Developing self-care skills such as washing and personal hygiene can sometimes be an issue for people on the autism spectrum. If they have sensory differences, such as a heightened sense of smell or touch, washing may be an uncomfortable experience. Here are some tips for overcoming these barriers and strategies for helping an autistic person develop self-care skills.
Keep a sensory record
If you suspect that sensory issues are affecting the person's self-care skills, keeping a record of their reaction to different types of washing or clothing which they have difficulty tolerating can help you adapt their washing and dressing routine to something they are more comfortable with.
It may be that the sensation of water on their skin from a shower is uncomfortable for them, so you could try bathing instead or use a preferred fabric for washing, such as a sponge or flannel. Perhaps the smell of a particular soap, shower gel or shampoo is an issue so you could try unscented or hypoallergenic alternatives. Check that the washing powder or fabric conditioner you are using is not irritating the person's skin and try alternatives for sensitive skin if necessary. Perhaps the person is reluctant to wear particular items of clothing because they dislike the feel of certain fabrics or the colour or pattern of the clothing.
Check mental health
For some people, not taking care of themselves may be an indication of depression or other mental health difficulties. If this could be the case, you may want to seek some professional help from your GP, or find a counsellor with experience of supporting autistic people. You can search for counsellors and Child and Adolescent Mental Health Services in our Autism Services Directory.
Use social skills training
Perhaps the person finds it difficult to understand why it is important to wash and have clean clothes. If it is something that does not annoy them, why should it annoy everyone else? If might be helpful to do some social skills training on why it is important to keep clean. If the person enjoys doing an activity which involves contact with with other people, there is an added incentive to keep themselves clean.
Break down an activity into small steps
Adults with autism can find it difficult to organise things, or remember in what order to do things. If personal hygiene is not a priority for the person, then you may need to remind them to wash themselves or their clothes on a particular day, or how often to brush their teeth or shave. They could decide how to schedule these tasks into their week and write them on a calendar. There are two main ways to teach self-care skills by breaking activities into small steps:
- forward chaining: teaches a skill in small steps from the first activity, ie to get dressed in the morning, first you put on your pants, then your socks, etc
- backward chaining: starts at the last step and works backwards through the activity, ie once the person has brushed their teeth, move backwards through each step slowly.
Use prompts and motivators
For instance, if you are trying to teach them to wash their hands, you could use the below prompts in the following order:
- physical: hold their hands and wash your hands together
- gestural: mime washing your hands next to them while they wash their hands
- verbal: say "wash your hands" or show them a ‘wash hands’ symbol, which you can leave above the sink as a prompt for next time.
Using rewards and motivators can help to encourage a particular behaviour. Even if the behaviour or task is very short, if it is followed by lots of praise and a reward, the person can feel positive about their behaviour or skill.
Try to give praise and rewards immediately and in a way that is meaningful to the particular person. Some people like verbal praise, others might prefer to get another kind of reward, like a sticker on a star chart, or five minutes with their favourite activity or DVD.
Use picture symbols
You may find that you need to leave physical reminders of each activity in the appropriate room permanently, for example, symbols, or written lists of all the different steps for brushing teeth in the bathroom and the same thing for getting dressed in the bedroom. You can download free symbols from the following websites:
Last updated: 22 February 2017
Quick link to this page: www.autism.org.uk/self-care