If you have a child, you know the struggle that can come with teaching your child how to complete daily tasks - things like getting dressed, brushing teeth, and combing hair. These activities of daily living (or ADLs as they’re known in the therapy world) are essential for teaching our children independence. But sometimes, these skills don’t come easily. Sometimes these daily routine tasks are extremely challenging and can cause daily meltdowns, refusals, and overall extra stress in the home.
What are some of the main daily routines (or activities of daily living, ADLs) that your child completes (or that you WANT them to complete)?
All of these daily routine tasks require a variety of skill sets, as well as a step-by-step process. Let’s look at each one a little bit closer.
The first step to using the bathroom (or using the toilet, going potty, whichever verbiage you choose to use) is knowing WHEN to use the bathroom. This refers to the ability of interoception, which is the body and brain’s ability to understand and process internal information. You can learn more about interoception here.
The next step is clothing management. This might include managing buttons or snaps, zippers, or strings/ties. Your child will need to be able to grasp and hold their clothing as well as understand how to pull and push. This requires bilateral integration (using both hands simultaneously) as well as fine motor skills.
Next, your child will need to be able to process the different sensory components of using the bathroom. This includes the olfactory sense (sense of smell), the auditory sense (think of the sound of the toilet flushing), the visual sense, and the proprioceptive and vestibular senses (in order to move through the bathroom and maintain balance).
Finally, the last step is hygiene. This includes wiping afterward as well as washing hands. These skills require the use of fine motor skills, core stability, and sequencing.
If any of these skills are challenging for your child, using the bathroom will be difficult. It’s important to identify the WHY behind your child’s struggle, and knowing which skill(s) they find difficult is the first step.
Getting dressed and undressed requires many skills. First is knowing which clothes to wear! This requires some executive functioning - understanding the weather, visually looking through options, and making a decision. Sometimes, making the initial decision of what to wear is the hardest part!
The actual process of getting dressed requires many different skills, ranging from bilateral integration to sensory processing.
If any of these skills are challenging for your child, getting dressed and undressed will be a struggle. It’s important to identify the WHY behind your child’s struggle, and knowing which skill(s) they find difficult is the first step.
Brushing teeth is a common struggle for many children. It requires a significant amount of sensory processing and coordination to master! Try this: brush your teeth with your non-dominant hand. Feel how difficult that is, how awkward it feels. That’s often what it feels like for a child who struggles with fine motor skills and coordination abilities.
The sensory components associated with brushing teeth are vast: tactile processing, olfactory and gustatory processing (smell and taste), auditory processing, and proprioception. Additionally, your child must be able to grasp and squeeze, and pinch the toothpaste bottle and lid, as well as manage their toothbrush. They must understand how much force to use when brushing as well as be able to orally manage their saliva and toothpaste as it bubbles. There’s a lot going on! Add on that they need a certain amount of sustained attention for success!
If any of these skills are challenging for your child, brushing teeth will be a fight. It’s important to identify the WHY behind your child’s struggle, and knowing which skill(s) they find difficult is the first step.
While not every child needs to brush or comb their hair daily, many do and many children find it very difficult. Why? Well, let’s dive into the different skills that are required for success with brushing or combing hair.
We can add on to this - children who have their hair put into ponytails or braids, which requires additional tactile and proprioceptive processing and sustained attention.
If any of these skills are challenging for your child, brushing or combing hair will be a difficult daily task. It’s important to identify the WHY behind your child’s struggle, and knowing which skill(s) they find difficult is the first step.
A necessary life skill is to bathe. Whether this comes in the form of a bath or a shower, your child likely bathes on a weekly (or daily!) basis. But what if it’s a fight each time? What if there are certain parts of the bathing routine that are a struggle? Let’s look at the different areas of bathing and why they may be difficult.
First, there is a tactile component to bathing. Being able to tolerate different types of tactile input is necessary in order to tolerate the water and the different temperatures, soap, and different washcloths or brushes. This includes tolerating water on their face, which is often a difficult area of bathing as water will likely get on your child’s face when washing their hair.
Next, there is body awareness (which is related to the vestibular and proprioceptive systems) which is required for your child to understand where they are in space, how to move in and out of the bathtub, and how to wash themselves. In addition, there is a balance component that is involved with stepping in and out of the tub, as well as being able to either lay back in the tub or tilt their head back to wash their hair (all related to the vestibular system).
There are additional senses involved, such as the olfactory sense (sense of smell), auditory sense, and visual sense. There is a lot going on during bathtime, which can oftentimes be overstimulating!
Finally, there is the ability to transition to and from the tub. This includes understanding when it’s time to bathe and when it’s time to be done. This includes clothing management (see “Getting dressed/undressed” above) as well as using a towel afterward.
If any of these skills are challenging for your child, bathing will be a very challenging activity. It’s important to identify the WHY behind your child’s struggle, and knowing which skill(s) they find difficult is the first step.
Personal hygiene refers to anything related to cleaning your body. This includes wiping after using the bathroom, washing hands, washing your face, using a tissue to blow your nose, etc. Many of these are involved in other daily tasks. The skills required for various personal hygiene tasks look like:
Another daily life task that is necessary for all of us! But often, sitting down to eat a meal is very difficult. Why? Let’s look at the different skill sets involved.
First, there’s the ability to regulate your emotional state as well as your energy level in order to feel calm enough to sit down and focus on eating. This goes right along with sensory processing and interoception - which also includes knowing WHEN you are hungry or full, and identifying those hunger cues accurately.
Next, postural control is involved in order to sit upright at the table for a certain amount of time, which simultaneously requires endurance. Going along with this is bilateral integration and fine motor skills to manage the food and utensils (including silverware and drinking items).
Then, there is the sensory component to food - the smells and tastes and sights and sounds of all the different foods. Don’t forget about the tactile sense - how the food feels on your hands and in your mouth. Adding to this is your ability to manage the food or drink in your mouth, which involves oral motor coordination as well as being able to safely swallow.
Finally, there is a certain amount of sustained attention that is required to sit and eat a meal.
If any of these skills are challenging for your child, sitting down to eat a meal will be a struggle. It’s important to identify the WHY behind your child’s struggle, and knowing which skill(s) they find difficult is the first step.
In order to participate in activities of daily living (ADLs), as well as to participate in leisure activities (anything fun that you enjoy!), you must be able to safely move through your environment. This can include walking, running, cycling, or using an assistive device such as a wheelchair.
Safely moving through the environment requires sensory processing at a high level! You must visually navigate through your space, avoiding obstacles. You must be able to process any auditory input you hear and understand what certain sounds mean (such as a siren). You must be able to maintain a certain amount of balance and body awareness as you move (vestibular and proprioception). You may need to make executive functioning decisions like which route to take while walking or determining if a path is safe.
If any of these skills are challenging for your child, safely moving through the environment may not be so safe. It’s important to identify the WHY behind your child’s struggle, and knowing which skill(s) they find difficult is the first step.
In addition to identifying the variety of skill sets required for each routine task, it’s also important to take into consideration your child’s overall motivation to complete the task. If your child isn’t motivated, if they “don’t see the point” in completing the task, they are unlikely to participate - whether they have the skills or not! Therefore, in addition to building the necessary skills, it’s also necessary to figure out a way to motivate your child to become more independent in these daily routine tasks!
There are some general strategies that can help your child improve their independence and success with their daily routine activities, and then there are specific strategies for each daily routine.
Many of us use visual schedules daily - whether it’s the calendar in our phone, a wall calendar, or a daily planner. It helps us stay organized and know what we need to do throughout the day and when things need to happen. With that in mind, it’s easy to see how our children can benefit from using the same strategy.
Finding the right visual schedule for your child can take some trial and error. There are hundreds of different options - you can create a weekly or monthly visual schedule, or keep it more simple and create a daily schedule. You can use pen and paper, a whiteboard with dry-erase markers, laminated paper and velcro, or even a magnet board. There are endless options for sale on the internet as well as easy DIY calendars. Again, the right one for your child may take some trial and error, but it’s worth it to find which one works for them if it helps them get through their day easier!
Learn more about using visual schedules by listening to this podcast episode.
In addition to using a visual schedule for daily routines, using a visual timer for certain tasks can be beneficial. Your child may struggle with a non-preferred daily routine task because they don’t know how long it will take - a visual timer helps with this! Your child can see the timer and can better anticipate when the task will be finished. Visual timers are also helpful for transitions. Be sure to use a visual timer consistently in order for it to be effective. Also, keep in mind that a visual timer may be more distracting or anxiety-inducing for some children - everyone is so unique, and what works well for one child may not work well for another.
Incorporating a regular sensory diet routine into daily activities is helpful for all children. A sensory diet is a series of personalized, sensory-based activities and/or strategies that are utilized throughout the day and at certain times of the day to help your child feel regulated and able to complete certain tasks.
Identify which daily routine tasks your child struggles with and try incorporating a simple sensory diet BEFORE that routine task. A sensory diet can be short and sweet, as short as 5 minutes and no longer than 15 minutes, and should help your child meet their sensory needs. Once your child’s sensory needs have been met, they are more likely to be successful with their daily routine tasks.
Learn more about sensory diets here.
When looking at your child’s ability to get through their day and participate in daily routine tasks, it’s important not to overlook their overall health and wellness. How was their sleep the night before? If they struggle with getting a good night’s sleep, this can affect their ability to get through their day. What about your child’s nutrition? Do they struggle to eat a variety of foods that provide their brain and body with good fuel? Oftentimes a nutritional deficiency can cause challenges with focus and attention, mood, and the ability to complete complex tasks.
There are a variety of health factors that have been associated with mood and behavior, which can have an effect on your child’s ability to complete daily routine activities. It’s worth looking into!
In addition to using a visual schedule for when to use the bathroom (if needed), you can create a visual schedule with the specific steps of using the bathroom. This could include: closing the door; clothing management; hygiene; flushing. This visual list can be helpful if your child struggles with attention and sequencing.
Change the sensory components of the bathroom. Use dimmer lighting, place twinkle lights on the ceiling, add an essential oil diffuser to eliminate noxious odors, include music into the bathroom routine, etc. If your child dislikes the noises in the bathroom (oftentimes, it can be too loud, too much echo), try using noise-canceling headphones or earplugs.
As for clothing management, try different types of clothing items that are easier for your child to manage. Additionally, practice the fine motor skills necessary for clothing management. This can be done during play with a variety of fine motor games that build dexterity and bilateral integration. For ideas, check out this digital course for fine motor skills.
For more ideas to help your child gain independence when using the bathroom, listen to this podcast episode all about the skills required for using the bathroom!
Along with using a visual schedule for the different components of getting dressed, using a weather app can be useful to help your child understand what the weather will be like for the day and which clothing items work best for which types of weather.
Overall sensory integration is important for dressing. Sensory integration is your brain’s ability to process and understand the different types of sensory information your body receives. As mentioned earlier, getting dressed/undressed involves many different types of sensory input, including vestibular, proprioception, and tactile. Completing fun sensory activities throughout the day to include these three types of sensory input can be beneficial.
Additionally, try using a mirror to help your child better understand where their body is in space and how their clothing relates to their body. Watching themselves get dressed can also be highly motivating for some children!
If your child struggles to brush their teeth, try these different strategies to help manage the different sensory components and build the necessary skills:
For more ideas to help your child brush their teeth, watch this YouTube video.
Often, this takes consistent practice to gain the necessary skills. However, if your child cannot even tolerate a brush/comb to their hair, try some of these strategies to help:
Start by including a sensory diet routine BEFORE it’s time to bathe. This should include some vestibular input (specifically a task that includes a head position change - something that simulates the same movement as leaning the head back to wash/rinse hair) as well as some calming proprioceptive input / heavy work.
Prior to the transition to the bath/shower, be sure to provide several “warnings” that the transition will be occurring. Using a visual timer may be helpful, as well as a visual schedule that also includes what your child will get to do after the bath.
Change the bathroom sensory components, similar to what was already discussed, to use the bathroom successfully. Changing the lighting, the noise, the smells … all of this can help to create a more calm bathtime environment.
For more ideas, watch this YouTube video.
One big challenge that often occurs with personal hygiene tasks is tactile processing - your child may struggle to tolerate different textures, and different types of tactile input. If this is the case, start including more tactile experiences throughout their day. This can look like more messy play - try different wet and dry tactile mediums such as shaving cream, mud, rice, cotton balls, etc. Consistent exposure is key! Be sure to engage in these messy play activities WITH your child.
Fine motor skills and body awareness are also important factors for personal hygiene tasks. You can build these skills with different gross motor and fine motor activities, including:
Learn how to build a simple obstacle course with minimal equipment by watching this YouTube video.
Additionally, sometimes it takes consistent practice to achieve success and independence with personal hygiene tasks. Stay on course and continue to help your child with these tasks as they build the skills!
The first step to achieving success with mealtime is to make the mealtime experience more inviting and positive. Set up the table and dining room so that it is fun and exciting - try different lights, different dishes and table settings, different music, etc. Allow your child to have some control over the situation - maybe your child can choose what music to listen to during dinner. If the meal table is inviting, your child is more likely to enjoy sitting at the table to eat.
Engage your child in a sensory diet routine 10-15 minutes before the meal starts. This sensory diet routine should achieve several things: meet your child’s sensory needs so their arousal level is “just right;” provide calming heavy work so their nervous system is regulated; prepare the body for eating (which includes engaging the core muscles for sitting upright, the hand muscles for manipulating the food and silverware, and the oral structures for chewing and swallowing). An example of this could look like:
Again, that is just an example! Your child’s sensory diet routine will be unique for them!
Communication is key for safety in different environments. This can look like talking with your child about expectations and helping them follow these expectations; this can look like using visuals to identify landmarks and complete tasks such as crossing the street safely; this can look like practicing and role-playing before leaving the house.
Additionally, body awareness is key when moving through any environment, even the house. Some strategies to help improve body awareness and understanding how your body is related to objects in space:
Ultimately, what is the best way to master a skill? Consistency! Consistent practice and exposure to certain tasks and skills is the best way to ultimately gain independence and achieve success. This is true for daily tasks that your kiddo completes. If they try a daily task once and are not successful, that doesn’t mean you should do it for them. It simply means you need to step in to help build the skills and the confidence so your child can begin to learn how to complete the task. It may take longer than expected, but with consistency, they can get there!
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