- Use non-perfumed soap
- Be aware of bathroom lighting levels and minimise any noises, e.g. sometimes the sound of the water filling the bath tub can be bothersome to a child. Try filling the bath with the door closed and call them to the bath when it is ready.
- Use firm but gentle pressure when shampooing or drying your child with a towel
- Before bath time do activities that provide deep touch input, for example, resting your hands on your child's shoulders and applying moderate pressure, or giving your child a massage. Having your child carry out heavy muscle activities (proprioceptive activities) before their bath or shower can also help them to calm, for example push-ups, sit ups, pushing against another person's hands whilst in a high kneel).
- Make the transition from undressing and getting into the bath as quick and smooth as possible.
- If the child dislikes having their face or body washed, encourage them to wash themselves. Self-initiated touch produces a less defensive response. You could try a variety of different items to wash with e.g. sponge, flannel etc.
- Use a large sponge or loofah sponge. Rub firmly to decrease defensiveness.
- If the child is showering, use a hand held shower nozzle. Let the child control the direction and force of the water. The spray from a handheld showerhead connected to the taps is often gentler than an electric showerhead.
- Use a large towel, and quickly and firmly wrap the child in it. Avoid exposure of the wet skin to the air: the light touch may trigger a defensive reaction.
- Provide deep-touch using a towel to the head, hands and feet to decrease defensiveness. If the child will tolerate it, provide a firm massage, using lotion to avoid skin irritation.
- If your young child dislikes the bath, start small; place a plastic tub within the bathtub so the child can feel more secure (never leave a young child unattended). Let them play with non-soapy water with no expectation that they will wash or have their hair washed.
- Place a child safe unbreakable mirror on the wall or place on the bathtub rim so that the child can see themselves in the bath, this may help them feel more secure.
- For a young child, try placing removable pictures or bath stickers on the tiles around the bath or on the inside of the bath so they can have something visual to look at as a distraction. Try placing these removable vinyl stickers on the ceiling of the shower cubicle/ above the bath so the child has something visual to look at as a distraction when they are having their hair washed or rinsed. Or, hide a toy under the bath bubbles and have the child try to find it with their hands while closing their eyes, they may be able to tolerate having their hair/ body washed and rinsed with this playful distraction.
- Let your child have a shower or bath after someone else so that the room is warm. Heat up the towel for a few minutes if necessary. Alternatively allow your child to shower or bath first if they are unable to tolerate the smells of bathing products used by other people.
- Let your child stand and watch the shower for a few minutes before venturing under the spray.
- Let your child regulate bath or shower temperature, within reason. Be careful as children with sensory processing issues can have a very different sense of 'cold' and 'hot'. For safety, and to prevent accidents, make sure the temperature on your water heater/ thermostat is set to a safe maximum level.
- Play music while your child is in the shower or bath to soothe them (keep music devices far from the tub).
- If your child gets overly excited in the shower and starts jumping around, be sure you have an extra-long bathmat to keep them from slipping.
- Talk to your child and explain every step, particularly when you are going to touch them with the soap or shampoo.
- Visual aids can be used in order to help your child understand the activity.
- Consider adaptive equipment that may make the task easier, for example a grab rail may offer more support getting in/out of the bath.
- A Practical Approach at Home for Parents and Carers: Autism Spectrum Disorders Children with Disabilities Team Occupational Therapy Falkirk Council www.falkirk.gov.uk/cwd
- Is it Sensory or is it Behaviour: Behaviour Problem Identification, Assessment, and Intervention by Carolyn Murray-Slutsky and Betty, A. Paris.
- Raising a Sensory Smart Child by Lindsey Biel and Nancy Peske.