Autistic Hygiene

I think I should have written this post a long time ago because hygiene tasks are such an important issue for parents of autistic kids to understand, and for autistic people themselves to understand as well.

Note – As someone in the comments graciously pointed out to me, and what I should have mentioned originally in this post, is that I am a white person which affects specific hygiene experiences, especially showering and hair care, so please keep this in mind regarding any advice or suggestions in this post.
It’s important to note that hygiene tasks are often different for people of color, especially regarding showering and hair care. Please keep this in mind, and reach out to autistic people of color for suggestions and for their own experiences on hygiene and hair care.

Why Hygiene Can Be Difficult For Autistic People

Hygiene tasks intersect with so many different aspects of cognition, listed below –

One, it’s a task that (we are told) needs to be done consistently, whether it be everyday, every few days, or even every week. Doing something consistently takes planning.

Two, because it has to be done so often, one has to transition into and out of that task very often. Task-switching can be quite difficult for a lot of autistic people, both due to executive function issues, as well as autistic inertia and hyperfocusing.

Three, each hygiene task uses a lot of executive functioning and is actually a lot of steps. Most neurotypical people may not even notice how many steps brushing your teeth, taking a shower, or even just changing your clothes can be. But it’s a lot. And that can be overwhelming, especially for any autistic person with executive functioning issues.

Four, each hygiene task relies on motor planning and movement. A lot of autistic people have co-occurring physical disabilities, such as dysgraphia (which could probably make brushing your teeth difficult for example), hypermobility, hand-eye coordination disabilities, or generally poor balance. A lot of these disabilities may not be diagnosed at all. Autistic people may find it difficult to actually physically do what is needed for brushing their teeth, or worried and anxious about falling over when taking a shower.

Five, which is what I’ll talk about the most here, and what I always talk about – sensory sensitivities. Hygiene tasks are a ball of sensory input. Consider showering – this involves multiple temperature changes, being wet/water (each droplet can feel like a needle on your skin for some autistic people), sensory environment of the bathroom (cold tile floor, loud fan on), sound of the shower, touching metal, drying off with a towel (fabric may be scratchy), more temperature change with a hair dryer (very loud for anyone with hyperacusis), wearing slightly damp clothes, and if you didn’t dry your hair, shivering when going to bed or for the rest of the day because it is so cold.

And that’s just one hygiene task – A very common task that parents often say their autistic kid refuses to do, or doesn’t do as much as they’d like.

Consider reading that whole section above one more time, and then think about just the shower part – doing that every other day for years and years and years. Does that sound easy or pleasant? And that’s not even counting the willpower and energy it takes to stop doing a task you like to do and decide to do that hygiene task instead.

I’d Rather Write This Entire Blog Post Than Take a Shower

You read that right! I am currently, instead of showering like I needed to tonight, writing this blog post! Because it is easier for me to write an entire blog post for an hour, than will myself to do all of the tasks necessary to take a shower.

Here is a break down of all the tasks that have to be done to take a shower:

  1. Get out of chair
  2. Look for new clothes to wear (really 2 steps here to find them)
  3. Put clothes in bathroom
  4. Turn on bathroom light
  5. Make sure there’s a clean towel
  6. Make sure the clean towel is in the bathroom
  7. Go to the bathroom
  8. Wash hands
  9. Turn water on
  10. Wait for water
  11. Check if water is warm enough
  12. Wait longer
  13. Check if water is warm enough now
  14. Change clothes
  15. Get in shower (temperature change)
  16. Wet hair
  17. Open shampoo bottle
  18. Tip shampoo bottle over
  19. Put shampoo bottle back
  20. Wash hair
  21. Use soap
  22. Rinse hair
  23. Turn off water
  24. Grab towel without opening shower curtain (Temperature change if mess this up)
  25. Dry off with towel completely, dry hair
  26. Wrap towel around
  27. Get out of shower (Temperature change)
  28. Dry with towel again to be slightly warmer
  29. Put new clothes on
  30. Put towel back
  31. If long hair, brush hair with Wet Brush to get knots out (so scalp doesn’t hurt), dry hair more with towel
  32. If long hair, hair’s still wet (Temperature change)
  33. Put old clothes in laundry hamper

And I’m sorry, you want autistic children to do this every other day? It’s exhausting!

Something I wish I had known earlier is that some people have very dry skin, so showering everyday or every other day can actually make their skin worse, drier, and more painful. This is actually a big reason why I didn’t want to shower so frequently, and it wasn’t even an “autism” thing! Though some autistic people can’t use lotion regularly due to sensory sensitivities as well.

And if you have physical disabilities as well, showering can be even more tiring than for an abled autistic person (yes, I have even more steps than what is listed above).

Showering Alternatives

Alternatives to showering could be as simple as a wet washcloth with soap on arms and legs, making sure to use deodorant, washing hair in the sink to reduce number of steps, or dry shampoo. If showering’s possible but not very frequently, one could alternate between wet washcloth days and showering days so it’s not as taxing. Some people may choose to take a bath instead as well, though it has the same temperature problems as showering does for the most part. Some autistic people have found that showering with a shower cap, and only washing their hair on some days but not others, cuts down on having sensory overload. If an autistic person can’t deal with water getting into their eyes, they could try wearing swimming goggles when showering or bathing.

Teeth Brushing

Sensory sensitivities for brushing teeth include the toothpaste, which is often way too minty for many autistic people and feels like your mouth is literally burning (imagine using alcohol to brush your teeth, that’s the best equivalent I can think of). And the other big one is the type of bristles being used. Some autistic people have a huge problem with traditional bristles on brushes, and how they feel against their teeth, similar to how many autistic people have texture sensitivities. The good news is that there are a lot of alternatives to standard toothbrushes, and a lot of alternatives to minty toothpaste.

For toothpaste, I used bubblegum flavor even through college, until I found a mint toothpaste that wasn’t so minty and didn’t burn my mouth (fun fact, some people, including autistic people, can actually be allergic to an ingredient in mint toothpaste! I don’t but some autistic people do have this allergy).

One other issue could be the temperature of the water that the autistic person is brushing with. It could be that cold water is worse than warm water, or vice versa.

Teeth Brushing Alternatives

Here’s a list of different flavored toothpaste that are quite easily available now –

  • Strawberry
  • Chocolate
  • Cinnamon (this can be burn for some autistic people, useful for other autistic people)
  • Bubblegum
  • Pineapple
  • Blueberry
  • Flavorless
  • And many others (even Pina colada flavor, apparently!)

Here’s a list of different types of toothbrushes (not endorsing any products here) –

  • Silicone finger toothbrush – has different types of bristles than traditional toothbrushes
  • Nano toothbrush or Micro toothbrush – toothbrush with very small and very soft bristles
  • Electric toothbrush – may have different feel on teeth than manual bristles
  • Autobrush – a retainer-like brush that cleans all of your teeth at once

For more on teeth brushing, check out NeuroRebel’s post here.

See this twitter thread for other options of toothbrushes and toothpaste and strategies.

Other things to do in conjunction with brushing, or especially if the autistic person can’t brush very much – See if they can floss (may have to get the non-minty and non-wax kind), use mouthwash, or even use a water flosser.

Fingernails, Haircuts, Hair Brushing

I won’t go into detail on fingernail clipping and haircuts in this post, but I know this is a really common question from non-autistic parents of autistic kids. I’d just advise to try to figure out what’s going on – is it a sensory sensitivity to rough skin for toenail clipping, a sensory sensitivity of feeling all the individual hairs fall on their neck for haircuts, the sound/feel of the nail clipper, or the sound of the haircutting clippers? Maybe the autistic person needs to wash their hair after each cut of their hair so it doesn’t bother their skin, or cut their hair leaning over so it doesn’t fall on them. Maybe the autistic person needs to only trim their toenails after they shower so their skin is softer and doesn’t bother them when they touch it. Maybe they need to be in control of the nail clippers or the haircut scissors/clippers so they expect it. Maybe they need to see someone use it on someone else to get familiar with it. There are a lot of things to consider when trying to figure out what works for one autistic person.

For autistic people with long hair, getting knots out can be really hard. I’d highly recommend using lots of conditioner where the knots are when the hair is wet, and only brushing the hair through when it’s wet, with a Wet Brush (not an endorsement for the product, but as someone with scalp sensitivity who had long hair for a long time and lots of knots, the Wet Brush certainly saved me a lot of anguish and tears), or any other brush that doesn’t pull on the hair as much. Using ponytails, headbands, or braids, if possible, can be a decent way to prevent knots or maintain hair between hair washes, though it can sometimes cause scalp tension, headaches, or pain from hair being pulled back so tight.

To Autistic People Who Struggle with Hygiene:

If you’re an autistic person, or disabled person in general, who struggles with hygiene tasks –
You are not bad or wrong for having greasy hair.
You are not bad or wrong for smelling.
You are not bad or wrong for having teeth problems.

Hygiene is something our society places a lot of value on, too much in my opinion.
It is so hard for autistic people to do these things, and I don’t think non-autistic people can understand just how hard it is for us.

Please don’t place your worth on how put-together you look or whether you do X/Y/Z hygiene task that day.

Would it be nice if it was easier? If you could do it regularly? Sure, of course it would!
But there’s nothing wrong with you for not being able to. It’s okay to just not have the energy. It’s okay to have not solved the reasons why you can’t do it yet.

I hope you find a solution. I hope you find alternatives that work for you. And yes – it is absolutely okay to take a day off of your regular (or irregular) hygiene schedule sometimes.

To Non-Autistic People:

If you do not personally struggle with hygiene tasks, please remember that many disabled people do. Please remember that not doing these tasks can lead to bullying at school, and even being passed up at job interviews. And that disabled people don’t deserve that.

The judgment and quick assumptions people give disabled people who show any ounce of poor hygiene honestly can ruin lives. At the very least, it can make people feel shame or guilt for not being able to shower or brush their teeth as often as they are “supposed” to by societal standards. Please remember this article when you see someone with greasy hair, or that someone smells. Remember that there are a lot of reasons that people may not be able to shower frequently, and I’ve definitely not listed all of the reasons here. There are a lot more.

So, to non-autistic people, I say – Please be kind.


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10 Replies to “Autistic Hygiene”

  1. This is great. Thank you. I do want to point out though that some of these hygiene tasks are specific to a white person. Black folks definitely need to use lotion/oil right after showering, many with natural hair don’t shampoo often or at all, conditioner or oils need to be added to the hair, and combing or brushing wet natural hair will break it. Folks might have a style they don’t get wet, so a shower cap would be one step in this case. Most kids are going to have their hair protective styled, so they wouldn’t be combing or brushing, but would need to squeeze water out of braids/twists.

    Liked by 5 people

    1. Thank you for pointing this out! I should have stated (and will add at the top as well) that this is from the perspective of a white person and may not be what non-white people need in terms different types of hygiene tasks.

      Like

    2. For some reason I have the same skin and hair routines, and learning how black people do it was a revelation. I figured out somewhat late (not before developing eczema!) that my skin and hair need oil straight after washing, and I don’t wash my hair at all now and it stays completely clean. In winter I need to add oils to it every day. My skin and hair are very dry and my hair is very thick and also curly/wavy, as well as being fine. Only now in my thirties am I able to keep my hair healthy and not need to keep it short, due to having initially learned white peoples’ hair care! Shampoo or even conditioner just destroy it 😐. And my skin is now completely intolerant to soap lol.

      Liked by 2 people

  2. I had to smile at your list of all the chores to be done before a shower and you are so right! That said, I’ll confess I’m a shower-freak. I sometimes take 2 a day and I wash my clothing every other day. My roommate, also ASD, is the opposite. But I will tell you what I’ve done to decrease the steps. I have a backpack in the bathroom and during the course of each day, I put a clean set of underwear and other necessaries whenever I go into the bathroom. I wear the same type of clothes so I own 7 black tunics, black leggings, black boots, and so there is no decision there. I stuff them in the pack also. Because I seem to pee so much I make many trips to the bathroom and that makes it easy to bring stuff in like pads, etc., and I have my deoderant and stuff like that on a shelf so never have to worry about that. You are so right that it is very difficult to do all these chores before a shower. People don’t understand it but most of us neurodiverse do. I think it helps that I’m now old and retired and have more time to get through the day. When I worked I used to break up my chores into Joseph Campbell’s Hero’s Journey. Threshold crossing, dragon slaying, brother battle, etc. I especially did this when driving to work. Wishing you all the best, and I understand…

    Liked by 2 people

  3. One of the most kind and comforting things I’ve ever read. I could add many more dislikes to the shower list…but won’t. ; ) Thank you for your kind explanations so that more people “get” us.

    Liked by 2 people

  4. It’s amazing the number of times I can get in the shower, wash hair, condition hair, and then get out.. not realizing that I still need to do body wash or face wash. At least after that point, I’m compelled to do my lotion skin care because I hate hate hate the drying feeling after a bath and simply NEED to put lotion on my face, hands, and feet at minimum. Also shaving is such an effort too.

    Liked by 4 people

  5. Yes! I used to only take baths, then I moved and I literally googled “how to take a shower”. I still sometimes feel I do it wrong somehow, like in what order do you wash which part, how do I know the shampoo is fully rinsed out if I can’t see clearly? And I knew executive dysfunction makes it hard (I definitely have to think about all the steps) but I’m just now realising how sensory issues go into it as well.

    Liked by 2 people

  6. I’m sorry but… how do you know there is a clean towel in the bathroom if you’re not already in this room?
    Like, how do you manage to do 6 if 7 is not done yet?
    (I assume the list is in chronological order.)

    Liked by 1 person

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