Supporting Self Care Skills
Many personal care tasks involve high levels of sensory stimulation, motor control and sequencing. These are skills that take time to develop and master independently for all children. Below are a few tips and strategies to try and support the development of washing, dressing and toileting skills.
Washing
Many children may find bathing or showering challenging due to sensory sensitivities
Using visuals to communicate the planned routine for washing and having a regular routine (e.g. bath time then bed time) can help reduce anxiety around unpredictability. Consistency and clear communication can make these activities feel predictable and safe.
Use a visual task strip to break the bath or shower activity into small, manageable steps (e.g., “turn on water,” “soap body,” “rinse”).
Respect Sensory Needs. Some children may prefer baths over showers, or they might enjoy using a jug to pour water instead of a showerhead. Similarly some children will like a firm rough towel to dry afterwards or might like to ‘roll’ in their towel to increase calming deep pressure input to support regulation.
For some children, using a timer to show how long the bath or shower will last will work well.
Similar strategies can be used to support children to clean their teeth, along with experimenting with different toothbrushes and toothpaste flavours to find what suits best.
Dressing
Dressing can be a difficult task for all children to master. Learning to dress independently can be made easier by breaking down the process into small, manageable steps. A great method is to teach the last step first, gradually working backward until they can complete the whole task on their own. This approach makes the process more rewarding, as children experience success and accomplishment quickly.
Break Down the Task
To teach a child to get dressed, start by dividing the task into small steps. For example, when putting on shorts, the steps might look like this:
- Face the shorts the right way.
- Hold the waistband.
- Put legs through the leg holes.
- Pull the shorts up to the waist.
Once they can do the last step independently, teach them to do the second-last step (putting their legs through the leg holes) as well as the last step. Keep working backward through each step until the child can complete the entire task of putting on shorts independently.
Be patient and encouraging: Each step may take time to master. Use visuals such as a picture chart or task strip showing the steps of getting dressed to help the child remember the order and process.
Adapt to sensory needs if the child is sensitive to certain textures or clothing types, choose clothes that they feel comfortable wearing (e.g., remove tags, choose preferred fabrics/ colours, loose clothing or using tight base layers before attempting dressing).
Toileting
For toileting issues, it is best to seek professional advice from a GP, Health Visitor or medical professional such as a Nurse or Occupational Therapist. Sometimes toileting issues may be a result of diet or another health related issue – it is always best to seek medical advice in relation to any toileting issue.
For some children, the multisensory experience of the bathroom will be too much. The smells, temperature, noises and textures will need considered to make the bathroom experience more comfortable.
- Children who are very responsive to textures and temperatures might prefer plastic toilet seats and experimenting with different toilet papers/ wipes until they find what they need.
- Children who like to keep their feet on the ground might benefit from reducing the distance between the toilet seat and floor (a step might work, or using a stable potty is another option).
- Noise cancelling or reducing headphones might support children sensitive to noise within the bathroom.
- Visual supports such as signs identifying hot surfaces and water will be helpful for children who need more time to register temperature.
- Visual supports identifying the steps involved in toileting will be useful for all children.
For some children, their interoceptive signals or internal body awareness sense needs support. Some children may not register that they need the bathroom until they are very uncomfortable, or they misread signals from their body and frequently visit the bathroom.
Children who struggle with interoceptive signals around toileting can benefit from social stories that explain the process in a simple, step-by-step way. Use visuals to show when and how to use the toilet. For example, you could set a timer for regular bathroom breaks and explain, “When the timer goes off, it’s time to check if your body needs the toilet.” This helps create a routine for those who may not feel the urge to go until it’s urgent.
Develop a routine of regularly visiting the bathroom e.g. establish patterns/ rules around using the toilet e.g. before leaving the house, after each meal etc.
There may be children and young people who are sensitive to messages from their body, and interpret early signs of needing the toilet as an urgency to go. They will then go to the toilet with much greater frequency, and may be anxious about not getting there on time. An alarm or visual toileting schedule and gradually extending time between toilet visits can be helpful.
More information on toileting and interoception and other useful resources from ERIC for toileting below:
Bladder and Bowel UK have some great resources.
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