Learn how to get your free toothbrushing task analysis to help teach the skill of brushing teeth.
Toothbrushing is an important part of maintaining good oral hygiene and overall health.
Toothbrushing can be an overwhelming and hard skill to learn especially if they have sensory issues with brushing teeth.
Breaking the skill down and finding appropriate sensory strategies can help.
What is Task Analysis
Task Analysis is a systematic approach used to break down a task into smaller, more manageable components. This can help to define the sequence of steps needed to complete the task, and identify any potential problems or risks associated with the task. It can also be used to identify any skills or knowledge required to complete the task. Task Analysis can be used in a range of fields including education, engineering, psychology, and business.
How Can you use Task Analysis to Teach Toothbrushing?
Task analysis is a great way to teach any complex skill, including tooth brushing. First, break the task down into its component parts. For tooth brushing, this might include picking out a toothbrush, putting toothpaste on the brush, wetting the brush, brushing each quadrant of the mouth, etc. Then, provide a step-by-step demonstration of each part of the task. After the demonstration, have your student practice each step, giving gentle reminders and feedback as needed. Lastly, have your student practice the full task of brushing their teeth, with you providing encouragement and feedback. This process can be repeated as needed until your student has mastered the skill.
A Simple Toothbrushing Task Analysis Example
To help you understand the toothbrushing task, I will provide a step-by-step analysis.
Gather your toothbrush and toothpaste.
Wet your toothbrush and put a pea-sized amount of toothpaste on the bristles.
Start brushing at the gum line using a gentle circular motion.
Brush the outer and inner surfaces of the teeth.
Don’t forget to brush the chewing surface of your teeth.
To clean the inside of your front teeth, tilt the brush vertically and make several gentle up-and-down strokes.
Brush your tongue to remove bacteria and freshen your breath.
Rinse your mouth with water or mouthwash.
Spit out the water or mouthwash and store your toothbrush in a clean, dry place.
Get your Free Toothbrushing Task Analysis Checklist
In less than 5 minutes you can get your free toothbrushing task analysis already written out for you in a step by step process to save you time and to teach the skill of brushing teeth.
Helpful Strategies for Toothbrushing
Toothbrushing can sometimes be an overwhelming experience for some individuals, so it can be helpful to incorporate some sensory strategies to make the process easier. Here are some ideas to make toothbrushing more enjoyable and effective:
Use a timer. Setting a timer for two minutes can help them know when the toothbrushing session is over.
Provide a variety of toothbrushes. Offering different textures, shapes, and sizes of toothbrushes can make the experience more exciting and fun.
Use musical brushing. Playing music while brushing can help them focus on the task and even encourage them to brush longer.
Watch a video or use a toothbrushing app to distract or make it more interactive.
Use flavored toothpaste. Toothpaste with interesting flavors, such as bubble gum or fruity flavors, can make brushing more enjoyable.
Inside: Does your autistic teen or young adult struggle with starting a skill? Learn strategies and resources to help with task initiation.
Your autistic teen or young adult has to get ready in the morning to get out the door by a certain time and it is always chaotic. You feel like you are always having to tell them what to do to get out the door.
You have asked your autistic teen to take a shower 10 times today and they still haven’t started…
You start to think to yourself, are they lazy?
Are they not motivated to do these activities?
I want to help you change your thoughtson how you view your autistic teen or young adult doing activities of daily living or every day life skills.
I want to help you get to the root of the problem of why they may be having difficulty with everyday life skills and how you can support them. This starts with learning about executive function skills. This post will specifically look at task initiation.
*This post contains affiliate links. There is no extra cost to you, but if you purchase through our link we will receive a commission.
What is task initiation?
Task initiation is the ability to start a new task. This can include being able to start a task they don’t want to do. This could be anything from getting ready for the day, to completing homework, to doing a chore. Difficulty with starting a task can make productivity a challenge.
Executive functions are a broad group of cognitive skills that can impact how you function with everyday tasks. These cognitive skills include: impulse control, emotional control, flexible thinking, working memory, self-monitoring, planing and prioritizing, task initiation, and organization. Today will will focus on the cognitive skill of task initiation.
Task Initiation and Autism
Task initiation is one of the core 8 executive functioning skills. What does this mean for autism and executive function skills? When researching executive function skills and autism, I came across this really interesting research by Dr. Gordon and I learned about it from his conversation with Learn Play Thrive on their podcast. You can check out the episode and transcript here. What I learned from this episode was that executive function appears differently neurologically for autistic people. They are using cognitive control networks differently.
They go on to first explain inertia in physics, which is the tendency that objects have to either continue moving (if they are already moving) or continue staying still. An object in motion stays in motion an object at rest stays at rest, unless acted upon by an outside force.
So if that is inertia, what is autistic inertia? It is the tendency that autistic people have to want to remain in a constant state. When they are asleep, they want to stay asleep. Whey they are awake they want to stay awake. When they are working on one thing, they want to stay working on that one thing. They go on to say that this can exist in everybody, but it is more pronounced in autistic people.
“Participants described difficulty starting, stopping and changing activities that was not within their conscious control. While difficulty with planning was common, a subset of participants described a profound impairment in initiating even simple actions more suggestive of a movement disorder. Prompting and compatible activity in the environment promoted action, while mental health difficulties and stress exacerbated difficulties. Inertia had pervasive effects on participants’ day-to-day activities and wellbeing.” (Buckle et al., 2021)
The research further details how this relates to task initiation. “Initiation impairments were often related to the height of the cognitive threshold to overcome, so it was more difficult to get out of bed than to pick up a phone, and complicated activities such as leaving the house were especially difficult. Having another person provide all necessary information or start off the task lowered the initiation threshold, thereby facilitating action.” (Buckle et al., 2021)
Examples of task initiation with life skills
When looking at task initiation, you will want to look at how they start doing a skill. You can take a look at what types of prompts they need to get started or if they are able to start a skill on their own. Here are some examples of starting different life skills during the day.
When the alarm goes off for the day they are able to start to get ready by going to the bathroom and changing their clothes.
Cleaning their room when it is dirty and knowing where to start with cleaning their room.
They are able to make a simple meal or get food when they are feeling hungry.
They are able to look at the weather outside and start by picking out clothing to wear for their day.
They notice their hands are dirty and are able to start the task of washing their hands.
They look at a checklist of work tasks and they are able to start with the first task.
They are able to start their homework assignment after directions are given.
Indicators of difficulty with task initiation/or possible signs of challenges
Individuals who struggle with task initiation may need many reminders from adults to start a task and they may delay doing an activity or rush to do it at the last minute.
What this could look like with life skills:
You asked your teen to take a shower, but they are refusing to take a shower (this could be because of task initiation, but it could also be because of sensory processing challenges) If you are needing help with teaching taking a shower you can check out this resource here.
They may have difficulty starting on cleaning up a mess or cleaning their room.
They may have difficulty getting ready for the day and picking out clothing items.
They may not know what activity to do first when getting ready in the morning and trying to leave the house.
I want to take a moment to acknowledge that some adults working with autistic teens and young adults may view these difficulties as being lazy or not motivated to do the skill.
The most important thing to remember is that executive functioning struggles absolutely do not represent laziness. Difficulty with starting a task is a real cognitive block and really does impact their ability to complete a skill.
How do I evaluate task initiation skills?
Here are some ways that you can evaluate an individuals task initiation skills.
Complete an observation of various life skills. Ask them to complete some simple life skills or skills you know they are having difficulty with and pay attention to how much prompting or help you need to give them. Are they able to get started on their own or what strategies do you need to help them with to get started?
Here are a couple questions to ask yourself when you are working with them:
Do they struggle with procrastination?
Are they able to start a task right away or do they need help?
Do they need visuals or reminders to help them get started?
If you are noticing that they are struggling in these areas you can reach out to their support networks. This could include their teachers, occupational therapist, speech therapist, psychologist, and or doctor. You could also reach out to them to ask for a professional evaluation.
Strategies to help with task initiation
There are a variety of strategies you can use to help with task initiation. You may have to try out different ones for the person and skill you are working on.
When looking at strategies to help with task initiation I wanted to go back to the research study by Buckle, et al. They found that, “prompting from another person in their presence was the most helpful intervention. Even having someone working nearby without interacting was often helpful. Participants also found it easier to do anything where another person was depending or counting on them, even from a distance, and most difficult to do something only for themselves.” (Buckle et al., 2021)
Prompting is giving a prompt in some form as a way of helping someone move onto another task. This could be anything from:
a person verbally telling you what to do
someone handing you something to get you started
writing the step out for you or looking at a checklist with the steps written out
or you hearing an alarm go off to get you started.
It can be helpful to have a specific support person be designated to help the individual get started on something new to help them feel grounded and safe that it is okay to get started on something new.
Break Skills Down Into Small Steps or Task analysis
“Several participants had developed personal techniques to reduce the pressure of expectation. For example, by telling themselves “all you have to do is…” one tiny step, they could circumvent the sense of pressure and demands that could cause them to get stuck.” (Buckle et al., 2021).
Break a skill down into small manageable steps for them to see what to do and what is expected of them. If they can clearly see what the first step is going to be this can make it easier to get started.
A formal term for this can be task analysis. This is when you break a task down into smaller steps.
He said that he uses visuals for a variety things during his day. He uses them at his work at his computer, in his home for doing chores, and in his kitchen for meal planning.
Types of Visuals
Written word of the step or task
black and white picture of the step
colored picture of the step
real life picture of the step
PEC pictures of the step
the actual object that you need to use to complete the step
Another strategy that Oswin stated was giving a person wait times. Meaning giving them enough time so that their mind can go ahead and start shifting and with enough wait time those planning steps can start to happen.
Timers or Visual Timers
Oswin also said that he uses timers to help him when he can’t have an external person there to help him initiate or prompt him on a task. You can use a visual timer like this one here or a timer on your phone.
A visual timer displays how much time is left on it so it can be very helpful with someone who may need a visual as to when the task will be done. This allows them to better see a start and a stop time. Someone may have difficulty starting a task because they don’t understand when they could be done. We all want to be able to see an end result when we are working on something. So using a visual timer can be a way to give a concrete end to something.
Help them see the end of the task
Sometimes they may not want to get started because they don’t understand when they will be done or they can’t visualize the end of the task. If you can help them see when the task is done this could also help them get started on the task. You can do this by using a visual timer, writing the steps out or using visuals of the steps, or showing them the end result with a model.
Written checklists can be a great strategy to break the skill down into smaller steps, but also to write out the different tasks they need to get done as part of a routine. For example for a morning routine you could write down the big tasks that need to get done such as: go to the bathroom, wash face, brush teeth, get dressed, eat breakfast as an example.
I have included a free checklist PDF that you can print off and write down the tasks or the steps for a task that make sense for your situation. You can get these free blank checklist forms by joining the email list and becoming a member of the Learning for a Purpose community. Just enter your best email address below!
Resources and further reading
If you are wanting to learn more about task initiation and look at further research and strategies for autistic teens and young adults you can check out these resources.
Buckle KL, Leadbitter K, Poliakoff E and Gowen E (2021) “No Way Out Except From External Intervention”: First-Hand Accounts of Autistic Inertia. Front. Psychol. 12:631596. doi: 10.3389/fpsyg.2021.631596
The body odor and greasy matted hair show your teenager has gone days without showering. Again. Cringing, you brace yourself for the dreaded battle if you dare intervene. But if you don’t speak up? You worry your teen will sit alone in the cafeteria or be ridiculed by cruel peers. You need to figure out a way to help them care for their body.
The teenage years bring about a lot of changes and new experiences and one big change is going through puberty and having an understanding of changes occuring in the body.
Not all teenagers with autism will have difficulty with personal hygiene care skills, but for some it can bring on new stress and anxiety with learning a new self care routine or how to care for their body in a different way. They may have difficulty understanding why these changes are happening or some of the social situations as to why they need to make these changes.
Why Taking a Shower May be Difficult for Them
Sensory Sensitivities to the feeling of water on their body and feeling wet
Difficulty understanding why we need to shower
Being dirty and having oily hair doesn’t bother them
The change in temperature of getting in the shower may bother them
They may have difficulty with balance and coordination with standing in the water
Getting dressed after showering their skin may feel like it hurts
Taking a shower takes so much energy
Taking a shower is sensory overload
The smells of the shampoo, conditioner, body wash
There are a lot of reasons why taking a shower may be hard for them… Just be willing to listen to them and work together to help them figure out how to take a shower.
What can you do to help?
Have an understanding and patience that this skill is hard for them. Be there to support them and help find ways that work for them to learn the skill.
I have put together a list of products that may help you adapt how to take a shower in order to make it a little easier for them.
*This post contains affiliate links. There is no extra cost to you, but if you purchase through our link we will receive a comission.
A shower dispenser for the soap can help make it easier to get the soap out to use. They just have to push a button to get the soap out and this may help them identify better between body wash, shampoo, and conditioner.
A color changing shower headfor the correct water temperature. This may be helpful for someone who has difficulty regulating the temperature of the water on their own.
Color changing smart light that is color coded with the color lables on the soap dispenser. You can set up the color chaning smart light to be the same colors as the color labels on the soap dispenser and set each color for a certain amount of time. This will give an additional visual cue as to when to go to the next step. This way they aren’t standing under the shower for a long time without washing their body and letting the water get cold.
Swim Goggles may be helpful for someone who has difficulty getting their eyes wet while in the shower.
Ear plugs may be helpful for someone with sensitivity to the sounds in the shower.
A reclinging hair salon chair may be helpful to set up at a sink to wash their hair if they have difficulty washing their hair by themselves in the shower. Especially if they are older and are wanting more privacy in the shower.
These are additional ideas that are helpful for in between showers to help keep their body clean.
In this bundle, I give you tons of practical tools and resources to help you teach your teen or young adult how to shower. I give you specific strategies to teach each step of taking a shower, sensory adaptaitons, how to set up the bathroom for success, and TONS of tools to help you teach the skill. I use real life pictures of teen boys or teen girls to help them have a visual for each step.
What strategies or products have you found to be helpful when teaching your teen or young adult how to take a shower? Share in the comments below!
Inside: It is normal to feel scared and anxious during times of change. Find out an easy way to help create a routine for individuals with autism and your family.
Right now as I write this post, there are a lot of changes going on in the world with a global Pandemic.
This might mean that your child’s school is closed, daycare is closed, you are home from work, or you are trying to work from home.
There are a lot of changes going on and that can be scary and uncertain.
What does this mean for Children and Teenagers with Autism?
Change may be extra hard for them to process and understand right now. Some individuals with autism really thrive on routines and when that routine is changed it can have a big impact on their everyday life.
I want to remind you to take time to show compassion, empathy, and understanding towards your kids right now as they are experiencing a lot of change in their daily routines as well as yours.
What can we do to help them through these changes?
Build a Routine Together
First, we need to figure out what type of routine will work for your family. Think about what type of structure works well for your child or children, but also keep in mind what works for you as the parent caring for your children.
This can seem overwhelming at first, but I am going to do my best to help make this transition a little easier for you.
Think about how you may want your day to flow together instead of thinking of it in time chunks. Are there parts to your day that you know need to get done such as eating times, sleeping times, getting ready for the day, or specific activities you would like to do with them?
List out the big activities that need to get done in the day.
Then from your list do you feel like it needs to stay in a specific order for your child to really thrive from a specific routine, or are they okay with flexibility and changing things if they need to?
I don’t want to give you a specific schedule/routine to follow because every family is different in what works for them.
For example, I do not like to have things scheduled out for me because I get upset if it doesn’t go as planned. Instead, I like to think about 2 or 3 things I know I would like to get done that day and work that into my schedule as a flow to my day.
Here are some examples of activities of how you can set a flow to your day without giving time constraints to the activities.
Flow to a day:
Work Time (Reading, writing, math)
Free Play/Technology time
Outside Time if able or want to
Quit Time or Rest or (reading or writing)
Life Skills Opportunities (help with meal prep, work on a specific skill the child would like to get better at)
Screen Time/Technology Time
Get Ready for Bed
These are just examples of activities, you do NOT need to feel like you need to do EVERYTHING in a day.
Right now your children need you to be there for them and to feel loved. They need time to connect with you, play, eat, and sleep.
How do you build a routine together with your children?
One thing you can do is ask them what is something they would like to do today? Is there a specific game they would like to play, movie to watch, or skill they are wanting to learn?
Building a routine with your child may hopefully help them feel excited to do something they want to do and help with these new changes.
Because I don’t know about you, but I don’t like being told what I have to do all of the time. I like to have a say in what I want to do during the day and your children will most likely feel the same way.
Also, think about the times during the day when your child is in their best mood. Do they do better in the mornings, afternoons, or evenings? Take that time to find a way to really connect with your child. Try doing something fun whether it be playing a game together or a certain play activity that they enjoy.
Get your Free copy of Building a Home Routine Together Planning Guide!
Another way to help with the transition and changes to a new routine can be by using visual schedules.
Visual Schedules can be actual pictures of the activities, a real-life object from the activity, or a written checklist of the order of events.
A visual schedule may be helpful to use when changing your routine so they have a better understanding of what may be expected of them. Especially if they were used to using a visual schedule at school. You may want to reach out to their teacher if you are able to see if they were using a visual schedule and see if they could help you create one for at home to make it similar to what they had at school.
Some individuals with autism may need more help with getting their sensory needs met during the day, especially during times of change.
If you are able to check-in with their teacher or if they were receiving occupational therapy services, see if you can ask them what types of sensory activities they were doing with them and what worked well for your child.
Here are some additional resources to help you come up with different sensory activities ideas that you could do at home.
Lastly, I want to make sure we think about how to help you meet your needs throughout the day as a parent.
Your daily routine and schedule has most likely changed as well and this may mean that you are feeling very overwhelmed, frustrated, scared, and anxious.
It is okay to have these feelings, I know I have been feeling this way.
We need to try to stay calm in front of our children during these times of unknowns to help them feel a little comfort during their day.
One strategy that has been helping me during this time is to think about what I have control over in my life.
I have control over how much I use social media or what I want to read on social media.
I have control over what activities and things I can do with my children during the day.
I have control over how I will react in certain situations.
Think about what you have control over in your life right now and try your best to focus on positives and gratitude right now.
Also, think about what things do you need during the day to help you feel calm and like yourself?
Do you need time to watch a show, read a book, take a bath, 5 minutes to yourself to collect your thoughts?
I know it can feel impossible to make time during the day for yourself, but as the parent, you are such a huge part of your child’s life right now and they need you to be there for them. You can’t be there for your child or children when you are so overwhelmed and tired.
Download your Free Cheat Sheet
Grab your Free Copy of the Building a Home Routine Together Planning Guide! In 5 minutes you can help set up a routine that works for your child with autism and your family to help make the day go smoother.
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Feel Confident and Successful Teaching Life Skills
Inside: Learn how to analyze your teaching session to reflect and make a plan for helping you create a meaningful and successful learning opportunity.
*This post may contain affiliate links.
You set up the perfect learning session with a kiddo to work on teaching them life skills by having the materials all setup and ready, in a quiet environment, and the steps of the activity written out for them to follow. You model and show them what you want them to do and you are there to support them and guide them as they are learning this new activity. Then halfway through the session things start to take a turn for the worse.
The individual is not focused, they can’t work on this skill anymore and they are just done. They get up and walk away or they start to throw the objects in front of them. They are overloaded and frustrated.
You think to yourself, what did I do wrong?
How can I teach them this skill if they won’t even work with me for longer than 5 minutes?
You think to yourself, I am such a failure.
What you Should Know About Teaching Life Skills
Every individual you work with and every teaching session is going to be different with a different outcome. Some sessions may go as planned and you feel like a rockstar, other times though it may be an epic fail and that is when you start to question your ability to teach life skills.
Whether you are an occupational therapist, a teacher, or a parent we all have times when teaching a new skill will either go well or not so well.
I am here to help you get back on your feet and feel a little bit more like a rockstar when it comes to teaching life skills even after a session that went horribly wrong.
Because as an occupational therapist I have felt defeated and overwhelmed and lacked my own confidence when teaching a kiddo a new skill.
Over the years I have realized that every teaching session and every individual I work with is going to be different based on so many factors. I wanted to create a way to help you feel more confident and successful when teaching life skills so I created a Free Problem Solving Checklist for you to use to reflect on your teaching sessions and help you make a plan for your next session.
How to Problem Solve What is Going on When Teaching Life Skills
You are probably wondering what do I do after a teaching session doesn’t go well? The first thing I like to do is to remind myself “I am a good therapist.” My heart is in the right place and I am here trying to help them learn something new.
Use positive words and phrases to talk about yourself, because if we start to get too down on ourselves, how can we best support the individuals we are working with?
The next question I like to ask myself is, “How can I make the session meaningful for the client I am working with?”
The first area I want you to think about as you problem-solve a teaching session is Motivation. Is this life skill that I am teaching a goal of the client/individual? Do they understand why working on this skill is important to them?
If they are not motivated to work on this skill with you, is there a way that you can help motivate them or can you help them understand why this skill is important to work on? The answers to these questions will vary for each individual and this is when you get to put your creative juices together to help figure out how to motivate them or how to make this goal meaningful to them.
Other areas to think about with motivation are is the individual having a hard day? Are they feeling sick or are there other outside factors going on that are affecting them right now?
We are all entitled to having bad or off days and sometimes it can be hard when those days happen to be the days we are working with them.
If this is the case and they are just having an off day, is there a way that you can make the session fun for them? Could you change up the teaching session and create a positive experience for them? Because sometimes it isn’t always about teaching the specific skill as it is just helping form a positive relationship with the individual to help them gain your trust.
Motor Skills Involved
The next area to think about and analyze about a session are the specific physical motor skills involved to complete the life skill. Do they have the strength, endurance, fine motor skills, etc to complete the steps of the skill you are working on? If they don’t have the motor skills to complete a specific step how can you help them either learn those motor skills or is there a way to accommodate or change that step to be completed in a way that they can be successful with that step?
The next area to think about is the materials you are using to teach the skill and the environment you are teaching in. Can they use and access all of the materials that are needed to complete the skill? Are they distracted in this environment? Do they need any other additional supports?
Ask yourself these questions and really take some time to figure out if there would be a better set up for teaching the skill you are working on.
Teaching the Skill
Think about how you taught the skill to the individual, did they understand what was expected of them? Did they have enough time to process each step or were they distracted? Analyzing how you actually taught the skill can take some time to get used to and may take some time at first. Think about how you spoke to the individual, how you reacted when they did something, or think about how they reacted when you did something? Taking time to reflect on how the actual teaching session went with how you reacted and the individual reacted can help you better understand how to work on that skill next time. If they responded well to something, try doing more of that next session or if something didn’t go well think about how you could improve upon that for the next session.
Actions or Emotions
Each individual will have different reactions and emotions towards us when we are working with them. Things to keep in mind and consider when working with someone is do they have any fear or anxiety with learning this skill? Do they have a hard time keeping their attention or are they distracted easily?
If you feel overwhelmed with trying to understand how the individual may be feeling, please seek out additional support with medical advice or professional services to better help and assist the individual you are working with.
The last area to think about when teaching life skills could be sensory related. When you were teaching them were they upset by smells, lights, movements, sounds, or taste? We are constantly surrounded by sensory information in our day to day life and each individual will respond differently to sensory input and we just need to be aware that this may also affect how they learn when teaching them life skills.
What to do: Reflection and Making a Plan
Now that I have given you some ideas and tips on areas to analyze and reflect on after a teaching session, I want to help you feel successful with your next teaching session by helping you make a plan.
By identifying some problem areas you can now feel better about the next session and create a clear action plan for the next session. To make it easy for you, I just want you to think about one problem area that you identified and think of one or multiple solutions to this problem area that you could change for next time.
Another way to think about this is also by creating an if-then problem statement to help you. For example, If the client starts to get distracted then I will let them take a 5-minute physical activity break by doing a gross motor game with them.
By creating a plan and being able to reflect on each teaching session, this will help you feel confident and successful when teaching life skills.
Download your FREE Problem Solving Cheat Sheet for Teaching Life Skills
Use this cheat sheet to help you reflect on your teaching sessions, make a plan, and help you feel confident and successful when teaching life skills!
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Print it out or use it on your computer to help you problem solve your next teaching session.
Use it to make a plan for your next teaching session and help you feel confident and successful when teaching life skills!
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