Handwashing for Children with Autism (ASD)
The need to wash our hands isn’t new. But keeping everyone’s hands clean has taken on new importance, as we know, in the battle against coronavirus or COVID-19.
Parents know the routine, right? Some kids love the sensory experience of the soap and water, meaning we cannot pry them away from the faucet. Other kids avoid the sink because the soap and water create an uncomfortable sensory feeling that makes the child fight handwashing.
wash hands
So, what can be done to help children with autism wash their hands thoroughly and stay as safe as possible in this uncertain environment?
First, you know your child best. If your child loves the sensory experience of the soap and water, help them wash thoroughly and according to the CDC’s Centers for Disease Control and Prevention guidelines. Help the child scrub for at least 20 seconds and dry with a clean towel. Try using scripted language to help all caregivers use the same vocabulary and process, e.g., mom, dad, stepparents, grandparents, sitters, etc. If the child really doesn’t want to stop handwashing, tell him/her what time they get to do it again and follow through. A gentle alarm or timer can help you both remember when the next opportunity will be.
temperature
Then, set up the environment for success. Have everything ready—which sounds obvious—but you don’t want to begin the process and discover that the soap dispenser is empty. Make sure the water temperature is not too hot or cold and the clean dry towel is within reach.
If your child really dislikes the sensory process of handwashing, you may need more tools than scripted phrases. You might choose a quick social narrative or story about handwashing. Read the story with the child and any available brothers or sisters.
finished
Use the same key phrases from the social narrative you read with the child. For example say, “wash hands” and begin the process. Use a song or visual timer if available to signal that the handwashing must continue until the end. Say, “Finished! Dry hands” or “All done. Dry hands.” Help the child put the towel where it belongs until the next time.
Another option is this small collection of ResCuesTM. ResCues are professionally created, ultra-short, social scripts to support language and learning. For use by anyone, ResCues are scripted, but also include flexibility and language coaching within each short script.
Try these ResCues. Read aloud. Also try, printing and posting in the environment so that all caregivers have access to the same cues for the interaction. Alternate vocabulary terms are italicized in parentheses. Coaching for the caregiver are regular text in parentheses.
Why we wash hands:
Say,
Germs (or dirt) are on things we touch.
We can clean the germs (or dirt) off our hands.
Let’s wash hands.
Using Hand Sanitizer:
Say,
(Be excited!)Time to clean hands!
Look! Hand cleaner.
Two squirts (or drops).
Squirt, squirt (or drop, drop).
Rub, Rub, Rub.
All done.
Washing at sink:
Say,
(Be excited!)Time to wash hands.
Water on.
Two squirts of soap. Squirt, Squirt (or 1, 2).
Rub, Rub, Rub (sing a song or count as part of the hand rubbing routine).
Water off.
Dry hands.
Also try pairing the same social narratives and ResCues with video-modeling for washing hands. Video-modeling is a powerful teaching tool for people of all ages.
On the subject of hand sanitizer, there are people that are sensitive to alcohol and other ingredients in sanitizers. If your child has a known sensitivity, be sure to communicate the sensitivity with all caregivers and educators interacting with your child. If your preference is that your child not use hand sanitizer for whatever reason, communicate that to everyone in your child’s care circle.
Helping kids understand the language and the process lays a foundation for independence.