Self-Care Skills

For individuals on the autism spectrum, developing the skills that are required to participate in everyday activities, such as, washing and personal hygiene can be more challenging compared to those without a diagnosis.

The reasons for this are varied and will depend on the individual. An Occupational Therapist can assist families to explore these reasons, and develop tailored intervention plans to meet children and family needs.

This blog contains some starting points to consider when assessing children’s self-care skills, and provides some intervention strategies to assist children to develop their skill sets.

With the April school holidays approaching, what better time to work on developing skills in dressing, bathing and grooming.

What may be some of the underlying difficulties for developing self-care skills?

  • Sensory processing challenges

Some children on the autism spectrum will show signs of sensory processing challenges. This means that they may seek or avoid everyday sensory experiences, which involve feedback from one or more of our senses: taste, smell, touch, sight, and sound. 

These children will have a stronger reaction to different sensory input compared to those without a diagnosis.

When analyzing activities, such as, haircutting, it is beneficial to think about what the underlying sensory experiences could be.

For example with haircutting, a child is exposed to different stimulus:

  • Auditory (noise), such as, hairdryers, clippers and background noise
  • Tactile (touch), such as, water (including mist bottles), combs, and scissors
  • Visual, such as, mirrors, and having the head tipped back in a washing basin
  • Smell, such as, hair cleaning products

All these different stimuli can have either a positive or negative experience for children, and can provide clues to understand their behaviour.

  • Mental health

It is not uncommon for children who experience sensory processing challenges to display heightened anxious behaviors around self-care activities.

  • Language delays

Delays in receptive (what we hear and understand) and expressive language (what we say and how we say it) may also contribute to delays in self-care skills. Speech Pathologists can provide strategies to improve overall verbal and non-verbal language skills which can assist children to follow everyday routines and activities.  

What can be done to assist children to develop their self-care skills?

  • Social stories

For some children on the autism spectrum, a fear of the unknown or what may happen, can significantly impact their ability to perform a task.

Social stories are a fantastic way to fill in the gaps in a child’s knowledge and explain:

  • Who will perform the task
  • What will happen in a step-by-step fashion
  • When it will happen
  • Where it will happen and
  • Why the task is important to perform

Occupational Therapists work with families to create these stories and tailor them to each individual situation. Including personal photographs can further assist the child to relate to the story and reduce any underlying anxiety. Reading these stories at bedtime is beneficial to increase familiarity and provide a positive bonding experience.

  • Consider alternatives

For some children, changing the manner in which the task is performed can make a world of difference. If a child dislikes a particular sensation, then brainstorming how to make that activity more comfortable for the child can assist with task performance. Some replacements could include:

  • Dressing – changing the type of fabric, removing tags, or buying clothes without patterns or seams
  • Bathing – changing the type of products used, sponge washing, or changing the head position when showering to make children feel more stable
  • Task breakdown

For some children, taking a gradual, step-by-step approach is beneficial to help children to master components of the activity, rather than expecting them to perform the whole task by themselves.

Depending on the activity, the task could be broken down into smaller chunks, such as, teaching a child to put their arms through the jumper first and slowly building their independence.

  • Visual schedules

Remembering what step to perform first, second and third can be challenging for some individuals on the autism spectrum. Creating a step-by-step visual of the task can help children to know what’s coming and keep track of where they are up to.

  • Incentives

Lets be honest, self-care activities aren’t always going to be the most exciting thing for a child. There could be many reasons for this, but by tuning into children’s motivators, a child may be more willing to participate. Providing a child with positive feedback for a task well done will often be more intrinsically motivating than chasing up a child because they have not completed a task. The trick with motivators is to find what works and constantly assess if the motivator needs to be changed. By making the motivator meaningful and task specific, such as, stickers, or rewards, a child may be more motivated to develop their self-care skills.

  • Prompts

Assessment of a child’s language skills should always be considered when providing self-care interventions. Some children may need increased prompting to assist them to perform tasks, such as, physical, gestural and/or verbal prompts. Working in collaboration with a Speech Pathologist to support children’s development may be beneficial for skill development.

We also have an amazing group called “Life Skills” which will be running over the April School Holidays. Please give us a call or email us if you are interested in registering your child for this group.

If you have concerns regarding your child’s self-care skills, please consult an Occupational Therapist at Building Blocks Therapy.

Alice McKinnon

Occupational Therapist – Building Blocks Therapy

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