This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Q: How can we teach our five-year-old child on the autism spectrum to spit out his toothpaste after brushing?
Perhaps you could start with a solid object, like a rubber ball.
SAFETY TIP: Use a ball large enough to fit in his mouth but not too small that he might swallow it. Also make sure it doesn’t taste bad. Some rubber objects taste really bad.
Have him learn to put the ball in his mouth and then “spit” it out to drop it into the sink. That might work to teach him the concept of “spitting.” Reward him for spitting in ways that make sense to him.
If he can begin to understand the concept, then maybe he will be able to generalize it to spitting out toothpaste.
The problem with autism spectrum kids, however, is one of generalization. The child may not be able to generalize the idea from the ball to toothpaste. You may have to do some experimenting with other objects, foods, pictures, etc.
WARNING: Your child actually may over generalize the concept of spitting to other items (like saliva or food) just like all kids do. You will have to teach him when to spit and when not to spit. This also can be difficulty for a child on the autism spectrum.