Overcoming obstacles to good personal hygiene for a child with ASD

Children do not come into this world capable of taking care of themselves. At first they depend on their parents for everything, but little by little they learn to wash, dress and feed themselves. Usually, a child will master daily self-care skills with relative ease. Many are self-motivated, as evidenced by the words of a young child who wants to be like mom or dad: “I do.” Of course, they can easily go back to “I can’t do it” in the next second.

Children with an autism spectrum disorder often ‘can’t’ or ‘will not’ take the initiative to become more independent in their self-care. They ‘can’t’ because they lack the necessary motor skills or they ‘won’t’ because of sensory issues, inability to sequence, or simply don’t understand the social importance and why it’s necessary.

Children on the autism spectrum may need some additional steps to learn to manage their physical self-care, such as prompting, modeling, and specific teaching or training. Most children with ASD do not learn basic hygiene skills through observation alone.

So how do you get your child to be independently responsible for their own personal care needs? You start early. I know it’s often easier and less time consuming to do it ‘for her’, but think about the habits you’re imposing, the long-term dependency you’re establishing, and the social awkwardness you may be contributing to.

Let’s take hygiene for example. No parent wants their child to be ridiculed or ostracized at school for a preventable appearance or smell. Children with ASD are already vulnerable enough to bullying as it is; there is no need to add fuel to the fire.

So what are you doing now to help your child learn to take care of his physical needs and appearance? If you’ve tried a number of things and feel like you’re getting nowhere, here are some strategies to consider.

– Determine where the fight is. Identify and remove (or at least reduce) any possible obstacles. Does your child lack the motor skills to button a shirt, comb their hair, or brush their teeth? Does the thought of touching a wet, slippery, slimy bar of soap make washing your hands a daily battle? If so, seek the help of an occupational therapist to treat muscle weakness or sensory sensitivity.

– Break the instruction into small steps, one action at a time. Example: The goal is to wash your face. Step 1 – Get a towel. Step 2: turn on the water. Step 3 – wet face (with or without cloth). Step 4 – Apply soap, and so on. Depending on your child, you can even create more steps, like finding the right water temperature when you turn it on. Practice each step until your child has it down, praising him very specifically for his effort and/or achievement.

– Create an image labeling each step. Many children cannot sequence a series of steps in their mind and do not remember what comes next or may have attention spans so short that they lose their train of thought. Having a visual to refer to will help guide them through the process and is helpful for them when you can’t be around. Remember to identify when the task should be done (time and place), e.g. after eating, before going to bed… Writing a social story for each task that can be read repeatedly will also help.

– Explain why good hygiene is necessary; never assume your child “gets it.” Find ways to help your child understand the social importance of being clean, smelling fresh, and looking good. Create a vision board titled When I Look and Smell Better, Good Things Happen by cutting out images from magazines and using personal photos of what it means to have good hygiene and what the results of doing it are. Then hang it in your child’s room as a constant reminder.

– Pay attention to the environment. Sometimes simply making your child’s bedroom and bathroom sensory-friendly can have a positive impact on their motivation to stay well-groomed. Making laundry easily accessible, finding an unscented shampoo you really like, having towels available with the right texture, and even playing some music in the bath or shower can help.

As children approach puberty, it becomes increasingly important for them to master a self-care routine. Hitting your tweens presents more and more hygiene issues that need to be addressed, such as shaving and menstruation. Remember, when teaching any child or young adult to take care of her own body, it is always good to teach in the natural environment and, if possible, during a time when stress levels are low.