Personal Hygiene Activities for Children with Visual and Multiple Impairments
Written by,
Jennifer Freeman, Certified Orientation and Mobility Specialist
Note to the reader: This is Part 2 of a series. My goal is to help families and IEP teams be thorough in teaching independent living skills to students of preschool age, students with visual impairments, or students with multiple disabilities. To read Part 1, which includes an overview and tips for getting dressed, please see my blog post, Independent Living Skills for Students with Visual and Multiple Impairments.
This blog post is written for the Teacher of Students with Visual Impairments, Orientation and Mobility Specialist, and/or other team members to help support parents on their journey to increasing their child’s independent living skills. Thus, the language in this blog post may say “your child”, as you will be using that language with the child’s parents.
Disclaimer: The author nor the website receive any compensation for the sale of a product through this blog post. All opinions and recommendations are of the author herself and not reflective of Allied Independence. The author did not receive free product for recommendations, nor has she been in contact with any of the direct sellers of any products mentioned in the article below.
Why Independent Living Skills Matter
Welcome back to my blog series about how to foster independent living skills (ILS) with your child who has multiple impairments or is of preschool-age. As an Orientation and Mobility (O&M) Specialist, I am lucky enough to work with individuals who have visual impairments entering the school system at age three, and I work closely with them throughout their school careers. During my tenure, I started to pick up on a pattern of behavior when I was assessing students.
My students were learning the advanced O&M skills such as how to navigate a campus, cross streets and shop, but they were unable to independently shower, get dressed, manage their clothing or accomplish several daily living tasks.
Privacy is essential when practicing personal hygiene activities with children who have visual impairments
Children who have vision loss do not always realize that other people can see them. Sometimes children who have vision loss assume that other people’s eyes work like theirs.
At around the time that you are toilet training your child, he is being identified by the early intervention team and will begin going to school where kids practice having privacy while using the toilet so this is why working on privacy is so important.
Here are some tips for teaching self care to blind children from Project Ray.
Strategies for supporting privacy while practicing personal hygiene activities
Create privacy boundaries within the home for using the bathroom for both yourself and your child. Tell your child, “I am closing the door to the bathroom while you go potty to give your privacy and will be just outside the door in case you need me.”
Follow this link to read about 5 Ways to Teach Your Child About Body Boundaries from Fractus Learning.
Now, let’s get to the skills!
In this blog post, we will cover these Personal Hygiene skills for children with visual and multiple impairments:
I can wash my hands!
I can dry my hands!
I can blow my nose!
I know how to protect my skin!
I can brush and style my hair!
I can brush my teeth!
I can wash my face with verbal assistance!
I Can Participate in Drying My Own Body After Bath/Shower!
I can participate in towel drying my own hair!
I can shower and bathe!
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I Can Go to the Toilet by Myself! Accident Free!
Children who have vision loss are not often toilet trained when coming into the school system at age three because parents are not sure how to go about toilet training. Let’s work on ditching those diapers!
Strategies for teaching children with visual impairments how to use the toilet by themselves:
Write down times that your child uses the bathroom everyday and see if you can narrow down a timeline. Share the information regarding the patterns that you have found with your child’s teacher and IEP team so that they can continue to reinforce the bathroom schedule at school.
Set your child up for success for toileting without accidents. If he can’t unbutton his pants, put him in pants that he can pull up and down. Teach your child to pull up and down his pants.
Switch to pull ups so the child can feel when they are wet.
Purchase a secure ladder or step stool to help your child safely navigate to the toilet.
I can do it star system for students with visual impairments from Target.com
Don’t forget to reward your child! You can work with the child’s vision professionals to develop a reward chart that is appropriate for his needs whether it is tactile or in large print.
2. I Can Wash My Hands!
This is a much more complex area then we often realize! How many sinks and faucets do we encounter in our daily lives? Not only are the knobs and faucets different but some are automatic or have sensors. How is a child with vision loss going to learn to use all the sinks in the world if he is not exposed to them?
Strategies for teaching children with visual impairments how to wash their hands:
Remember the standard rule that the cold knob is on the right and hot is on the left.
Expose your child to every and all faucets you encounter and talk about it. Don’t just wash their hands for them. If you don’t go out much, find a hardware store and go touch the sinks and faucets in the hardware store and talk about them.
Hand washing is a great time to work on the concepts of left/right, up/down, hot/cold, away/towards clockwise/counterclockwise. For instance I would introduce a sink at Starbucks to my student by saying, “The cold knob is on the right towards the back of the sink near the mirror and the hot knob is on the left towards the back of the sink near the mirror. Let’s follow the outline of the sink to locate the knobs. Okay, now grab the right cold knob and turn it counterclockwise and towards the mirror to turn it on. Now feel the water, it’s cold. Let’s add some hot water and see if we can make it warm!”.
Automatic sinks or toilets in bathrooms tend to startle all my students. Verbally prepare them for what they are about to encounter. Many of my students do not like the sound of an air-blow dryer or flushing toilets, especially when they are not expecting to hear the loud noise that often echoes in bathrooms.
Using soap is a great time to work on hand concepts! Teach concepts all about the hand as your child learns to wash his hands. For instance, you pumped the soap into the palm of your hand. Now put your two palms together and rub by moving your hands in opposite directions.
Be sure to use common names when describing parts of the hand such as thumb, index or pointer finger, middle finger, ring finger and pinky.
3. I Can Dry My Hands!
Strategies for teaching children with visual impairments how to dry their hands:
First, teach your child how to locate the different dispensers/blowers in bathrooms.
Try to use left/right and clock concepts to explain to your child how to locate the dispenser/blower. For instance the towel dispenser is on the wall to the right of the sink at 3 o'clock.
Allow your child to explore paper towels dispensers and explain how each works differently.
Warn your child about the noise the blowers make because not all people like the blowing sound.
Explain that blowers can be hot and be cautious where you touch them.
Take it one step further and talk about how to find the towel dispenser as well as where to put their trash when they are done drying their hands. It’s a difficult task to dry clean hands and not touch inside the trash can when going to throw away the towel.
Discuss how different blowers function and that some are automatic and some require a button be pushed to activate them.
Teach your child to dry his own hands.
4. I Can Blow My Own Nose!
Strategies for teaching children with visual impairments how to blow their own noses:
Teach your child how to locate the tissue box so that he can retrieve a tissue when needed.
If the child has an extra runny nose, consider helping your child place the tissue in their pocket and/or buy a small tissue pack to allow the child to keep in a pocket for quick and easy access. Tissue boxes can move so they are not always easy to locate.
When the child is done with the tissue, take it one step further and teach your child to find the trash can to throw away their tissue.
If there is not a trash can available, teach your child to put the tissue in their pocket until they can locate one.
O&M Bonus App for Personal Hygiene:
I Do Hygiene helps cover topics such as shampooing, washing your face, taking a shower, brushing your teeth, washing your hands, applying deodorant, boy in bathroom, girl in bathroom, public restroom, combing long hair, shaving with an electric shaver and making a ponytail. This app is accessible and you can use picture sequences to teach skills, listen to or watch videos and make videos. The price for this app is $4.99 but well worth it!
5. I Know How to Protect My Skin!
Strategies for teaching children with visual impairments how to protect their skin:
Again work on body related concept knowledge so that he understands where and how to apply lotion or sunscreen.
Try teaching your child to squeeze the sunscreen from the bottle into their hand.
Get a squeeze friendly or pump type lotion dispenser so that your child can be successful at retrieving the lotion.
The Car Autism Roadmap website link recommends that whenever possible, give your child a choice of products, choice of textures, fragrances, etc.
6. I Can Brush and Style My Hair! *
This is a great time to discuss different hair styles, colors of hair people have and anything hair related. Often my students do not know their own hair color. To this day, my students learn very late (after age 12) to brush their own hair or style it on their own, which is why it is so important to teach your child young.
Strategies for teaching children with visual impairments how to brush and style their hair:
Allow for extra time for your child to learn to brush their own hair during times when you are not in a rush.
Teach your child to brush his or her hair in a systematic fashion. This is a great time to work on the concepts of left/right, top/bottom and up/down. For instance have the child start by brushing their hair on the left from top to bottom. Verbally prompt him to move the brush over slightly to the right and brush from top to bottom.
Allow your child to explore different brushes and hair accessories and talk about what each item does.
Explore people’s hair styles by having your child touch appropriate people’s hair. I often have students touch my low or high bun, braid or hair when it is down to explain how hair can be worn differently.
Take your child to a store and explore hair products and accessories. This is easy to do at any store such as the Dollar Store, Target, CVS, Walmart, Walgreens, Rite Aid or stores such as those.
Describe your child’s hair to them. Describe the child’s parent’s hair to them. If the child ever got lost from their parent it would be helpful if they could say or explain what their parent looks like. For instance, my mom has long blonde hair and she wears it in a ponytail a lot. She is tall and has green eyes. That is a much more helpful description than “I do not know.”
How the O&M Specialist can help students with visual impairments brush and style their hair:
Scalp Massage Brush from Target.com
Talk about what their O&M instructor looks like by describing their hair.
Tell your child what family members look like by starting with hair color and describing what that color means to them.
Surprisingly as an O&M early in my profession I did not mention what I looked like to my students and some of my students thought I had red hair but I am really a brunette. Since I go in the community with them, it would be good for them to describe me if they are trying to locate me. As the child gets older, we O&M’s are often hiding out of view so that people in the community act naturally with our students. For that reason, it is good for our students to know how to describe us as well as family members.
This Scalp Massaging brush was recommended by a parent who tried it with her son who has sensory issues related to his head being touched.
7. I Can Brush My Teeth!
Applying tooth paste with a visual impairment can be tricky. Below are great strategies for helping your child brush their teeth. Vision Aware also wrote a blog post on applying toothpaste after vision loss.
Strategies for teaching children with visual impairments how to brush their teeth
Refrigerate toothpaste so that the person can feel it when it is placed on their hand, squeezed in their mouth or placed on their finger.
Teach your child to get his own toothpaste by squeezing some in his hand (palm is easiest) and having him scoop the toothpaste from his hand onto the toothbrush. That way he can feel what he is doing.
All younger kids might need additional brushing to get their teeth clean but let them try and work on learning anyway. You can always finish up brushing at the end.
Teach your child how to turn on the water so that they can access water to brush their teeth. Typically cold knobs are on the right and hot is on the left. Try using concepts such as turn the right cold knob to the right going clockwise or turn the left knob to 7 o’clock to turn on the hot. Children are never too young to begin introducing these concepts.
I have seen some teachers who apply toothpaste to plate and allowed the child to scoop it off the plate.
A softer toothbrush with wider handle might help a child who has sensory needs.
Keep all toothpaste related supplies in the same location so that the child knows how to locate them.
Consider buying toothpaste that not only tastes good but is easier to apply. You might try a toothpaste that you can pump for instance versus squeeze.
Talk your child through the process. Use terms and concepts such as bottom molars, front teeth, right top teeth etc to describe where the toothbrush needs to go.
Toothpaste squeezer from Amazon.com
Do hand over hand to teach the child how to hold the toothbrush and explain the motion the need to make to brush their front top teeth. For example, with your right hand have the bristles face towards your teeth and move your right hand left and right in motion so that you brush your teeth clean.
Consider buying a toothpaste squeezer for the toothpaste so that is stays more organized Tooth paste squeezers found from this link on Amazon
Make the experience fun and routine so that the child knows what is expected of them.
Purchase a musical electric toothbrush so that your child has an idea of what is the appropriate amount of time to brush their teeth.
Work on how to feel that the toothbrush is cleaning ALL the teeth.
There’s a newer product out called toothpaste bites. You can place the toothpaste bite or chew tab in your mouth, bite down on it and add a wet toothbrush. The toothpaste will foam up. You can of course buy this product on Amazon.
Consider buying a toothpaste dispenser. They also sell them on Amazon.
8. I Can Wash My Face with Verbal Assistance!
Strategies for teaching children with visual impairments how to wash their face with assistance:
Always discuss parts of the face so that your child knows where to touch. Allow your child to explore his face and yours.
Teach your child the function of each aspect of their face. For instance, “You have teeth to chew your food and a tongue to help you with chewing. Can you make the chewing motion? Can you wiggle your tongue? You have two eye brows, one is on the right above your eye and the other eyebrow is on the left. One purpose of eyebrows is to keep sweat from dripping into your eyes so instead the sweat drips to the side of your face and down your cheeks.” This type of explanation will better help your child identify what you are asking when it is time to wash their face.
Faces are our presentation to the world so it’s so important that you child understands that since they probably can’t use a mirror, they need to have awareness of whether they have a clean or dirty face by feel.
Teach your child how to cup one hand or two to gather water from a sink. First demonstrate with hand over hand. Next give him a chance to try and make the cup position with just verbal instructions.
Teach your child how to turn on the water so that it is not too hot to wash their face. Discuss how you make water warm. How you use the cold and hot knobs. Explore all the knobs and sinks in your home.
Teach your child to locate the water portion of the faucet by placing one hand on the facet so that he does not hit his face as he brings his head forward to wash his face.
Provide face wash that your child is successful at distributing to himself. Typically pump face soaps or bar soaps work best. You can buy an easy kid friendly pump soap on places like Amazon.
9. I Can Participate in Drying My Own Body After Bath/Shower!
This is a great time to discuss body parts so that your child knows how to dry them!
Strategies for teaching children with visual impairments how to dry their body:
While not in the shower, teach your child how to hold, move and place the towel in order for him to learn to dry himself. If describing what to do is not working, try teaching your child through hand over hand. Once your child gets the motion down, only verbally describe what they need to be doing so that he can be successful when the shower is done and still stay warm.
Start from bottom to top or top to bottom. So for instance, teach him how to dry his head and what to do with his hair. Have him move down his body and work on drying his torso and back, move to the hip area and move down to the thighs, calves and feet. You are teaching body concepts as you work on this!
10. I Can Participate in towel drying my own hair!
For individuals that have long hair, teaching the person to dry their hair might be more challenging than someone with short hair.
When discussing how to dry hair remember this is a great time to use concept language such as left/right, top/bottom, crown of head, back of head etc
Discuss how a person with long hair might want to wrap their hair in an additional towel and leave it rested on their head so that their hair doesn’t drip
Consider buying a smaller hair towel for individuals who want to place the towel on their head.
11. I Can Shower and Bathe!
One important factor in teaching your child to wash their own body is helping your child to identify the names of their own body parts.
Strategies for teaching children with visual impairments how to identify their own body parts:
Introduce body part concepts in all aspects of their life and every time you think of it. I have used massage for my toddler to teach her about her body parts and even muscle groups.
Listen to body part related songs such as head shoulders knees and toes.
Strategies for teaching children with visual impairments how to shower and bathe themselves:
Prior to getting in the shower, use lotion to teach your child how to rub soap across their body. You can try this with a dry loofah sponge.
Encourage your child to wash their body by themselves. stand in the shower, place your hands behind your back and begin talking your child through the process of washing their own body. Again, it’s another great time to work on concepts of left/right, up/down, top/bottom and body parts!
Teach your child how to locate the soap in the shower and keep soap in consistent locations.
If your child uses body wash, try using the pump version of body wash. Teach your child to pump the soap in his hand and then place in on the loofah or rub his hands together to begin washing his body.
Play a wash your own body parts song while your child showers.
Additional Resources for teaching personal hygiene to children with visual and multiple impairments.
What personal hygiene skills do your students work on? What are some of the strategies that you use? Comment below and let us know!
