Bath time can be stressful, confusing, upsetting, and a challenge for all parties involved. Not to mention the added concerns over safety.
It is very common for children with autism spectrum disorder (ASD) to react negatively to activities related to personal hygiene and cleaning. In those instances where a child is also diagnosed with sensory processing disorder (SPD) the issues are only exacerbated.
Consider brushing their teeth.
Overcoming tooth brushing struggles with autism is no small task. The weird smells, tastes, and feelings alone that come with brushing are enough to make the whole process off-putting. But whether the challenges are related to sensory issues, conceptualization hurdles, or difficulties staying on task, it is something parents and their children need to resolve, together. Bathing and showering are no different.
The first step is being fully aware of the challenges you are facing. Although bathing and showering is second nature to a lot of us, when we really think about it, there is a lot going on in that tub. Your child with autism is very likely fully aware of all of them. This means there are so many things to consider from the child’s point of view that could make them dread bath time.
They can include:
Fear of the water
Distress over the water being too hot, cold, high, or low
Aversion to air temperatures after getting out
Disorientation from being in a small confined space
Difficulties maintaining bodily control on slick, glossy surfaces
Instability from stepping in and out of the tub
Panic over the plughole and all the abnormal sights and sounds that occur once its unplugged
Making things even more frustrating is that sometimes kids have a great time in the bath, only the next time to hate it with extreme prejudice. Maybe a child will even grow out of an initial dislike of bathing, only for it to return a few years later or when puberty hits and the need for showering increases tenfold.
Enhancing the challenge even further is the inability to properly communicate. It can be especially tricky to calm, orientate, and guide your child through the process when they’re too worked up to listen or talk.
And once you get stressed, the challenges snowball from there.
So to say the least, bath time with autistic children can be a roller coaster. It is important to know all of the fears or challenges your child may face before focusing on how to address it.
Special Sensory Issues to Consider During Bath Time and Overcoming Fears
There are the added complications of sensory processing issues faced by so many children with autism every single day. For instance, consider the sound of the water gushing into the tub - seeming to bounce off the tiles and the sink, echoing within the room with the potential to be overwhelming to a child with autism. It is important to focus on sensory challenges to try and understand possible triggers for your child.
If your child also has a diagnosis of SPD, this could intensify bathing challenges in the following ways:
Bright bathroom lights
Mirrors reflecting illumination
Rough textures of the washrag and towel against sensitive skin
The feel of water on the skin, hair, or face
The slippery slickness of the tub’s surface
The smell of soap
The slimy feel of shampoo
That’s a LOT of sensory input to the process, especially when it occurs in a very short period of time.
Bath time towel and robes
It is little wonder bath time can turn into a terrifying situation for a child with autism.
The brains of autistic kids simply aren’t wired to be able to process all that information quickly enough, and the result is often feelings of fear or extreme distress. Their “flight or fight” responses may instinctively arise to protect themselves from these unpleasant sensory sensitivities.
This is when you’re likely to encounter resistance, tub meltdowns, and a total refusal to cooperate.
Ashley Lavoie is a mom of three and manages both child and adult ADHD and neonatal diabetes. She is advocating for awareness and loves writing and connecting with other families like hers.
Editor's note: This information is not meant to diagnose or treat and should not take the place of personal consultation, as needed, with a qualified healthcare provider and/or BCBA.