Supporting young PDAers with personal hygiene
Personal hygiene can feel challenging for lots of children and young people. Expectations of everyday routines, social pressures and lack of autonomy – can all trigger anxiety for young PDaers. On this page we look at why it may be hard and suggest ideas to help you develop a compassionate approach that focuses on minimising pressure and distress.
Why young PDAers can struggle with hygiene tasks
They may experience sensory issues which cause discomfort. Keeping clean can also involve a lot of demands which need to be repeated on a regular basis. Often hygiene tasks are put at the start of the day. This can prove to be a barrier to getting going on other things and cause the whole day to get off on the wrong foot.
It seems pointless
They might wonder why they need to bother with some hygiene tasks. Your PDA child may benefit from a gentle, age-appropriate explanation of why the task is required. If they can understand the importance of hygiene, they might make the choice themselves to participate.
Sensory sensitivities
Personal hygiene activities often involve sensory changes that can be triggering. Your child might find certain sensations very unpleasant. It might be that they cannot communicate this to you using words and so will show you using behaviour. They may lash out or avoid the task to stop themselves from feeling discomfort.
Demand avoidance
Being asked to do lots of hygiene tasks on a regular basis can feel overwhelming. Your PDA child might manage to brush their teeth a couple of times one week. But this can lead to an expectation they will be able to do it again and again.
Executive functioning difficulties
Struggling to sequence and organise tasks can make them feel difficult to start. Understanding how things like this can affect your child, can help you work together to find a way forward.
Helping your child to manage hygiene tasks
Giving your child as much choice as possible around hygiene can help them feel more in control. Letting them know that it’s okay not to do the task can take the pressure off and give them a chance to choose doing it. It can be a way of reclaiming control, so they feel less avoidance. Other ways to help could include:
Time and frequency
The task alone can be enough of a demand. Try asking yourself: does this really need to be done at a set time, or can we be flexible? Does it need to be done regularly, or could it be ad hoc? Approaching hygiene from an “anything is better than nothing” point of view lowers everyone’s stress.
How they do it
Helping them find ways to reduce discomfort by doing things differently and on their terms. It might be that they prefer to have you brush their hair downstairs while they’re watching a programme. Or they may choose to brush their teeth with a finger covering rather than a normal toothbrush.
Separating tasks
Try avoiding bunching tasks together. For example, it might seem like a good idea to do all hair related tasks at the same time, but by leaving hair in a towel after washing, or brushing later in the day, you can help prevent overwhelm.
Support sensory sensitivities
This could include choosing products that are un-fragranced or mild tasting toothpaste. Offering control over temperature or making the environment warm so it doesn’t feel cold when they get out of the bath. Try to anticipate what might be distressing and offer solutions and alternatives.
Using fun tools
There are lots of products you can try to make hygiene tasks more exciting. Crazy colour bath bombs, bath crayons and foams can be a fun distraction for children of all ages. Using a toothbrush with their favourite character on it and having different or flavourless toothpaste might encourage them to brush their teeth.
Be playful and use novelty
Turning things into a game or playful activity can help. For example, taking toys into a “play bath” or roleplaying as you brush teeth, can make tasks seem more inviting.
Make it easy
For example, offer access to facewipes so they don’t have to wash their face, or dry shampoo so they don’t need to wash their hair, or a fluffy robe for after the bath so they don’t need to dry themselves.
You might find that what works one day may not work the next and that’s okay. Offering a couple of different options and keeping things flexible can help your PDAer to feel in control of what they’re doing.
Letting go and accepting that sometimes it isn’t possible for your PDA child to do the task can take the pressure off everyone. Having a break and trying again another day when people are in a better place could be a healthy approach.
*Jane