Making everyday tasks a bit easier for children with ASD and sensory difficulties
Daily washing and bathing
These activities and environments can be difficult for a child with sensory needs.
There may be small changes that can be made to reduce anxieties and upsets at these times.
Smells
This can have a strong impact on a child and make just entering the room difficult or impossible. What might seem like mild smells to us may be overpowering and pungent to a child if they have a heightened sense of smell. Some things that can help with this are:
- remove cleaning products, air fresheners and so on before they come in the room
- use fragrance free products for bathing
- open window before your child enters the room
- if your child likes a scent or perfume, spray a little of it to help
Noise
Bathrooms are often large loud noisy places with running water, flushing toilets, fans, buzzing lights which can be a daunting area for a child with sensitive hearing.
- introduce soft furnishings to absorb sounds such as towels, curtains, mats, soft flooring
- run bath and sink before child enters room
- try to using water resistant speakers to play music to mask or distract from sounds
- ear defenders may be need if they become upset
Lighting
These areas are often very bright, white clean sparkling places which look very inviting but for a sensory sensitive child it may not be the case.
- reduce brightness of bulbs
- cover reflective surfaces such as mirrors, tiled areas and floors with towels and matting
- remove or reduce flickering of bulbs
Dressing and un-dressing
This is an area of which lots of children experience difficulty at some stage and will often let parents do if not encouraged.
Some children may not like getting dressed or un-dressed if they do not have the skills to put on or remove items of clothing or use fasteners.
- lay out your child’s clothes in the order which they put them on to help build on independence
- use visual strips to show sequence and order of clothes being put on and removed
- experiment with fasteners, start with what your child finds easiest
- give them opportunities for your child to use fasteners away from dressing. Such as Velcro on book bag, zips on lunch boxes, laces with beads to tie
- start with small expectations and use backward chaining. Let your child put the last item on such as 1 sock and then build up to 2 socks and so on
- your child may benefit from using a large mirror to help them with their body awareness and independence
- let your child sit on the bed, stool or the floor to give them stability
- make dressing and undressing fun and encourage role-play. Play dressing up as their favourite characters or let them try on your clothes
- use dolls, bears to model dressing and undressing
- let your child help you get dressed, model how to use fasteners
- use themed books to help your child understand the routine
Some children may also have difficulties due to their sensory sensitivity.
- use a room your child is familiar and comfortable in
- establish a routine so your child can predict when they will need to get dressed or undressed
- use photographs, books or a visual strip
- consider if your child has a preference for certain elements of their clothing
- will your child only wear a certain colour?
- does your child prefer a certain material cotton, wool, vinyl and other textures?
- does your child have a preference for tight or loose clothes?
- do their clothes move easily or make them feel restricted?
- do they like patterns and pictures or are they a constant distraction?
- does your child have a like or dislike to certain smells of wash powder or materials such as wool
- do necklines, waistbands, seams, labels and tags distract your child or do the cause irritation or discomfort?
Eating
Some children really do not like to eat. This may be due to lots of different issues. But some little changes could really help your child.
- consider the room:
- is it a room they feel comfortable in and familiar with?
- are there too many smells?
- is the room hot or steamy?
- is the room noisy with the sound of utensils or appliances such as the washing machine or dishwasher?
- your child may prefer to sit in a different room than the kitchen area if too stimulating or to go in when all the meal has been served and noises have stopped.
- is it a good time? Your child may not want to eat or be hungry if they are tired, frustrated or upset.
- your child may eat better if they have other things to focus on such as music, talking to parents and peers (TV if necessary)
- your child may need no distractions. Sitting at a busy, noisy table may be overwhelming, and they may need to eat alone or at separate times
- children’s preference of foods may be determined by:
- sight: colours, shapes, presentation on plate
- smell: mild, strong
- texture: solid, mashed, purée, soft, rough, slimy, wet, dry and so on
- temperature: their own perception of hot, cold, warm may differ to ours
- if you are familiar with the texture and appearance of food your child prefers then you can introduce new foods that imitate or that are similar so your child feels comfortable
- consider the furniture your child uses they may prefer to sit at a table and chair if they are unsteady they may often prefer to feel the floor under their feet and may help reduce fidgeting when eating
- you may need to use cushions or seat pads if your child sits for long periods of time when eating. Benches often help children to sit in a more up right position
Finger nails
Children can try to avoid these activities due to the sensitivity and the level of contact needed.
- replace the word ‘cutting’ with trimming or tidying as this can be quite worrying for some children
- talk about and use books to explain why we cut our nails
- show your child you cutting your own finger nails
- use dolls and teddys to show them
- explore how you can sit together: from the front, side by side or sat on your knee to find what is best
- explore the time of day: is your child calm or may be more sensitive at certain times?
- start a routine so the task becomes predictable for example, after bath time or on a Sunday night before school
- experiment with scissors, nail cutters, nail files and so on to find which one they prefer
- use novelty equipment such as coloured or character scissors
- give them a hand massage before cutting them to reduce their sensitivity and help your child prepare. You could let them massage you too
- help them to do a bit themselves with a nail file
- use things to distract them if your child doesn’t like to look such as book, finger rhymes, music, songs and the TV
Using the toilet
Learning to use the toilet can be a difficult skill for many children to learn. Sometimes for children this new experience can be overwhelming, there may be ways to make it a little easier a possibly enjoyable.
consider the room. Is it a room the child is already comfortable with? If the bathroom is over stimulating for a child who has sensory difficulties then you may want to start with a potty in a familiar room to begin training
- some children find widening their skill difficult. They may learn to use the potty they then be reluctant to use the toilet. You may need to go back to basics to teach the child to use the toilet
- you could use a toilet seat to help support your child and reduce the possibility of and feeling of falling in
- if your child feels unstable or easily loses their balance it may be useful to fit a hand rail to give them more confidence and independence
- try putting something under their feet such as a stool to provide extra stability
- choose the right time to start toilet training. Avoid stressful times such as when a new baby is arriving in the family, if the family is moving house, or if your child is ill
- also consider the time of day you begin the use of the toilet or potty don’t ask the child when they are upset or frustrated. Wait for your child to be calm and happy. We need to make sure the experience is a positive one
- you may want to use a visual prompt as part of a timetable or an object for them to associate with toilet time. It will help your child to know what to expect
- you may want to use a little rhyme or song to help the child prepare for the task
- you may need to build a bag of toys to keep in the bathroom for your child to play with while on the toilet to encourage them to stay a little longer. Make these things fun and inviting so they are interesting to your child, keep these items for this time so your child becomes familiar
- some boys prefer to sit when they pass urine this may be if they feel unstable standing
- you could use a small ball or object that floats in the toilet pan to encourage your child to urinate standing. This can also be good to help them aim.
- consider materials used such as toilet paper. Your child may not like the feel of it if the paper is too rough
- you could use nappy wipes as your child will be familiar with the smell and texture
- a mirror may be useful to help a child with cleaning and dressing this will also encourage their independence
- you can model the routine to your child by letting them visit the toilet with you so you can show them how you do it
- visual strips can be used to help children work through the sequence of toileting and encourage independence
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Disclaimer
Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.