Task analysis for brushing teeth (printable steps)
By the IEP Atlas editorial teamLast updated
Short answer
A task analysis for brushing teeth lists each visible step of the routine, from getting the brush to putting it away, and scores each one as independent or prompted. A 12-step list grouped into setup, brushing and cleanup works for most students. The score is the number of steps done with no help, tracked daily and graphed weekly.
A toothbrushing task analysis splits the routine into steps that an adult can watch and score, then counts how many the student did alone. Most lists land between 10 and 14 steps. The version below uses 12, grouped into setup, brushing and cleanup, because students tend to get stuck in one group rather than at random.
Teams usually teach this routine in life skills programs, during the after-lunch hygiene block, or as a home goal the family scores. The format matches the handwashing task analysis, so a student with both goals uses one kind of sheet. For how task analysis fits with other data methods, see the IEP data collection pillar.
The 12-step toothbrushing list
Each step has a check an adult can see in a few seconds. Swap in your own wording if the student uses an electric brush or a different storage setup.
| Phase | Step | Scored as done when |
|---|---|---|
| Setup | 1. Gets the toothbrush and toothpaste | Both items are on the counter |
| Setup | 2. Takes the cap off | Cap is off and set down |
| Setup | 3. Puts toothpaste on the brush | A pea-sized amount is on the bristles |
| Setup | 4. Wets the brush | Bristles have touched running water |
| Brushing | 5. Brushes top outside surfaces | Brush moves along the outer top teeth, left and right |
| Brushing | 6. Brushes bottom outside surfaces | Same for the outer bottom teeth |
| Brushing | 7. Brushes inside surfaces | Brush reaches the tongue side, top and bottom |
| Brushing | 8. Brushes chewing surfaces | Brush scrubs the flat tops of the back teeth |
| Brushing | 9. Keeps going until the timer ends | Brushing continues to the end of the set time |
| Cleanup | 10. Spits and rinses mouth | Toothpaste is spat into the sink |
| Cleanup | 11. Rinses the brush | Bristles are rinsed under water |
| Cleanup | 12. Puts items away | Brush and paste are back in the labeled cup or bag |
Step 9 makes the timer part of the routine. Use the length the family's dentist recommends, and keep it the same on every scored day. A sand timer, a phone timer or the built-in timer on an electric brush all work.
The blank scoring sheet
Copy this grid onto the task analysis data sheet, one row per step and one column per scored day.
| Step | Date | Date | Date | Date | Date |
|---|---|---|---|---|---|
| 1 to 4 (setup) | |||||
| 5 to 9 (brushing) | |||||
| 10 to 12 (cleanup) | |||||
| Steps done alone | __ of 12 | __ of 12 | __ of 12 | __ of 12 | __ of 12 |
| Where and who scored |
On the printed sheet, give each of the 12 steps its own row; the grouped rows above only show the layout. Mark I for a step done after the natural cue, or the code of the most help given, such as G for a gesture, V for a verbal hint, M for a model or PP and FP for partial and full physical help. The prompt hierarchy examples define each code. The last row matters more than it looks. A score from the classroom sink with the teacher is not the same task as a score from home with a parent.
Completed example: Marisol's after-lunch routine
Marisol is a fictional 14-year-old in a middle school life skills class. She brushes after lunch at the classroom sink with a manual brush and a 2-minute sand timer. The teacher scored her for 3 days before writing the goal, then the para scored her each school day.
| Week | Mon | Tue | Wed | Thu | Fri | Weekly median |
|---|---|---|---|---|---|---|
| Baseline | 3 | 4 | 3 | 3 of 12 | ||
| Week 1 | 4 | 5 | 5 | 4 | 6 | 5 of 12 |
| Week 2 | 6 | 6 | 7 | 5 | 7 | 6 of 12 |
| Week 3 | 7 | 8 | 8 | 8 | 9 | 8 of 12 |
| Week 4 | 9 | 8 | 9 | 10 | 9 | 9 of 12 |
Her setup and cleanup steps became independent first. By week 3 she did steps 1 to 4 and 10 to 12 alone on most days. The brushing steps were slower. Step 7 (inside surfaces) and step 9 (brushing until the timer ends) still needed a verbal hint in week 4. The para noted that Marisol stopped brushing after about 40 seconds on most days and looked at the sand timer only when reminded.
That pattern told the team two things. First, the gains were real and steady, about one to two steps per week. Second, the sand timer was not working as a cue for her. They switched to an electric brush with a timer that pauses every 30 seconds, which also tells her when to move to a new part of her mouth. Changing the brush is a change in the goal's conditions, so the teacher drew a line on the graph on the day it happened.
Sensory and motor barriers to check first
A student who gags, clamps their mouth or drops the brush may not be refusing. Toothpaste flavor, foam, bristle texture and the feel of the brush on the gums are common barriers. Before adding prompts, talk with the OT and the family.
- Flavor and foam. A mild or unflavored, low-foam paste may get the student through steps 5 to 8.
- Grip. A built-up handle or a wider brush can help a student who cannot hold a thin handle steady.
- Pressure and time. An electric brush does the scrubbing motion, so the student only has to place and move it.
- Watching the steps. A picture strip or a short video model at the sink can replace many verbal prompts.
Write any change into the conditions of the goal. If the student brushes with an electric brush at school and a manual brush at home, those are two different routines and need separate sheets.
What reviewers and parents look for
These are the questions that come up at IEP meetings about a brushing routine, and where the answer lives on the sheet.
- Is every step scorable? "Brushes well" cannot be scored the same way by two adults. "Brush reaches the tongue side, top and bottom" can.
- Does the count include only independent steps? Parents often read a full row of marks as success. The total row should count I marks only, and the key should be printed on the page.
- Is clean the same as independent? No. A step count shows whether Marisol did the steps, not whether her teeth are clean. A dentist judges that. Say so in the progress report so no one reads 12 of 12 as a dental result.
- Are home and school scored apart? Families may score the morning routine at home. Keep a separate column or sheet, and graph the two settings as separate lines.
- What happened on the low days? A note such as "substitute para" or "new toothpaste" explains a dip before anyone asks.
- How is the school storing brushes? Follow your school's health and hygiene rules for labeled storage. That is a nurse or district question, not a data question, but parents ask it.
Turning the steps into a goal
The toothbrushing goal template in the builder already uses a step count and a setting. More routines are on the daily living goals page and the self-care goal hub.
- Weak: "Marisol will improve her oral hygiene."
- Measurable: "After lunch at the classroom sink, using an electric toothbrush with a 2-minute timer, Marisol will complete 11 of 12 toothbrushing steps independently on 4 of 5 consecutive school days, as measured by a task analysis data sheet."
The IEP must state how progress will be measured and when reports go to the family.[1] The sheet above answers both if every column is dated. Objectives can follow the phases, such as setup steps independent by the first report, brushing steps by the second and the full routine by the third. The task analysis measurement page covers scoring rules, and the hygiene goal hub lists related routines.
Teaching order and what it does to the graph
Teaching the whole routine every time and prompting only where needed gives a slow, steady climb like Marisol's. Teaching one step at a time and adding steps in order gives a stair-step graph, because untaught steps stay at zero. The guide to task analysis vs chaining shows how each approach should be scored. For many more routines in the same format, see the task analysis examples.
Frequently asked questions
How many steps should a toothbrushing task analysis have?
Most lists use 10 to 14 steps. Twelve steps grouped into setup, brushing and cleanup works for most students. Split the brushing steps further if the student misses parts of the mouth.
Does 12 of 12 steps mean the student's teeth are clean?
No. The step count shows whether the student did each part of the routine without help. Only a dentist can judge how clean the teeth are, so say that plainly in the progress report.
Can parents score the routine at home?
Yes, and it helps show whether the skill carries over. Give the family the same step list and codes, and keep home scores on a separate sheet or line so the two settings are not mixed.
Use it in IEP Atlas
- Task analysis data sheet
- Toothbrushing goal template
- Task analysis measurement guide
- Hygiene goal hub
- Self care goal hub
- Task analysis in the IEP glossary
Related guides
- IEP data collection: methods, sheets and schedules that hold up
- Task analysis for washing hands (printable steps)
- Task analysis examples for life skills goals
- Task analysis vs chaining: forward, backward and total task
- Generalization data across settings
Sources
- 34 CFR §300.320: Definition of individualized education program, Legal Information Institute, Cornell Law School
Written and checked by the IEP Atlas editorial team under our editorial policy. This guide describes general practice and federal rules. It is not legal advice; your state may add requirements, and the IEP team makes the decisions for each student.