My adult son does not like to wash himself, which is beginning to impact on social situations he is in. 

Sensory processing difficulties can impact on personal hygiene. If your son has a heightened sense of smell or touch, washing himself may be an uncomfortable experience for him.

It may be that the water from a shower is uncomfortable on his skin, or he may not like the smell of shower gel, shampoo, etc. It might be worth keeping a sensory diary to see if there are some forms of washing he will tolerate more than others, such as a bath instead of a shower or vice versa.

If he will not tolerate either a bath or a shower, will he wash himself with a particular cloth? You may need to find a particular fabric he tolerates more than others. He may also not like drying himself with a particular type or colour of towel. Again, it could be worth looking at whether there are particular towels, washing powder or fabric softeners he tolerates more than others. He may also tolerate non-scented products better than scented ones.

Help with organisation

Adults with autism can also find it difficult to organise things, or remember in what order to do things. If your son’s personal hygiene is not something that he remembers as a priority, he may need reminders that he needs to wash, shower or wash clothes on particular days. He may need this marked on a calendar and decide on certain days he is going to wash. He may also find it difficult to remember all the things he needs to do in the morning, ie have a shower, shave, brush his teeth, etc.

Your son may need a visual timetable of all the different steps left up in the bathroom or his bedroom to remind him (for details of free symbols, see the question about anxiety during school breaktime). Other people will use things such as personal organisers or reminders on their mobile telephone to remind themselves of everything they need to do before they leave the house (Lawson, 2005). For further suggestions, please see the question on teaching self-help skills.

Social skills

Your son may also find it difficult to understand why it is important that he needs to wash. If it is something that does not annoy him, why does it annoy everyone else? It might be helpful to do some social skills training on why it is important to keep clean. You may need to make it important to him - is there a particular activity he likes to do where he will come into contact with other people, so needs to keep clean?

Mental health

For some people, not taking care of themselves may be an indication of depression or other mental health difficulties. Your son may find it difficult to see why he wants to take care of himself. If this could be the case, you may want to seek some professional help for your son through counselling. The Autism Helpline has a small database of counsellors who work with adults with autism (you can also find more information in our section on counselling).