Your child with special needs: How to conquer independent bathing

20 plus Occupational Therapy tips and strategies to facilitate independent showering and bathing for your child with special needs

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“I have no time to myself.  Ever.  My other kids were at least taking a bath by themselves by the time they were 7, but I can’t leave him alone….”

The young mom had bags under her eyes and a stain on her T-shirt.  The corners of her mouth turned down in a helpless, sad expression as she looked at her sweet ten-year-old child with Down’s Syndrome who was playing quietly with the toys in the waiting room.

She was exhausted.

Raising a child with special needs can do that to you.

I spent 5 years working as an Occupational Therapist in a residential home for adults with Developmental Disabilities.  Plus, working with dozens of families who have a child with special needs has taught me a few AMAZING tricks.

And I’m happy to share every one of them.

This post contains affiliate links for your convenience

This post is part of a 12-month series called Functional Skills for Kids written by pediatric OTs and PTs to post on different developmental topics that impact functional skills for kids.

This month’s topic in the  “Functional Skills for Kids” blog hop is Personal Care, so check out the landing page for the rest of our posts and information on all things related!

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Children with special needs CAN be taught to be more independent.  This is important for their quality of life, as well as yours.  Some parents dig in even harder to do everything for their child with special needs.

Let’s face it, you won’t always be there for them.

And then what will happen?

The most important gift you can give your child with disabilities is independence.
Basic personal hygiene and bathing are some of the most difficult daily tasks for a child with special needs. Another problem is that disabilities such as Autism Spectrum Disorder, Down’s Syndrome, Tourettes, or Developmental Coordination Disorder are usually accompanied by other diagnoses.

These disabilities often are linked with intellectual disability, obsessive-compulsive disorder, motor planning dysfunction (apraxia or dyspraxia), attention deficits, and/or sensory processing difficulties.

 

Children with special needs may have gross motor delays that impact their balance and coordination.  Fine motor tasks like opening the shampoo can be frustrating.  Sensory processing issues may cause distress with the running water, the echoing sounds of the tile,  and the sensation of shampoo in their hair.  There are so many different aspects of showering to consider.  Check out this post by Your Therapy Source for a complete task analysis of bathing.

Does a Child With Special Needs even stand a chance?

Of course, they do!

Research shows that in instances where the child’s delay impacted the whole family, parents had a tendency to take over in order to save time during ADL tasks (Van der Linde, et al., 2015). I’ve seen it first hand and I catch myself on the verge of jumping in to help once in a while. But too much help can hurt in the long run. 

No one is saying it’s a simple task.

But, bite the bullet and start teaching them step by step how to do it on their own.    Here are my sure-fire tips for helping your child get started on a showering routine.  The sooner you start, the sooner they are independent

SO, Where do you start?

At the beginning.

1. Put all your child’s soaps, shampoos, deodorant in one caddy or plastic box.  This way everything is one place.

2. You may want to consider giving each family member who will use that shower their own caddy.  This will limit your child from accidentally using baby oil instead of shampoo, etc.

3. Establish a self-care routine and stick with it.  Many children with special needs thrive with a routine.  You can gradually fade yourself from the picture as your child grows more independent.

4. Use a picture app such as PhotoMind to remind your child or the routine.  Or try the free app called “iDo hygiene”, which addresses all the basic personal care tasks.

5. You can also use the apps “iDo hygiene” or “Making Sequences” to take pictures of each step to review prior to the showering process.

1) Get your stuff – a picture of the caddy, a towel, & pajamas

2) Get undressed – a picture of clothes on the floor of the bathroom (or right in the hamper- even better!) 

3) Turn on the water and make sure it’s not too hot.

4) MAKE SURE THE SHOWER CURTAIN IS ON THE INSIDE! (we’ve all made that mistake!)

5)  Wash your body – a picture of the soap he uses. 

and so on.

This may seem unnecessary, but after reviewing it a bunch of times, it becomes second nature.  Children with special needs thrive on routine.  They may flip through quickly, but it will help them remember all the steps.

Bathroom safety

1. 1. 1. The bathroom door should stay unlocked or slightly ajar in the case of an emergency.

      2. The shower curtain must be on the inside.

      3. To help your child with special needs learn the difference between the hot and cold faucets, try using red and blue hair scrunchies on the hot and cold handles.  Turn cold on first, then add hot little by little

      4. If you have a faucet or one knob shower, try using bath chalk or crayons in red and blue. Then, you can write HOT and COLD or  draw a picture to help your child understand.

      5. If your child has difficulty with balance, you may want to consider adding grab bars in your bathroom. You can get temporary ones that don’t crack the tile. It’s a good safety measure to prevent your child from falling or from getting in the habit of grabbing the curtain or the glass door.

      6. For a child with coordination and balance issues, you may want to get a non-stick mat  or even a shower chair. Or, get your child in the habit of sitting down (depending on your child’s level of physical disability).

Measuring out the soap and shampoo

There are a few ways to cut down on wasted shampoo and soap, especially for our impulsive kids who love to squeeze as hard as they can (or repeat a process three times) before they are satisfied.

1. 1. 1. 1. 1. Give your child a plastic tablespoon to keep in his caddy.  Teach him or her to measure out only one tablespoon of shampoo, conditioner, and body wash.  Choose shampoos, conditioner, and a liquid soap that have a small spout instead of a large opening.

            2. OR  Use shampoo, conditioner, and body wash that come in a pump.  Next, teach your child to use “one pump” only.

            3. Choose your child’s brand of soaps, shampoo, and conditioner and stick to that kind.  If possible, buy brands that have different color bottles (shampoo is a white bottle, conditioner is brown, etc.). Eventually, your child will learn which bottle is which and stick with his routine.

Not washing long enough or washing for too long

1. 1. 1. 1. 1. 1. Find a way to get your child with special needs used to a time constraint.  You can put a timer in the bathroom that goes off after ten minutes. I like a Time Tracker that lights up and has programmable sounds from Amazon, but you can even use a simple egg timer. If you look on Amazon, there are ghostbuster timers, cow timers, princess timers.  You can definitely get your kid excited about the timer if you find the right one!

               2. Or,  you can use music to set the pace. When the song changes, go to the next step. This can help kids who don’t wash for long enough or vice versa.   I recommend that you don’t leave your phone in the bathroom, though!  Try a little water resistant speaker with Bluetooth and hook up your phone from outside the bathroom or just use an old fashioned cd player.  Does anyone have those anymore?

               3. For kids who don’t wash the soap out of their hair, teach them to check the water at the drain before they get out. Are there still bubbles?  Then they need to rinse for another song.

               4. If your child has a really hard time with this, try using hair “spray paint” that they sell at Halloween time.  Spray their hair a funky color and then show them how it washes down the drain.  When the water is clear, they are done rinsing.

iDo Hygiene allows families to learn daily life skills with video modeling and fun games, for individuals with special needs.

Making Sequences can help a child to learn the parts of a story or a task to help them perform tasks properly in the correct order with more ease.

References for Your Child With Special Needs: How to Conquer Bathing Independently

Hauser-Cram, P., Warfield, M. E., Shonkoff, J. P., Krauss, M. W., Upshur, C.C., & Sayer, A., (1999). Family influences on adaptive development in young children with Down syndrome. Child Development, 70, 979-989.

Van der Linde, B., van Netten, J., Otten, B., Postema, K., Geuze, R., & Schoemaker, M. M. (2015). Activities of daily living in children with developmental coordination disorder: Performance, learning, and participation. Physical Therapy, 95(11), 1496-1506.

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This post is part of the Functional Skills for Kids series.  Check out all of the bloggers who are participating and learn more about the series by clicking on the link above.

For more information on the components and considerations related to Personal Care, stop by and see what the other Occupational Therapists and Physical Therapists on the Functional Skills for Kids team have to say:

Task Analysis – Independent Bathing in Children  | Your Therapy Source

Tips and Tricks for Teaching Hand Washing with Kids  | Growing Hands-On Kids

I can brush my teeth! Tips for Tooth Brushing and Oral Care!  | Your Kids OT

Tips to Help Kids Learn How to Blow Their Nose | Sugar Aunts

Sensory Friendly Tips for Kids Who Have Trouble Sleeping  |  The Inspired Treehouse

Your Child With Special Needs: How to Conquer Showering Independently | Miss Jaime OT

Adolescent Hygiene Challenges  | Therapy Fun Zone