Environmental Adaptation Using Sett Frame Work With Systematic Instructions to Reduce the Fear of Sitting on the Flush Toilet for a Child with Multiple Disabilities and Sensory Integrative Dysfunction

Abstract

The purpose of this research was to examine the effects of environmental adaptation using the SETT Framework with systematic instructions to reduce the fear of sitting on the flush toilet for a child with multiple disabilities and sensory integrative dysfunction. The case study was a male aged 14 years and 8 months with multiple disabilities and sensory integrative dysfunction who has the fear of sitting on the flush toilet. The research tools were: 1) a behavioral observation form for the fear of sitting on the flush toilet administered pre- and post-implementation; 2) three individual implementation plans regarding environmental adaptation using the SETT Framework with systematic instruction. Factors affecting the case study's preference were used as a teaching strategy, including environmental adaptation, telling stories, using picture cards, and reinforcement. The results indicated that the mean score on the fear of sitting on the flush toilet at a pre-implementation was 13.67 (91.13%), whereas that at a post-implementation was 5.00 (33.33%), with a decreased score of 8.67 (57.80%).