A child’s independence with self-care tasks is influenced by many factors, such as the task difficulty, the child’s skill level, the child’s age, emotional and sensory regulation, and the child’s ability to attend and follow adult directions. The simple tips below could help your child increase their overall independence and participation in self-care tasks, with consideration for what is appropriate for their given age.
Give Back Some Control
When a child is over-responsive to sensory input, they may dislike, avoid, or respond negatively to experiences involving this sensation. For example, a child who is very sensitive to touch or tactile input may have difficulty completing self-care activities such as tooth-brushing, dressing, and grooming. They may have difficulty tolerating clothing (like itchy tags), dislike eating messy foods with their hands, or have big reactions to hair brushing, tooth brushing, or having their face or body washed.
For a child who is sensory sensitive and avoidant of certain experiences, self-care tasks where they cannot control the stimulus can be very alarming and upsetting. A way to reduce fear and improve tolerance for aversive sensory input is to allow your child to gain back some control over the situation. For example, if you are brushing teeth, you can model this task and brush your teeth simultaneously with your child. You can also take turns allowing your child to brush your teeth with your toothbrush while you brush theirs.
It can also be helpful to use strategies such as counting brush strokes, visual timers, or brushing their hair/teeth to a favorite song so your child knows how long they will be expected to engage in the task. Another helpful strategy is to prep your child with calming sensory input prior and during the more aversive task, such as deep pressure through squeezes, massages, chewy toys, weighted blankets, body socks, and sensory brushes.
Meet Them Where They Are At
Learning new skills can be very difficult and frustrating for children who may have difficulty regulating their emotions. Your child may easily give up when trying to learn a new skill, leading to increased frustration and sometimes a refusal to participate in the self-care activity.
A simple way to increase your child’s self-confidence and ability to complete new or challenging activities is to use backwards chaining. Backwards chaining involves the adult or caregiver completing the majority of the task and having the child complete the final step of the task. For example, when putting on shoes the adult will begin the activity by undoing the straps, guiding the foot in, and having the child complete the task by fastening the strap.
Providing specific positive praise (such as “Wow, you did the strap all by yourself, I am so proud of you for doing it all by yourself!”) can help the child feel a sense of accomplishment. As your child gains confidence, you slowly allow them to complete more and more of the task until they are doing it independently. If your child continues to get frustrated, you can always validate their experience by recognizing their emotions and offering help.
Functional Skills
Self-care skills such as tying shoes, manipulating fasteners and bathing are very complex and have many steps. A way to increase independence with these tasks is to break down each activity and practice the functional skills that the child needs to complete the activity.
For example, if your child is having difficulty bathing independently, you can have them draw a picture where they color code the different body parts that need to be washed. For tying shoes, they can practice the in hand manipulation skills needed for this task by beading a bracelet, picking tiny toys or beads out of playdoh or putty, or practicing weaving yarn.
Thinking about activities that encourage the use of both hands can be helpful for self-care tasks such as buttoning, zipping, and tying shoes. Activities that encourage body awareness (such as copying yoga poses, labeling body parts, Simon Says) can help develop skills needed for bathing and dressing.
Visual Aids
Another common way occupational therapists help kids increase independence with self-care is by providing visual aids.
For kids that have difficulty following adult directions, paying attention, and sequencing activities, a visual schedule can be very helpful. Visual aids can range from an entire morning/evening routine, to detailing the steps needed to brush your teeth. They can be written instructions (especially helpful for kids who are hyperalexic), visual, or video format.
Labeling can also be helpful for activities like dressing to help your child practice identifying the front and back, or left and right of clothing.