A fade target of G for week four means you'll set the next target when she reaches this one.

The kit's sheet pairs the steps with a challenges-and-solutions table, because what derails this routine is rarely the steps. Its five rows: water too hot or cold (mark the "just right" spot on the faucet), resisting wet hands (fingertips first, her preferred temperature, water play before real washing), disliking the soap texture (try foam, liquid, and bar, and a favorite scent if she isn't scent-sensitive), rushing through (a timer or a 20-second song, and a handwashing visual on the mirror), and trouble with the faucet (lever handles or an extender). I'd add the opposite of rushing, the child who will scrub forever, for whom the same song that ends does the job.

Example 2: putting on a shirt

Pullover shirts first; buttons are a separate project. The kit's shirt sheet (p. 161) uses ten steps, and the ones a toddler needs hands for are in the middle.

The first arm is usually the sticking point, because finding an armhole you can't see requires mapping your own body in space. It's common for the second arm to go independent before the first, since once one arm is in, the shirt is anchored. Record what you see, even when the order seems backward.

Two things help this routine more than any prompt, and both are on the kit's challenges table: a visual cue for orientation (a sticker on the front, and the same starting position every time, so the environment itself is a visual prompt), and fabric. If she fights the shirt, start with textures she prefers, wash new clothes several times before she wears them, and cut out the tags, because no prompt level overcomes a fabric that feels like sandpaper. The kit also suggests slightly oversized shirts at first, and practicing on a doll, for the child who gets stuck mid-process.

Example 3: brushing teeth

This is the routine where the prompt hierarchy most needs a sensory caveat. The book is direct about it: if a child resists hygiene tasks, offer choices (two toothbrushes), use a calming strategy before you start, and build tolerance gradually. The kit's toothbrushing sheet (p. 159) says the same for a sensory-sensitive mouth: start with a toothpaste flavor she prefers, begin by just touching the brush to her teeth before any actual brushing, and try different brush textures. If the resistance is sensory, prompting won't fix it, and pushing through with physical help teaches her that toothbrushing is something done to her. The first task analysis for teeth may need to be a tolerance ladder rather than a skill ladder.

Once she tolerates the brush in her mouth, the kit's thirteen steps look like this:

Brushing itself is the kit's own worked example of fading a physical prompt: stand behind her at the sink, hand fully over hers on the brush in week one, then wrist guidance, an elbow touch, shadowing, pointing to the sequence card, and verbal reminders only by week six. If she pulls away from having her hand moved, hand-under-hand is the alternative: your hand holds the brush, her hand rests on yours, and she can lift off at any moment, which the hand over hand prompting post explains. The book's scaffolding script for this routine is a good model of a verbal prompt: "Take toothbrush... put on toothpaste... now scrub top teeth," one micro-step at a time.

The toothpaste steps are listed at full physical, or "you do it," for a reason. Dispensing a pea-sized amount is a fine motor task beyond most two-year-olds, and there's no shame in keeping that step as yours while the brushing steps fade. When she's ready for it, the kit's suggestions are a visual guide (a pea-sized spot marked on the counter) or a toothpaste dispenser; for a child who swallows the paste, a non-fluoride training toothpaste at first, and spitting practice with water games outside of toothbrushing time.

Example 4: shoes

Shoes have a built-in advantage: the natural cue (standing at the door, coat on) is strong and the reward (going outside) is immediate. The kit's socks-and-shoes sheet (pp. 175-177) starts with slip-ons and adds a single step for Velcro; laces are a separate sequence for later.

Two practical notes. Left and right stays at a visual prompt on purpose: the kit's fix is markers inside the shoes, colored dots, or the "shoes face out" rule, and a dot sticker is a prompt you never need to fade. And pulling the shoe on over the heel is where most children need hands longest, because it's a pull with the fingers while the foot pushes the opposite way, two movements at once, and it fades slowly. For a child whose trunk stability makes bending hard, the kit suggests a long-handled shoehorn or practicing on an elevated surface.

The handwashing sheet therapists use, for your bathroom.

The kit's full 12-step handwashing task analysis, the challenges-and-solutions table, and the weekly tracking grid with the level codes.

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How to build your own task analysis in 10 minutes

Any routine can be written up this way, and you don't need a therapist to do it, though if your child has one, ask for the version they're using so you're both rating the same steps.

Do the routine yourself, slowly, and say each movement out loud as you make it, writing them down as you go. You'll end up with more steps than you expect, which is correct; the kit's sheets run from seven steps (drinking from a cup) to thirteen (toothbrushing). Combine any two that always happen together if the list gets unwieldy.

Next, watch your child do the routine once with your usual help and write down the code that describes what each step took. Don't change your help yet. This baseline is often the most useful ten minutes in the process, because it shows you where you've been helping more than she needs.

Then pick a fade direction for each step: least-to-most (pause, then add help) for steps she's done before, most-to-least (enough help to succeed, faded on a schedule) for new motor steps. The least to most prompt hierarchy post has the three-question test. Finally, put the steps on a tracking grid with the days across the top, write one code per box each day, and drop one level after three consistent days. The prompt hierarchy chart post has the blank grid and the printable ladder.

The whole system is a way of getting the thirty minutes a week your child spends with a therapist to show up in the other hundred hours she spends with you. Organizing that into a weekly structure is what the bring therapy home every hour plan does, and the book and Resource Kit are sold together as a bundle.

Frequently asked questions

What is a task analysis in autism therapy?

A task analysis is a skill broken into its component steps, in order, so each can be taught and tracked separately (Cooper, Heron & Heward, 2020). ABA therapists and occupational therapists use them for daily living skills like handwashing and dressing. Parents can build one by doing the routine slowly, writing down each movement, then rating each step's prompt level.

How many steps should a handwashing task analysis have?

For a young child, around twelve. The Resource Kit's version uses twelve, separating the scrubbing into four steps (making bubbles, fronts of hands, backs of hands, between fingers) because those steps most often need physical help. Fewer steps hide where the trouble is; many more than twelve becomes hard to track at a sink.

What are the steps for getting dressed for a child with autism?

The kit's pullover shirt sequence is ten steps: get the shirt, find front and back (tag in back), lay it flat, find the neck hole, shirt over head, find the first arm hole, arm through the first sleeve, find the second arm hole, arm through the second sleeve, pull the shirt down. Pants are nine: get pants, find front and back, sit down, hold pants open, first leg in, second leg in, stand up (with support if needed), pull up to the waist, fasten the closure. Each step gets its own prompt level and fade target, and sensory factors (tags, seams, waistband tightness) come before any prompting plan, since a shirt that feels unbearable won't be put on at any help level.

Should I use the same prompt level for every step?

No. Different steps fade at different rates, which is the main reason to track them separately. A child can be independent at turning on the water and need full physical help rubbing her palms in the same week. Rate each step on its own and fade each on its own schedule.

The handwashing sheet therapists use, for your bathroom.

The kit's full 12-step handwashing task analysis, the challenges-and-solutions table, and the weekly tracking grid with the level codes.

Your email address

Website

Send me the sheet

One email with the PDF, plus occasional early-intervention tips from Andrea. Unsubscribe anytime.