On The BI Blog

Teaching Children with Autism Personal Hygiene Skills

July 25, 2022
By: Behavioral Innovations
autism hygiene checklist, autism and hygiene

Most kids have a challenging time keeping up with their hygiene habits. After all, why would you spend time in the shower when you can be jumping in muddy puddles?! Children with autism might struggle with developing hygiene-related skills, primarily due to the challenges associated with their diagnoses. A few things that can impact good hygiene skills are:

  • Fine motor skill deficits
  • Difficulty with time management
  • Difficulty with attending to an unpreferred task (finding it challenging to focus on unpleasant activities)
  • Challenges with other executive functions (such as organization or self-reflection)
  • Sensory issues
  • Receptive language issues (such as not understanding what someone is saying to them, especially if the directions are complex)
  • Difficulty with following multi-step directions or completing multi-step activities

Examples of Personal Hygiene Skills

Some examples of personal hygiene skills that children should develop include:

  • Oral hygiene, including teeth-brushing, using mouthwash, using floss
  • Cleaning one’s body/taking a bath or shower
  • Taking care of one’s hair
  • Handwashing at appropriate times
  • Blowing one’s nose when needed
  • Skincare (as appropriate or needed for each child)
  • Nail care (trimming and cleaning fingernails and toenails)
  • Managing periods (for females)

How to Help Children with Autism Develop Hygiene Skills

There are some recommendations based on behavioral science that can help most children to make progress in this area. Be sure to individualize the recommendations that we provide to your child. For instance, some children do better with step-by-step instructions given to them verbally, while others aren’t able to understand verbal instructions yet, so for those children, visual images might be more effective.

You can also contact Behavioral Innovations to receive professional support to help your child develop hygiene skills, among many other skills that will help your child be more independent in life.

1. Create Daily Routines

One of the most important ways to help children develop personal hygiene skills is to help them establish daily routines. Daily routines help children know what to expect. The repetition of an activity that occurs within a daily routine also helps children get better at a particular skill.

Children with autism often do better with learning new skills when they are expected to do those skills regularly and when they are given many opportunities to practice the skill. On the other hand, if children aren’t following daily routines and their caregivers only ask them to do a certain activity occasionally or at random times, this can cause confusion and stress for the child.

To help your child with autism improve their hygiene skills, consider the specific skills you want them to work on and then identify when they should do those activities in the child’s day or week. For example, you might have your child brush their teeth every morning after breakfast at 8:30 am.

2. Use Visual Supports

Visual supports can be used to help children with autism learn new skills and be more independent in their everyday lives. Visual supports create more structure and guidance to help people learn or complete tasks. They can reduce stress, anxiety, frustration, or challenging behaviors.

Visual provisions include pictures representing a specific activity or steps, videos of someone performing the activity, schedules or routines depicted by pictures and/or written text, color-coded or other types of organization systems, and much more.

Some ways to help children with autism develop personal hygiene skills while using visual supports include making a morning routine chart that your child can follow, creating a daily schedule that your child regularly looks at, and creating step-by-step instructions for hygiene skills (like tooth-brushing) that help your child complete the larger, more complex activity.

3. Providing and Fading Prompts

A prompt is something that helps your child complete a specific task or demonstrate a specific behavior. When you use prompts effectively and strategically fade them, you teach your child to become more independent with the task or behavior. You reduce the frustration and stress that comes with learning new things and increase your child’s ability to demonstrate a specific skill or behavior on their own.

Prompts can be verbal such as giving an instruction or gestures such as pointing toward an item you want your child to use (i.e., the toothpaste when working on independence with tooth-brushing). Prompts can be physical, such as holding your child’s hand when walking along a sidewalk to keep them from running into the road or ahead of you, or visual such as the supports we discussed previously.

You can use many prompts to encourage your child to develop personal hygiene skills. In addition to offering prompts, it is equally important to consider how you will fade (or reduce the use of) them. Keep in mind that some children can become too reliant, so it is necessary to be mindful of how you will reduce the support you give them to make them more independent with the skills being addressed.

Here are a few examples of using prompts to increase your child’s independence with hygiene skills:

  • Pointing to the items to use during tooth brushing (Gestural Prompt)
  • Physically helping a child to wash their hair or their body in the bath (Physical Prompt)
    • NOTE: Be mindful of privacy, particularly for older children and teens. You can still help older children in the bath or shower if it is needed. And you should prioritize safety by being present with a child in the bath at any age if their level of need requires this level of supervision. However, offer as much privacy as possible and try only having one person help them in the shower.
  • Telling a child, the steps required to complete an activity, such as changing a sanitary napkin for girls on their period (Verbal Prompt). You could also demonstrate how to change their pad by putting a pad on a pair of underwear and taking it off (Model Prompt).

Hygiene Skills and Autism

All children benefit from developing personal hygiene skills. These skills can be challenging to learn for many children, especially children with autism. There are many reasons for this. However, children, including those with ASD, can improve their ability to care for themselves and their hygiene. Some ways to support this goal are to create a daily routine with your child, to offer visual supports, and to use and then fade prompts.

Contact Behavioral Innovations for more support in helping your child with autism develop personal hygiene skills.


References:
Belsky, G. (n.d.). Types of executive function skills. Understood. Retrieved July 16, 2022, from https://www.understood.org/en/articles/types-of-executive-function-skills

Merriam-Webster. (n.d.). Hygiene. In Merriam-Webster.com dictionary. Retrieved July 16, 2022, from https://www.merriam-webster.com/dictionary/hygiene

Personal hygiene. Nationwide Children's Hospital. (n.d.). Retrieved July 16, 2022, from https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/personal-hygiene