My daughter has a lack of understanding why we need to keep ourselves clean and tidy

lorraineT

This discussion was created from comments split from: Hi, I'm Arlene. I'm a Specialist Learning Disability Occupational Therapist..

lorraineT

Hi there.

My daughter is 15years old and has autism. Her difficulties lie in sensory, speech and language social communication (expressive the more difficult), development delays, emotionally delays and immaturity. My daughter is small stature and has a number of medical probs including peanut allergy and asthma etc. The difficulty we are trying to help my daughter overcome is sameness and lack of understanding of why we need to keep ourselves clean and tidy. My daughter has never attempted to wash her own hair even though I frequently practice this with her by talking through what is happening next. My daughter wont brush her own hair she becomes tearful and sometimes angry but she doesnt mind me brushing her hair. Amy wont look in mirrors either she said she doesnt see the point even though we explain why. Amy used to be in speech and language arc due to lack of verbal communication with word retrieval etc. she is in secondary mainstream and is currently doing a couple of GCSE examinations and BTECS. Amy has ahigh level of support in shcool and outside (not independent traveller) and has a befriender but has no social worker. Please could you offer any ideas to us that may help our daughter on her way to independence. Thank you

BusyOT

Hi Lorraine, I'm afraid I don't have any easy answers but have you looked at or seen any of the FAIR resources http://www.fairadvice.org.uk/health-publications.php?category=booklets They provide easy to understand guidance on keeping clean and healthy - the visual format might help. I also wonder if a chat from her befriender might help - sometimes it's not easy to do as your mum tells you when you are 15!
Regarding the mirror: you could try a small mirror in her bag and tell her that after meals she must check her mouth to make sure that there is no food there and then then teach her to put on lipbalm whilst looking in the mirror. My thinking is that if you can encourage her to use mirrors for small specific tasks initially you may be able to develop this in the future.
Washing hair - you could try "backward chaining". You do most of the task but ask her to do the very last step (the last rinse) and then over time increase the last steps that she does until she is doing the complete task independently. It will likely be a slow process and she will probably need lots of encouragement and praise but it might help you get there in the end.
It is interesting that you don't mention that it is difficult to get her to bath or shower - it might be that she has just accepted that this is part of her daily routine and if you can somehow get other personal care tasks into her daily or weekly routine (without needing to know why they are important) this might help.
Please keep in touch and let us know how you get on or to chat more.