PERSONAL HYGIENE
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Let's start with the basics...
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​​​​Hand washing is an especially important skill especially now to teach. Start as early as preschool because it can help cut down the number of times they get sick. Here's a good
video example to help you being teaching your child on the spectrum to wash their hands independently. As you can see, hand over hand is often used as the first step. Encourage them to curl their fingers because many children keep their fingers extended. Combine this with a picture schedule hanging in the bathroom to help remind them of what the next step is.
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Tooth Brushing is a challenging task because many children need to build the strength in their fine motor skills to use a tooth brush effectively. Tooth brushing should be started as soon as the first tooth appears and should be repeated twice a day. A visual aid showing pictures of the steps helps with remembering all of the steps. Or purchase a standard teeth model so the child can see how they should brush their teeth. Talk to your OT about any sensory concerns and explore alternative to meet those sensory needs. Discuss any difficulties about spitting out the toothpaste or rinsing with the speech therapist. Find a local autism friendly dentist by clicking here.
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More Resources:
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Showering and Bathing has it's own steps to follow but most importantly for your child to have a visual aid that reminds them hot/cold so they don't burn themselves. Detachable shower heads make it so much easier to wash their hair. Give attention to any sensory issues because the experience needs to be positive. For some children who love to swim, bathing/floating in a lavender bubble bath can help many children calm down if they experience overload and be self-soothing. Make sure you have the time to supervise their safety. Keep supplies like soap, shampoo, conditioner together and clearly labeled. A visual schedule and/or social story that shows what body parts are washed in sequence and keep the sequence consistent. If they are struggling with the steps, back-chaining or working from the last step to the first can be a great strategy for some children. Again, consult with your OT for ideas or develop goals around building their strength to wash themselves. If a reward system is reinforcing to your child, create one for hygiene. Giving choices of choosing scents or supplies can make a huge difference with many children. Make sure this is done behind closed doors and increase their awareness of privacy.
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Hair care is another challenging part of personal hygiene due to the need for the person to have enough strength and dexterity to use a brush. An OT or PT can help develop goals, a plan and exercises to build their ability to be independent. You can practice on a doll's hair for girls or boys who are open to it. Back chaining is also effective so let them rinse the hair first and work backwards. In the meantime, getting a haircut that is manageable as you move towards independence can lessen the stress. See the Autism Friendly Hairdressers page to find a stylist near you.
Shaving for men and women has some similarities where you can use a men's electric shaver to prevent injury and it has a good grip. For women, I find using all men's shavers a much better quality and a better shave. If visuals help, show them before and after photos showing them how long the hair is when it's time to shave and what it should look like. If a non-electric shaver is preferred, then include what they should do if they get a nick. Be specific and have a trusted person who is of the same sex working with them so if they need to demonstrate what to do. Include info about when it's time to replace the blade. Again, work with therapists for more ideas and social stories to set up success.
Menstruation and puberty for girls should be done before they reach puberty to prepare them for the changes they should expect. Talk to her privately about the changes she can expect and keep it positive. For fine motor practice, have her peel stickers from a backing which is the same as pulling the strip off a maxi or mini pad. Practice putting it in underwear and you can use underwear that helps prevent period leaks. Use red food coloring to demonstrate what to expect. Keep the terms and conversation straight forward and simple. Have her get used to carrying an extra pad just in case. Let her get used to wearing the lightest pad. When your daughter starts to show physical changes, that's the time to talk to an OBGYN. Bring up concerns about how much your child understands what's happening. Some parents opt for giving the pill that can lighten or even stop a period of all efforts to improve hygiene fail. Talk to your daughter's OBGYN about choices and approaches you can take. Include supports in her IEP for when she has her period during school hours. Here's a link to more information of the steps you can take to help prepare your child for puberty.
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Resources to share
The Care and Keeping of You: The Body Book for Younger Girls book
The Care and Keeping of You 2: The Body Book for Older Girls
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POTTY TRAINING ROAD MAP
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Potty training kids with Autism has another level of complexity when there are communication challenges and to present it in a way that the child understands. Just like a child without a disability, we need to assess whether or not the child is showing signs they are ready to be potty trained.
How do you know if they are ready?
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Can your child imitate others? If not, this can be an ABA goal.
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Are they showing signs of wanting independence?
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Can they pull their pants down and up independently? If not, this could be an OT goal.
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Can they walk to and from the toilet independently? If no, this could be a PT goal.
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Are they showing a willingness to cooperate and not flee?
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Some key things you may want to include in your individualized program are:
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Plan on potty training during a long break from school/therapy sessions, at least two weeks.
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Keep track of accidents to see if you can spot a pattern
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Keep track of successes to compare.
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Create a structured program with short increments that works for your family with lots of positive reinforcement not limited to verbal praise. Use their favorite snacks and favorite toys.
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Make sure the environment is comfortable for them and that their feet are touching a hard surface. For example, if you are using a toilet with a toilet seat insert, give your child a stool to set their feet on so their legs aren't dangling. Not every child uses a potty.
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Also sensory sensitivities can include the type of underwear. A popular brand among parents are Hanna Anderson girls underwear and seamless hipster underwear.
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What sensory issues are creating barriers (for example, does your child cover their ears during the loud flushing noise) and does your child show any fears associated with using the potty.
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Using visual directions or pictures demonstrating the process can reduce anxiety because the child will know what will happen.
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Avoid punishing the child if accidents occur. Keep it positive.
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​Recommended books:
Toilet Training for Individuals with Autism or Other Developmental Issues
Toilet Training and the Autism Spectrum (ASD)
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​If you're struggling with potty training, consider reaching out for help with a professional.
are holding your child back from being potty trained.
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Local Providers for potty training:
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Galena Autism and Behavioral Services
Services: ABA and Toilet Training
Where: 4877 W Swamp Rd, Doylestown, PA 18901
Email: info@gabsautism.com
Call: 267-454-7357
Website: https://www.gabsautism.com/
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Lovaas Institute
Haddon Heights / Philadelphia Office
Services: Consulting in the home/Potty Party
Where: 423 White Horse Pike, Haddon Heights, NJ 08035
Call: (856) 616-9442
E-mail: info@lovaas.com
Clinical Director: Linda Wright, M.A., CCC-SLP/L, BCBA
Senior Supervisor: Susan Porreca, M.S., BCBA
Intake/Information: Kasie Leone
Website: http://www.lovaas.com/services_consultation.php
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Zimzum Consulting Collaboration
Services: Toilet Training & Feeding Programs. We find effective interventions that help children with delayed or severely delayed functions.
Where: 191 Main St. Suite 105 Emmaus, PA 18049
Call: 610-973-5335
Website: https://www.zimzumcc.com/aba