ASD and personal hygiene

A common difficulty with children on the autism spectrum is their dislike of personal hygiene. As I’ve experienced with my own children, they have difficulty with things such as showering, brushing their hair, having their hair cut, cleaning their teeth and changing their clothes. To some people, it may seem that they are lazy or slovenly.  The reality is that many of their difficulties arise from sensory issues.

Both my children have sensory difficulties. For my son, he tends to be over-sensitive particularly with regard to touch. As I wrote in this post, my son cannot tolerate certain clothes. He can become irritated from clothes that are too tight, too stiff or made of the wrong material. Clothing has to be ultra comfy and when I find an item of clothing that he loves, I stock up as it can be hard to find suitable clothes. Hooded garments are a particular favourite for my children as the soft fabric and the hood provides a way for them to feel happy or relaxed. Hoodies are always a great comforter for my children and always accompany us whenever we go out.

Sensory difficulties also make teeth cleaning very difficult for autistic children.  My son hates the taste of minty toothpaste and experiences a lof of discomfort when using a toothbrush. We have experimented a lot in this area and now use a strawberry flavoured toothpaste  and an electric toothbrush. Though an electric toothbrush is a bit pricey, this has helped my son to cope better with teeth cleaning.

Another challenge is showering and bathing. Some children hate the feel of water and for a time our son hated the sensation from the spray of water when taking a shower.  The other area of difficulty is the contrast in temperature; cooler water being sprayed on my son when he is hot is very difficult for him to deal with so its important we get the temperature of the water right.  Even leaving a warm bath into the cooler air can be an unpleasant experience for my children but I’ve found that warmed up towels and clothes can help when coming out of the bath or shower.

Washing hair is another difficult area. Aversion for hair washing can relate to the temperature of the water, the feel of water on their head, soap getting in eyes and the texture and smell of the shampoo and conditioner.  Both my children have very sensitive scalps which makes washing and brushing their hair a painful experience.  My son in particular is very reluctant to wash his hair but we’ve found the 2 in 1 shampoo and conditioners and the all in one body and hair washes useful.  It reduces the number of products my son has to use which makes the process of cleaning himself easier.  For my daughter, a good conditioner is essential as it reduces those awful knots you get in longer hair.  Similarly wide toothed combs and soft brushes are also helpful but again you have to practise with different brushes and combs to find what is right for your child.  You could look out for combs and brushes in your child’s favourite colour or one with a character motif on which can all help with motivation and engagement.

As for hair cuts, this is a common source of stress for many autistic children.  I know a teenager who refuses to have his hair cut as he hates the sensation of loosing his hair and the feeling of exposure.  For my son, he is the opposite and hates having hair on his head and if it gets to a certain length he is desperate to remove it.  Going to the hairdressers used to be a traumatic event but now he is that bit older he is coping better with a visit to the local barbers, as long as it is quiet and there is no queue!

Equally important is teaching my children about hygiene.  This is an ongoing process in our house.  I show my son when his clothes are dirty and need changing and I use a mirror  to show him when he needs to clean his face or when he needs to wash or brush his hair.  I don’t want him to become obsessed with his appearance but I think it’s important he understands the importance of being clean and tidy.  I also demonstrate how to do certain things which is a lot easier than just relying on verbal instructions which can be confusing or vague.

I’ve found that there are no quick solutions to the challenges of personal hygiene and it has taken me a while to find solutions to some of my children’s difficulties.  Nevertheless here are some tips that may help reduce stress.

  1. consider your child’s sensory issues;
  2. create visual timetables to encourage a good routine;
  3. be prepared to be flexible with your child;
  4. experiment with different products until you find one your child likes;
  5. try different toothbrushes;
  6. look for non-minty toothpastes – you could try the local health food shop;
  7. use a 2 in 1 shampoo/conditioner or use a body wash that can also be used for the hair;
  8. try dry shampoos if your child can’t tolerate washing their hair;
  9. try deoodrants and sprays but beware that the sensation of a spray may be upsetting;
  10. get the temperature of the bath or shower right for your child;
  11. for hand washing, try liquid soap which can be more fun than a slimy bar of soap;
  12. try different types of brushes and combs;
  13. if your child loves a particular item of clothing, stock up;
  14. show them when they are dirty and demonstrate techniques;
  15. write a social story or  look for a book on hygiene.

I’m sure there are many more tips besides these so if you have anything you would like to share please comment below.


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21 Responses to ASD and personal hygiene

  1. Pingback: World Autism Awareness Day | The Home of Pinkoddy

  2. Pinkoddy says:

    I’m still awaiting a full assessment with occupational therapy for my son and they said they’d give me tips then – but they did say you can get like a double sided toothbrush – so it does both sides of the tooth at once so it is done quicker.

    Our oldest is 16 now and predictability is key – for example if he can prepare himself that he will have his hair cut. We start this with visual aids when he was younger. Great post thanks for letting me share it.

    • Aspie in the family says:

      Thanks for commenting. I love the idea of a double sided toothbrush; I may look for one as my son still finds teeth cleaning difficult. Deb

  3. This is a great list and very helpful. Do you mind if I share this list with a few of my clients?

    “The child psychologist who thought she had all the answers to parenting until she became one herself.”

  4. susanne crayton says:

    Thank you for sharing all these tips. It is so nice to uderstand more about autism/ADS and the things that cause issues. Thank’s to people like you sharing soulutions and advice it helps others with children who are simmilar and also to allow others to understand why children react in situations. I will post this on my facebook as I know it will help some of my friends. x

    • Aspie in the family says:

      Thanks for commenting Susanne. As Steph says, lots of children have difficulties with personal hygiene so these tips and advice may help lots of parents. Deb

  5. jane alexander says:

    nits/lice is particularly horrible for these kids. No wet-combing or lotion doesn’t cause distress. :(((((

    • Aspie in the family says:

      Hi Jane; that must be difficult to deal with. Our eldest daughter (non-autistic) had nits once which was difficult enough so I dread how I would deal with that with her autistic brother and sister .

  6. Steph says:

    Hoodie fans here too :) All so true, and all things which can affect ‘NT’ children too – but it’s the extent to which they distress an AS/ASD child which differs wildy I’d say. My 4 yr old had maybe agreed to brush her teeth three times in 4 and a half years until recently, when someone suggested the fab Aquafresh ipad app. Now she loves doing it – some of the time…! Likewise she refuses to wash her hands after going to the toilet, and it’s not something which is easy to force a PDA child to do, so I’m hoping for an app for that soon too! My Dad was horrified when I said we don’t make her do it, but to be honest she is so rarely sick that actually it’s not worth stressing her out about the germs if they’re not affecting her anyway (just yet that is – I appreciate she will get to an age where this is important). She hates having her hair washed but bizarrely likes the sound of it being cut by me, so I have to cut a tiny bit every time I want to wash it! Funny, wrinkly skin freaks my girl out too!
    As for clothing, all she wants to wear is short sleeved jersey dresses. Can I find any of them in the shops? No. It would seem shops have gone straight from long sleeved dresses into strappy summer dresses. Aaaarrrrrgghhh!

    • Aspie in the family says:

      Hi Steph. Yes they do affect NT kids as well but as you say for our children with ASD’s the affect is a lot more severe. Love the idea of the Aquafresh ipad app! My daughter also had a phase of getting really panicky about her wrinkly toes and fingers after bathtime. She’s improved as she’s got older and she’s less worried about her skin now. As for clothes my daughter is similar; she loves t-shirts and really wont wear anything else. Like her brother, she is not comfortable in shirts and tops that have buttons, collars and anything fussy. She is much more comfortable in t-shirts. Have you thought about making your own dresses? Deb

  7. Jim Reeve says:

    My son has a lot of the same sensory issues that you’ve mentioned. Especially the one about tooth paste. Jacob’s has to be plain white Crest or he’ll resist. The best thing I can recommend is to start developing routines early and stick with them as best you can. Your list is very good.

    • Aspie in the family says:

      Thanks Jim; good idea about starting routines early. I wish we had done visuals a lot earlier. Deb

  8. Lizbeth says:

    Such good suggestions. We have issues with bathing and overall cleanliness. From not wanting water on his head to the feel of a washcloth on his skin we’ve struggled. We’ve come to a happy area but if we give him some wiggle room he’s back to not showering at all.

  9. Wordchazer says:

    This rings so many bells, not always with me or my family, but people I interact with every day. I do share the feeling which your son has of hating hair on my head – it feels so unkempt if there’s too much of it and I begin to entertain vivid thoughts of just what I would do with a set of clippers… I have worked with autistic/Aspie colleagues and bosses before and it can be very hard work, especially when they don’t understand the pressures that you have in your life which may lead to differing priorities than theirs. One boss in particular was hydrophobic which used to lead to interesting smells in the office when he felt under too much pressure to wash regularly! Thanks for a very informative and interesting read.

    • Aspie in the family says:

      Thanks for sharing your experiences Wordchazer. Its interesting to hear that other people share the same experiences as my son. So often I hear about people preferring not to cut their hair so its reassuring to hear that my son is not alone in hating his hair.

  10. Blue Sky says:

    As I wrote recently, I have been tackling many of these issue head-on, in the hope of getting my aspie boy into good habits ahead of the teenage years. He is now showering every day, but with my help, which will obviously have to stop soon. His biggest issue is that he doesn’t like the wrinkly skin on his hands after they get wet – it makes him panic. And I have no idea what to do, apart from suggest gloves….

    • Aspie in the family says:

      Showering every day is fantastic Blue Sky. We’re lucky if we can get our son in the shower twice a week. I understand about the wrinkly skin issue as my daughter had a phase of panicking about her wrinkled skin in the bath or shower. It took a lot of reassurance for her to gradually get used to it and she is a lot better now but you could try gloves. Deb

  11. The small boy was six before he stopped screaming down the hairdressers. He still doesn’t like having his hair touched, and hates having it washed, so it only gets done once every couple of months. He dislikes baths, but is liking showers since we had one installed recently :o) We also have the toothpaste issue – use bubblegum flavour here! We have never-worn jumpers – too scratchy, even when (seemingly) soft as anything, and he prefers to stick to the same few items of clothing over and over (a bit like his mum ;o)
    But, and I’m dead proud of him for this, he sat this evening (now aged 9) and cleaned under his fingernails for the first time ever!

    • Aspie in the family says:

      Hi Leigh, fantastic news about the fingernails. That reminds me of the terrible times we had trying to cut our son’s nails when he was a lot younger. One of us had to cut whilst the other had to try and distract. Fortunately he has got better as he has got older but at the time it was really difficult. Thanks for commenting. Deb

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