Personal Hygiene

‘You can lead a child with PDA to water but you can’t make him wash’ Neville Starnes,  PDA Society’s Parent Conference, 2015.

This comment during Neville’s talk, as a guest speaker, at the PDA Society’s first ever Parents Conference went down a storm and caused many a chuckle from the parents attending.

I think that many of us are so very familiar with such issues and experience great difficulty in trying to persuade and encourage our children to wash, shower, bathe, brush their teeth and brush their hair.

So let’s have a look at what may be underpinning these difficulties because what child would naturally want to be unclean, unkempt and smelly?

Doing anything that is expected of them, even things that are not directly asked of them can be perceived as a demand.

Low self-esteem may also play a part because when an individual is low or depressed, pride or interest in one’s self can be affected.

There may also be sensory issues at hand.  Hair brushing may be painful, standing under a shower may feel like being pelted with pins, water on the skin may itch and toothpaste may taste terrible not to mention feel painful.

So what can we as parents do to help our child?

Reduce the demand and perceived expectation

We can offer choices and be flexible in order to reduce the demand and the high levels of expectation that our child may feel we are placing on them.  We could do this by saying “would you like to brush your teeth now or later”, “would you like a bath or a shower”, “I have put some toothpaste on your toothbrush, I will leave it here for you in-case you would like to brush your teeth”, “If you don’t want to have your hair brushed that is ok, if you change your mind just let me know”.

Address any possible sensory issues

You could have a variety of different toothpastes for your child to choose from.

A variety of toothbrushes in different colours, with different styles of bristles may also be helpful.

Some children seem to find an electric toothbrush more tolerable, they may enjoy the vibrating sensation.

Different styles of hair brushes in different colours and with different textures of bristles may help.  There are some available that are especially delicate for de-tangling knotted hair.  Your child may prefer a very firm brush stroke while others may benefit from a very gentle and light brush stroke. Be very careful and patient when trying to smooth out tangles.  I found that using my fingers would often be the method most tolerated by my daughter.

A bath may be better tolerated than a shower if there are issues with tactile sensitivity.

A shower may be more preferential for a child who sensory seeks tactile stimulation.

A firm rub down with a towel both before and following washing may help those who do not like the feeling of water on their skin.

Try to make it as interesting and as tempting as possible

Again, different colours, textures and styles may make teeth and hair brushing more appealing.

Try to tempt them when they may be otherwise engaged E.G. brush hair when they are totally absorbed in an activity such as screen time.  They may be too involved with what they are watching to pick up on the demand involved and be more tolerant to go along with what you are asking.  Obviously don’t just start brushing their hair without notice always get permission first.

Ensuring the bathroom is appealing may also help, scented candles, different coloured soaps, different choices of bubble bath.

Glow sticks in the bath may be both appealing and fun and may also help with sensory issues.

Turning the bath into a Jelly bath used to work for us, it made a bath fun and she loved the sensory feeling of the slimy water.  It is very messy though so be warned!

Watching an Ipad while bathing can reduce any potential boredom. Obviously not holding it while they are in the bath but perhaps position the Ipad on a small side table next to the bath.

Music can really help my daughter relax and self-regulate.

Playing games while they are in the bath like charades or so on can make it more appealing.

What if nothing works

Sometimes there may be periods when nothing at all works.  During these times I tend to completely pull back on any suggestions at all.  These periods tend to be when my daughter is going through a particularly low spell.  I may leave things until her mood lifts or just back off for a few days, a week or even a month.  Once her mood lifts or following a period of complete abstinence I may then begin to try the above strategies again.

What no teeth brushing for a week or more! Yes, I know her teeth are important and it does worry me terribly.  However, no amount of me pushing is going to get me the desired result.  If I leave it for a week she may begin again of her own accord or when I begin to gently suggest.  If I push, I could then find myself in the position of being a month down the line and still no improvements because I have intensified the demand during a period when she really couldn’t cope with it.

We now seem to have a familiar pattern which turns around like clockwork.  She will maintain personal hygiene all by herself for extended periods.  This is often followed by some aspects of personal hygiene stopping all together but other bits remain in place.  Gradually she builds back up to full personal hygiene and so the cycle continues. It isn’t perfect by any means but my word it is so much better than where we used to be.

For more information about PDA please view The PDA Society and The PDA Resource



About janesherwin

I am the parent of a child diagnosed with Pathological Demand Avoidance Syndrome. My hopes and aims are to raise awareness of this complex Autism Spectrum Condition presentation.
This entry was posted in 3. Strategies, Understanding, Resources, Discussion and More, Personal hygiene, Uncategorized and tagged , , , , . Bookmark the permalink.

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