Helping a Child with ASD Develop Good Hygiene Habits

 
Teaching children good hygiene habits – brushing their teeth, washing themselves, combing their hair, and learning how to use deodorant – is one of the many challenges parents everywhere deal with on a daily basis. These skills are vitally important for all of us for health and social reasons.
 
Children with autism spectrum disorder (ASD) or other special needs, however, may have a more difficult time developing healthy hygiene habits because they lack the necessary skills and/or are sensitive to the stimuli associated with these tasks. Physical limitations, behavior problems, and other factors may also make attending to personal hygiene more difficult.
 
In addition, children with special needs may not experience the natural reinforcement most of us receive from engaging in self-care skills, such as feeling clean and comfortable. They may also be unaware of the social consequences of not having good hygiene.
 
The first thing parents can do to help their children develop good self-care skills is to teach them to work on these tasks one step at a time. Breaking each task down into smaller steps helps children learn how to accomplish them independently. It can also help them tolerate potentially troubling stimuli such as sounds, smells, and textures.
 
For example, if you are teaching your child about tooth brushing, you could break the task down into the following steps: 1) identifying the proper toothbrush; 2) putting the toothpaste on the toothbrush; 3) brushing each of the four quadrants of the mouth; 4) rinsing the mouth and then the brush; and 5) putting the toothbrush and toothpaste away.
 
It may also be helpful to create a social story that uses words, photos, and/or drawings to explain each of the steps involved in brushing the teeth that your child can review before beginning the task. Social stories may also be used to help children master bathing and grooming tasks.
 
In addition to teaching good hygiene skills in a step-by-step manner, providing some kind of reinforcer, or reward, for your child when he is doing a good job can be beneficial. The reward might be a sticker, a toy, some special praise, or a favorite story before bed.  Initially, you can provide these reinforcers in between each step of each task. Then, as your child gains independence and acquires tolerance, you can deliver a reward after each task is completed. Finally, you can reward him after the entire hygiene routine has been completed.
 
It is also a good idea to create a routine. If you have a routine and stick to it, your child will always know what comes next, and the task will become a part of her/his everyday activities. Similarly, providing a visual schedule, as part of a daily calendar or schedule, or as a separate schedule just for hygiene-related tasks, may help. This allows the child to know what is expected of him and allows them to see when they will be all done with their cleaning and grooming tasks.
 
Don’t forget the “fun factor.” Try to promote the idea that practicing good hygiene can be fun! There are singing toothbrushes and special bath toys that can make each task something your child looks forward to and enjoys. When he is doing a good job, provide a lot of happy social attention and make sure your child knows you are proud of him.
 
Breaking each task down into small steps, providing a schedule, making it fun, and providing reinforcement when your child is doing well can help make the task of completing hygiene skills easier for both of you.
 
If your child needs a lot of help, his school may be able to provide additional instruction or direction and help you learn how to teach each skill. When in doubt, or if things are too difficult, seek out the aid of a behavior analyst.
 
Developing good hygiene skills is not only vital to your child’s good health; it may also help him to be accepted by peers at school and people in the community.
 
By Sarah Helm, M.A., BCBA, LABA