Healthy Hygiene

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Transcript

GMT20240515-210515_Recording_as_2256x1504: 0:07

I will be presenting a little different than the typical standard of what I do for those of you who have joined us before and seen me present I will be going away from the slide and back to the slide, but just 2 or 3 times. So I just wanted to give you a warning for those who need just a little idea of what to expect visually with the changes. So we are here to talk about hygiene and puberty. Hygiene and puberty help is really what I hear parents say, right? I don't know what to do. Oh my gosh, the things they used to do, they don't do anymore. And so there's all of these dynamics and it's really a tough time. So in terms of hygiene and puberty and help you are here to learn about those challenges, but what can I do? Help. It's puberty. It's just not fun. That's the first step. Admitting that puberty is not going to be the fun part of parenting. I like to think of puberty as is. They're toddlers again, but they're bigger and smellier. And so it's just a little bit more complicated. And they're not as cute as toddlers. So it's a little bit of a different dynamic, but it's the same thing. And just a little bit about who I am. My name is Stacey and I am a strong believer in the impact of parent empowerment. And I think parent empowerment leads to us shifting the perspective on autism so that we can have more inclusive environments. I am an autism educator. Of course I advocate for the disabled community specifically, or should I say mostly for my neurodivergent, divergent community. And I am considered an ally of the autistic community. And I appreciate everything autism. And I say that in terms of, this is a journey for parents, in terms of understanding the diagnosis. And then now you're at a new developmental stage of puberty, which is startling. And it's different for every kiddo. And so it's a journey to getting to that point where you can breathe. And it's okay. I accept, but Oh, I have to like, take on puberty. And so you're Starting all over again because it can be challenging. So what we're going to do in this presentation is explore the dynamics between sensory processing and hygiene needs, because there's a little bit of overlap everything goes back to sensory when we're talking about autism. However, puberty adolescence and hygiene can significantly be impacted when it comes to sensory challenges. for our autistic kiddos. So we're going to uncover some of those unique challenges. And then I will share some practical strategies so that you can navigate your daily life, meeting the hygiene goals you have for your child. And I say, Goals you have for your child, because most kids don't have their own hygiene goals, right? They're just kids. And of course, we'll have some Q and a time. So you'll have time to connect with other parents and learn from them. All right. So let's talk about why we're here. And this dynamic of, teens versus parents. And I put that because the reality is. It pretty much is the parent perspective versus the teen perspective, right? You may think that they don't smell or their room is not messy or they look unkempt, but their perspective is very different because they are teens. They are coming into their own. They are. Toddlers that are bigger and trying to see who they are and stay in their ground and figure out who they are as an individual growing into that emerging adulthood, which can be a little scary. So one of the things that we have to talk about is the team versus parents around motivating factors. What we have to do, and a lot of these strategies that I will talk about are caregivers coming into an understanding of why you're having these challenges. And then that reduces your frustration and angst a little bit and then we can implement those strategies. So understanding the motivation is different. Teens are motivated by different things than parents are motivated by. And a lot of times, Parents and caregivers and therapists will say, okay, I have this external motivator, right? You get iPad time or game time or whatever their favorite activity is. If you take a shower, right? Let's say you have a kiddo who's not taking a shower. That may not be motivating to them enough for them to do a shower. So we have to remember, it's not always they don't want anything. They won't work for anything. It's you haven't found the right motivating factor and you have to think outside of what parents are motivated by and figure out what. Your team is motivated by, and it can get tricky. However, I'm going to share an example for context, which will get you thinking about your own individual kiddo in terms of. A shower, which is a very common challenge in terms of autistic teens, neurodivergent teens. They won't shower or right before puberty. They stop wanting to shower. They don't want to take a bath anymore. And before they wanted to take a bath all the time. So that within itself is a challenge because it's something new for parents, and it wasn't something that you were expecting. But thinking in terms of that motivating factor, you have to figure out what they're going to be intrinsically motivated by. Because even if you use reinforcements to shape and shift the direction of a behavior. It's not sustainable long term. So you've got to build in some internal motivation, especially with teenagers, because they're strong about standing their ground. So I had a kiddo and I just happened to be at the home and mom was directing him to go and take his bath and he came out and said that he took his bath and it was very obvious that he did not get wet. And Very obvious, right? So mom questioned him about whether or not he took a bath and if he used soap. And of course, as a teen, he said yes. So I told mom, let it go. We're going to marinate on this for a second. And I explained to mom. And then when he came back into the room, I said to him, so you were talking to me earlier about wanting to ask a few girls to the homecoming dance. This fall. Yeah. Yeah. Yeah. Yeah. I said, you talk a lot about, girls and you want to meet this girl and you want to have a girlfriend, your senior year, all of these things about girls. Oh yeah. He got really excited. I said, well, girls majority of girls, but the girls that you've shown me pictures of and the girls that you talk about, most girls like when boys smell nice. Yeah. Most like when boys smell nice just letting you know that girls like it when boys smell nice, they don't really like to be next to boys who smell stinky immediately. He was motivated to go take a shower and use soap. Why? Because his mother wanting him to take a shower so he didn't smell. Was not intrinsically motivating to him, but the girls wanting to date a boy who smells nice was already a motivation. Because I knew what he was motivated by, which, not unreasonable for a 16 year old male but he made the connection. And he decided whatever it was that was not preferred or internally motivated about the shower, meeting a girl was far more important. And he was going to take a shower and we haven't had any trouble with showers since. When we talk about the motivating factors, that is very important to understand. We often get caught up as parents and trying to motivate our children around things that we, as adults know are important and for teens. That's a total contradiction. Even if a teen knows that you are correct, they're going to disagree with you simply because That's what teens do right? Autistic or not. That's what teens do. So then we go into those developmental factors, which is exactly what I just said. The developmental stage of teens is preparing for independent adulthood. And if we think back before the days of college and work and retirement in a home, it was prepping for a family. People got married much earlier. So teens developmentally are designed inherently hormonally to want to be their own toddlers, just bigger and smellier. So we have to keep that in mind. You have to remind yourself, oh, they're a teenager, right? You have to get your support system so that you can get through the teen years, because that's just part of what they are supposed to do developmentally. All right, we're looking at motivating factors. We're looking at developmental stages. And then we have to remember teens versus parents. What do teens care about their peer approval? What parents care about good grades, clean room, being polite, all these other things. Teens are motivated by peer approval. You're no longer the everything to your child when they hit that puberty stage. I know it's difficult sometimes. And I'm not saying that your teens don't love you. I'm not saying they don't need you. I'm not saying that they don't want to be with you. But we have to remember that peer approval. Far outweighs parent approval when it comes to teens, that's why they do the things they do. That's why they break the rules. That's why they take risks. That's why they go against your wishes because what their peers think is so much more important than what their parents think. That's part of it because what are they prepping for going into the world on their own, right? Going into the world on their own. So you have to have a sense of self, right? And you're going to be with your peers. You are going into the world as a young adult. Not hanging around your parents, right? You're going to do what your parents did and hang around your peers. Remembering and keeping in mind that peer approval is. More important than parent approval, and I will give a scenario for context. Usually hair is a challenge, right? Whether it's growing your hair too long or teenagers growing their hair too long, wanting to color their hair, teens wanting to cut their hair, shave their hair, wanting to wear their hair in a certain way. Wanting to have a beard, wanting to have a mustache, not wanting to have those things. Those are the things that teens possibly may want to do and make decisions about once they get to that pubescent stage. And often it is in contradiction to what parents expect and want for their child. And we have to pick our battles, right? I always say hair, And I learned this from another mom hair can be changed. It's not permanent. It can be cut. It can be shaved. It can grow back. It can be changed. The color can be changed. Hair is not permanent. So pick our battles. However, we understand smelly hair can be a little. Offensive, right? And gross for everyone at the table and those who are in public. So thinking in terms of that peer approval, adults may be looking at and giving feedback to a teen about your hair is oily, your hair is too long, your hair makes you look this way. But if their peers think they're cool, if someone they're attracted to thinks they look good, if, a very basic example and I'm not trying to be stereotypical. However, this is an example that I had with my own Children. My boys wanted to grow out their hair. I didn't like it and. I didn't like it, who liked it? The three cheerleaders, they loved it. So guess what? It was a battle because the cheerleaders love their hair. Who are they trying to impress the cheerleaders? They're not trying to impress me. So when we remember that it's easier for us to think of the strategies of not getting into those battles and picking those battles using supports, right? Not just jumping in and trying to convince them or I am the parent. And that just makes all teenagers go the opposite direction. I'm not saying. That you should not be in charge of your household. I am saying we have to use communication strategies and we have to understand the motivating factors, the developmental factors, the hormonal issues that our teams are experiencing so we can have that open communication and be able to reach them and have those conversations that we need to have. That's all I'm saying. And then when you think about an autistic kiddo, we get into the sensory challenges, right? And those often go unnoticed for several reasons. One, typically the occupational therapist or the school doesn't think to do an updated sensory profile after puberty. It's necessary. Your child's body's changing girls and boys, their bodies change when they hit puberty hormones, all kinds of things are happening. New neurosynapses, new things are happening with their body and it feels. Uncomfortable, creepy and yucky, and it's new sensory information for their system to process. So sometimes you don't notice these changes until you have escalated. Inappropriate behaviors, right? And I do air quotes because it's inappropriate, but it's a response. It's not a behavior that they're choosing. They're responding to the sensations that they are receiving and how their body is processing the environment. So remembering that things like pubic hair leg hair, mustache, and beard hair, that is a new sensory experience. Let's say that They shave their legs or their beard or a mustache for the first time. Hair growing back is a new sensory experience. It can feel very uncomfortable for a lot of autistic teens. And so they are going to resist. Some of those hygiene tasks, they're going to push back because they are responding to the sensory information they're receiving. And our human instinct is to keep our sensory system. Safe. No, 1 jumps into an unsafe sensory experience willingly without something highly motivating. Making you do it, if it's going to be a risk or discomfort, right? People don't live in hot places because they don't like the sensory experience of heat. And this has nothing to do with autism. This is in general of human instinct. But if we put that together with an autistic individual who has a lot of sensory processing. Overwhelming experiences, then that's a lot during puberty. So pushing back on things like shaving their mustache, or shaving their beard, or cutting their hair, or anything that maybe the school demands, or if the church demands something, You're going to get pushback if you're not addressing the sensory changes. Just a tip to get an updated sensory profile from the OT or ask your child's school if that's something they provide because things change. Their body is changing. Significantly, their body is changing. The other dynamic is the stinky kid, right? And I'm just going to put this very simple. As one autistic college student told me, everyone says that I stink, I just don't smell it. I guess I just got used to it. It's really that simple. When you're saying as a parent. You smell, versus the teen who says, I don't smell anything. It's hard to convince them, right? So that's why we want to talk about the strategies to avoid getting to that point. The other part is, and I think we don't often think about this, and that is the, overwhelming responsibility that puberty brings, and I think that most of us don't think about it in that way because it's just what you have to do, right? And some families don't talk about it. And sometimes it's a secret and sometimes it's shame. So lots of overwhelming responsibilities around puberty, menstruation for girls erections for boys. That's a lot of responsibility. You are telling and prepping girls for the responsibility of taking care of their needs once a month when their cycle appears. Which is not fun for anyone, no matter what age you are, but you're telling a pubescent. Girl, this is going to happen. It can be very overwhelming for an autistic individual who's already overwhelmed with trying to manage everything that's expected. The other part is the overwhelming responsibility of responsibility, right? Now you have to put on deodorant. Now you have to shave. Now you have to do that more things on your list of things to do. Now your visual schedule looks overwhelming. It's a lot. So if we think about why we have this team versus parents, that is the foundation for those challenges, right? Then we can attack them from the proactive standpoint of saying, okay, I'm aware of these things. I'm prepping for these things. And how do I communicate to go around these things, right? Of motivation, developmental wanting to please their peers. Oh, my goodness. The sensory challenges Hormonal smells, right? And then how do I balance that? My child has to learn the responsibility because they are going to grow into an adult and they're going to have to take care of their personal needs. It's a lot, it's a lot. And I think that sometimes even with boys with erections and we say, this is what you can do, this is what you can't do. And now we're giving them a responsibility of being, for lack of a better term, sexually responsible. And it's whoa, that's a lot, right? It's a lot. Thinking of this in terms of this is what's going on behind the scenes. And then you have the challenges that. Are within the scene. And that's those potential areas of difficulty that contribute to the poor hygiene, right? And we all know the challenges are around somebody smells. That's the biggest flag is. They smell right? They smell the rim smells. They don't wash their clothes. They don't change their underwear. They smell right? And it's offensive to everyone except the individual who smells. So that's where we're battling that. It's not reinforcing for them to change, but it's highly reinforcing for the other people that they take care of their hygiene because it's an uncomfortable sensory experience for the other people, right? Whether they're autistic or not, when people are smelly, it's offensive because your nose says yucky. That's the message that you get. All right. So if we think of those areas of difficulty, it's the sensory challenges, right? It's the sequencing and following direction. It's the time management, right? All of those things are impacting. And resulting in poor hygiene. Let's talk a little bit about what that looks like. If we think about sensory challenges, we can think about the concept of. Feeling different fluids go through their body during an erection or doing, and this is puberty, right? These are the things that we have to talk about. This is the biology of our bodies, right? Young boys often during purity because testosterone levels are high. They have erections that just spontaneously appear, right? They have ejaculations that are not controlled. It just happens, right? It's something that we have to talk about because it is a different. Sensory experience when girls start their cycle, it is very overwhelming for all girls, but it is extremely overwhelming for someone who's already challenged with pubic hair as a sensory problem, right? What is that sensation down there? I don't like it. It's very uncomfortable. I want it to go away, but if I make it go away, it comes back. What do I do? And then you have this once a month thing that occurs that is uncomfortable on lots of levels. And I like to share stories and I'm going to stop sharing briefly. This is one of the back and forths and what I, so I want to share this story in reference to, I was working with soon to be 11 Set of twin girls who are autistic and we were prepping for puberty and menstruation, right? And what does that entail? What are your responsibilities and what's happening to your body? And we had social stories. And so we talk about it. We have these really appropriate videos that I think I'm going to put into the resources. But in the end, one of the girls. Looked at me and she said, so does this mean that once a month I'm going to bleed from my vagina because I don't have a baby in my tummy? I said that pretty much sums it up. And she looked at me and she said, I don't think I like that very much. And I said join the club when it happens, right? It's not the favorite time for most girls, teens, women. However, it is a part of life and how we Bring life into the world. So it is what we have to prepare for, but it is the reality, right? And I share that story because I thought it was wonderful that she understood the concept on a level she could understand it. And when she has questions, she can ask questions and it is going to be a curb. Progressive way for her to go into puberty prepared, right? Because we're starting ahead of the game. If we don't start ahead of the game, it doesn't mean that you can't implement those strategies. So we have the sensory challenges of all of these body changes that are happening. Our Children. Even if they have a way to communicate, that's efficient, whether it's or verbal or any other means of communication. It doesn't mean that children have the vocabulary to articulate. I remember a young boy not wanting to go to the bathroom. When he hit puberty, not wanting to eliminate his bladder at all. And it became a problem because bladder infection, all of these things. And it was urgent that we address this, but he was really resistant. And he finally was able to articulate that he didn't want to go to the bathroom because this was new, right? This was not something that was a behavior that we saw before. And he simply said, I don't want that funny feeling in my penis anymore. And then we said, what funny feeling? And he said, the one that woke me up in the middle of the night, and then now we have this connection, right? We know what can happen when boys are in puberty and they're sleeping. I think the term in the States is a wet dream. Sometimes that sounds a little slimy, but it is technically what's happening. And so thinking in terms of how scary that is, It was a discomfort to him, and he didn't want to experience that again. And his way of feeling like he had control over feeling sensory safe was, I'm just not going to let any fluids. Out, right? I'm just going to hold them in. So thinking of the why is important, right? And I know we have the basic functions of behavior of the why, right? Oh, it's sensory based. Why is it sensory based? What's really happening? Let's dig a little deeper and figure out how we can help them through that. Then we go into the concept of sequencing, right? And how sequencing can be, difficult when kids hit those teen years, right? Because sequencing is, Something important in terms of we have routines, they're doing routines. Yes, I have these tasks, but now we're adding more to the sequence. Now we're adding more tasks and responsibilities and we're adding them when what is changing, what is raging. Hormones, brain fog, memory loss, right? Discombobulated, disorganized brain in terms of sequencing can be off, right? Because one of the things I hear often from parents is, we didn't have this problem before. Yeah, you're right. You didn't have this problem before because they didn't have raging hormones, right? They didn't have body changes. They didn't have things that are impacting their sensory system and impacting their thought process. Because they weren't in puberty, so if we know that sequencing and following directions can become difficult for our teens, then we can prepare for that, right? We can implement strategies and that's our next slide that we will talk about, but knowing and understanding that the sensory component, the following directions, the sequencing is all impacted. By hormones, it just makes things insane, right? It makes things insane. So knowing that, what are we going to do? What are we going to do? We address the sensory challenges. We. Become aware of the fact that sequencing and following directions may be difficult. They may be struggling with remembering things that they used to remember and that we're adding on more, right? Because there are more deodorant. It may be even having to do shaving or some different skin treatments, right? For acne. The other part is time management. All of these things, sensory hormones, sequencing impacts, time management, executive functioning is impacted, and it's a struggle. It's a struggle to struggle for parents because they're not getting things done in a timely manner. Their body clock is saying to sleep in because they're teenagers, but school starts early. So there's a conflict right there. So the time management is impacted. And these are the top 3 that I feel are the areas that really contribute to the result of poor hygiene. In regards to what we know is important, because the reality is, poor hygiene can lead to health issues, right? Poor hygiene can lead to mental health issues. If you have social isolation, poor hygiene can lead to lack of a job opportunity, which can lead to mental health issues because they're not feeling like they are contributing and they have control over. What they want to do, because they don't have a job in their own money. So understanding the significance of a hygiene is something that all of us don't have to get a training on. But. The autistic teen is not thinking that way. They're not making that connection because they're teenagers. So we have to understand their perspective and what could be impacting and then figure out how do we implement those strategies, right? How do we implement those strategies? The best way to implement strategies is to be proactive. But even if we have to react, we still use the same strategies. We just have to implement them in a different way, right? Or with an intensity level so that we can counteract any more reactions. Visual supports. Now, visual supports is something that a lot of times either older kids push back on because it looks so babyfied or parents think they don't need them. Therapists and teachers think they need to wean them off of visual supports, but visual supports are Perfect for all ages. We all use our phones, our calendars, reminders, alarms to visually support our daily schedule. We use visuals on the road when we're driving. We use visuals when we're traveling to know where to go. So visual supports can be very helpful. They just look different for older kiddos, right? You need to look at the child, what they gravitate to, even though they like dinosaurs. Maybe they don't want dinosaur pictures on their visual schedule anymore. Maybe they think a visual schedule is babyfied because they don't want to do Velcro dots. Fine. There are tons of apps to help support daily schedules and daily routines. Visual supports, right? I love it. Even the AI things we have, right? Siri. And I think it's Amazon has Alexis. And then I think Google has something. So thinking in terms of visual supports can be used in various ways for older kiddos. And just looking at that as a way to help support those prompts for remembering to put on deodorant, to use the soap when you shower, to rinse out, The conditioner or the shampoo before you put the conditioner in, right? Those little things. You don't want to stand in there and remind them. They don't want you to remind them. Visual supports laminate and stick them on the shower door modeling the other part of hygiene and all of those things is modeling. But I will say the modeling from the parent is not always received. As well because that's the parents, right? That's the dynamic, but if you use modeling, if you have access to maybe older cousins or cousins, the same age, or maybe if you have a family or parent group that you, a community of folks that you hang out with, let the other teens model the healthy hygiene, right? That's where that, I have your peer pressure comes into play, right? The cheerleaders can be just as impactful with messy hair as they can be with clean hair, right? It may be long and messy. But maybe they can impact the cleanliness of it, right? So thinking about that peer pressure and how you can use your community support systems, even talking to the school counselor to see if they have any ideas or any tips. Modeling is good. I just find that when it comes to teens, it's better received from other teens because it just is. Reinforcements are always helpful, but tread lightly because teenagers tend to ask for, Expensive things if you don't set those boundaries and remember that reinforcements are not sustainable. When you're looking at that extrinsic reinforcement, always keep in mind, you're using it to shift to change to jump start a change in their behavior, but have a plan to fade it out because you can't sustain. Going to the store and getting a new game every week, right? Because they took a shower. Intrinsic motivation. Remember I talked about figuring out what is it they're already intrinsically motivated by, even if it's something long term. And I will give an example. I'm watching the time so we can have time for questions. But one of the examples, I did share one earlier. Another example of intrinsic motivation. Is a kiddo who was not really interested in, changing their clothes. They wanted to wear the same clothes, which is fine, right? You can wear what you want to wear. They took a shower, but they would wear the same thing. They had it. In 3 different ways, and they washed and that's what they wore, right? Fine. Whatever floats your boat. Lots of people wear uniforms. Lots of people wear the same style every day to work. I get it. However, they also wanted to get a summer job. The summer job required different clothes, right? You can't wear a tank top and basketball shorts. To a job interview or on the job. So how are we going to use that intrinsic motivation for wanting a summer job to we have to look at least 2 more things for you to wear that look presentable for getting a job. And then. It falls into place because they get other things that they're motivated by, like someone they're attracted to, or a peer group they want to hang out with. My point is using something, they want, even if it's long term, this individual was 14 and couldn't work until they were 16, but we use that. Because we knew that was something they talked about all the time. They couldn't wait to be 16 to get their own job. So they could buy what they wanted. That's all they talked about. Just like we talk about. I can't wait to move out of my parents house, because I don't like their rules. And then we realized we have to pay rent and utilities. And so then we're like, huh, maybe the rules weren't so bad, but thinking in terms of what they want, and how do I use what I know they want. Even if it's far into the future. To make the connection to drive the healthy hygiene. And hopefully that makes sense, but I will have resources in the Google folder for you to access to help you with this strategy as well. I touched on the next 2, which is technology and peer pressure, but I do want to encourage everyone. I know that we say our kids are on technology so much, but we're on technology all the time. We do everything on our phones. Banking appointments, we sign up for. Facebook groups, trainings, everything on our phone. We want a mobile app to do everything. Our children see this is the society we live in. So using technology to your benefit, and there are so many apps for reminders about hygiene. If your child has time management for showing them the importance of hygiene. Use technology. If you're not tech savvy, reach out to someone, who is maybe your child's teacher therapist or friend or family member. But technology is a game changer teenagers, especially those that are entering puberty and want to have that. I can do it on my own. Having that technology and feeling like they're in control of their hygiene can be really beneficial when you set it up on an app. It's just remember they're teenagers. We have to remember, we have to think a little bit like a teen, even though I know it's really hard and then meet them where they are and use that intrinsic motivation to get them to have healthy hygiene. Yeah. And I always think of healthy hygiene is 1 of those non negotiables, right? In terms of there are lots of things that I don't feel that we have to make our Children do lots of things. I don't feel Children have to learn their entire life. And they can be. Independent and productive citizens, however, unhealthy hygiene impacts your health. It impacts your quality of social life in terms of isolation. Not so much about not being invited to every party, but a lot of times it impacts the person's ability to do things they want to do. And so that's why we need to find those ways to motivate them because it is important. This is different from eating a healthy range of vegetables because we think it's important. We have ways to supplement that. It's not it's important, but. Lots of people survive without doing that, but healthy hygiene impacts a lot. So that's why I think it's important to understand where they're coming from, how you can use their intrinsic motivation to connect to what you need them to do to have healthy hygiene in order to decrease the frustration on both parties and to have a non smelly house. Because usually healthy hygiene, the first part is it's smelly, whether it's smelly clothes, smelly body, smelly hair, smelly feet, It's smelly and everyone's annoyed. That's usually what is the biggest initial trigger for that. The other part really quick in regards to tips and I pulled this from the slide on siblings, because I do think it's important. If you do have an autistic teen, and there are siblings, make sure that everyone has responsibilities. I'm not saying that everything has to be equal, but things have to be fair. I'm not saying and when I say fair, in terms of. The expectations for your autistic child should be the same in regards to your family guidelines and rules, but you need to make sure you accommodate and use strategies that work for their individual needs. And that's the fairness, right? Everybody has to be clean when we go to dinner and no one can smell. But how do we support the autistic team and young adult to make that happen? Because it's a different experience for them than it is for the non autistic sibling. So just a little A couple of tips that I put in and you'll get a copy of this slide as well. All right. So burning questions. I have some questions already that I will pull up I'm going to turn off the slide to answer the questions, but what I wanted to do is I wanted to really just thank everyone who came to this event. Those of you who are watching the replay. Because I think it's very important for caregivers and parents to understand how they can tackle these challenges when it comes to healthy hygiene, because it is real. It is very challenging when autistic teens start pushing back on hygiene. It's challenging on very different levels. And in various environments, right? And so it is very important and I love how I put thank you together in 1 word don't know how that happened anyway. Thank you for coming. Ah, all so someone wanted to know the OT, what they would look for in the sensory profile. That's a really good question. Autistic kiddos should have a sensory profile completed either while they're getting evaluated or shortly after because the sensory system is important for us to understand. It doesn't mean there's always going to be significant challenges. It's just helpful in determining strategies for teens. There are specific sensory profile protocols, assessments that an occupational therapist or someone who is trained it can be done within the autism 360 program as well. If you're a client with us, but it is something that they would ask questions to you, the parent. They would also ask questions from the team and then they would put together an analysis of the information to develop a sensory profile for you. Which would help to guide what is the struggle, what is going on and how can we support them? And if you'd like to know more, Kimberly, we do have a course. I think that's available in the app on sensory profiles and all of those things. And it covers all of the ages. That's a really good question. All right, so we have someone who has a 7 year old that lacks personal hygiene and does not like bathing loses his temper if asked to shower and doesn't do it properly. All right, so for this situation, and I totally understand, right? Because it's a 7 year old and why aren't they bathing? There's lots of reasons why younger children do not want to bathe or shower, even though ironically they love water play. All right. But it is a different experience. And there are several reasons why it can be sensory overload for them. One of the things that we try to do in between getting to the point where we can get them in the bath of the shower is old school wet ones. Or if you live in an environment where they can go outside and run through a shower sprinkler or go jump in the pool, at least that kind of douses some of it. It doesn't necessarily use the soap, but it is a way to do it. I have a mom who actually used a strategy because she lived in a warm place and they would make this like, Colored soap. They didn't make soap, but it was like some kind of way to color the soap and mold the animal and then they would go outside and become purple and it was soap. And I think Crayola makes a sensory soap that is different colors and different smells. And then they would. Become this purple person and then rinse off outside, which that's how she bathes her son. It was a struggle. Now, that's not always accessible, but I give that example to say, sometimes we have to look outside the box in order to at least get them clean, maybe white bees to just get the important critical parts. But the main thing to longterm fix the struggle with a young child, not wanting to be the shower is you have to. You're out why their sensory system is not able to tolerate those activities. And once you figure out why, then it's an easy solution. And then it's resolved. It really is so if your kiddo doesn't have a sensory profile, definitely make that request. So here we have a 10 year old that is starting to get that wonderful odor that the hormones bring deodorants aren't well working. The texture in the field discussed hygiene, but using deodorant is extremely anxiety inducing which that is another concern, right? Oh, my gosh, now we're going to build anxiety around hygiene and we don't want to do that either during that tender moment. So great question and concern is very valid. What I would suggest is they now make deodorant wipeys and that has been my saving grace for many families in terms of they now make wipeys that are deodorant and they just wipe. And they're good. They also now make creams like some kids don't like the cakey bar or the roll on. It feels sticky. There's different ways. Some kids don't like the way it feels under their arm. It feels weird. So they also make deodorant creams where they can just put it on and rub it in. If they can tolerate lotion. So what I would look into is looking online. Amazon has lots of different products. Options for how we can do deodorant and the white bees and the cream has been my go to, and it's been working pretty well. So that's something you can try to implement. And you can always send me an email if you're still struggling, and I'm happy to problem solve with you. All right, washing hands every day. Any idea how to fix the situation really struggles. So I guess the question is, when it comes to washing hands, is it interfering in. Other people's items getting contaminated, or are they sickly because of it? So 1st, we have to decide. Is it causing a major problem? And if it is, okay, this is what we need to do to fix it because it's causing problems. If it's not causing problems, backup solutions, right? Use a visual support to communicate just like we brush our teeth. You wash your hands 2, 3 times a day. The other times you can use a white wet one, or you can use hand sanitizer. And that's the rule, right? And use that visual schedule, that visual support to communicate that. It's not that you're dictating it. Remember the visual supports communicate what the expectation is, what to expect, what's happening next and when they're done. And so you can do that in various ways. The other thing is try to figure out what they want to do. Do maybe if they have something they're interested in, that involves needing clean hands. That can be tricky because a lot of times cleanliness it's not important to kids. They eat off the ground. They eat off the floor. They put anything in their mouth. It's really not that big of a deal. It's the adults that get concerned because we know what could possibly happen. With the washing hands, you can have an agreement on these are the 2 important times you have to wash the other times. These are your alternatives for other people's things to be sanitized, right? For other people, if it involves food. All right, so this is the comment is, I'm just going to read it verbatim. It says, has anyone else had issues with bum wiping? My nearly 9 year old holds his poop until he's desperate to go. Usually, by the time he gets the toilet, slightly soiled underwear, this is very common. This parent, I'm not sure the name, but it's very common after he's finished the toilet refuses to wipe terrified of getting. Yes. It's encouraging the first white and we have to do the rest for him. So I will tell you my solution. One, I would definitely. Ask the occupational therapist if they've done a sensory profile, or if they have not to look into his interoceptive system, because that's why he is hoarding his feces. It's just very discomforting to him. So that is very common as well. So maybe working around that sensory system, but also. We have to respect that does not want to get on hand. So we have 2 choices. 1, we can have gloves that he wears. Disposable gloves, and that's how he wipes or you can have a spray bottle or a bottle to make almost like a A bidet, which I really wish we had bidets everywhere. I know it's not everywhere, but it's a really great way for kids who have trouble wiping, whether they're autistic or not. It could be due to motor planning. It could be due to sensory aversiveness, but bidets are great, right? For getting everything clean. So thinking in terms of, I've had kids have a bottle they pour Or and then they just do a quick wipe and they get to choose if they want a wet wipe or a dry wipe, or if they want to just use water, but also gloves. If the concern is not getting his hands dirty. We have to remember that the sensory aversions are real. Their experiences are very different than non autistic people and everyone's experiences are different. If I'm in a room. Or a movie theater. There are some people wearing a jacket because they're cold and I'm not cold. That's a different sensory experience. It has, it's not necessarily about just being autistic. It's, we all have different sensory experiences. The differences for autistic individuals, it's the difference between meltdown, shutdown and trying to navigate their environment and communicate. Maintaining regulation is a struggle. Right so having that support giving gloves and validating that's something that they want to avoid is an easy strategy to implement right to override that. Ah, so hand over hand assistance with bathing is. A tricky one in terms of when hand over hand is started because we feel like that's what we need to do for several reasons, whether it's been taught, whether it's what we had to do. A lot of times it's not faded out. And now we're stuck in this hand over hand because they don't because they won't because they can't. Right? And the reality is that a lot of autistic individuals, whether they're intellectually delayed or not have motor planning hand strength. Difficulties due to proprioceptive sensory processing. Washing your body and wiping is really hard motor planning, or the pressure is never strong enough because they're not getting the proprioceptive input. That's why sensory profiles are key to understanding and knowing what supports to put in place because it impacts everything. Motor planning hygiene, everything. So thinking in terms of. Getting a 17 year old to bathe themselves is a challenge within itself when they're already getting assistance. The way you can back off of hand over hand is just to get a stick with the scrunchie thing on the back and let them do it because it's easier for them. To wash when they have something just to push and pull opposed to using a towel or scrunchie with their hand. Thinking of even I've seen I don't know what they call them, but they're like, these long scarfy things that are. Exfoliating something I don't know, but they can also do. That right to wash their back or wash their legs or in those crevices, because it's easier physics wise to push and pull than it is to motor plan. Specific parts. Put visuals as well into the shower, you can print them, laminate them and stick the men. I have a mom that has them on the outside of her glass shower. They don't get wet and she has. She protectors to protect them, so use your visual supports within the shower as well. I have a mom who actually drew visuals, the visual schedule for taking a shower, drew it on the shower wall. It's amazing. So all of those strategies can be really helpful. I think that we are at the end of our time. Thank you all for hanging in there with me. And explore the app, look for those resources that I mentioned you will have some things about sensory and hygiene to refer to. This is just a foundation. Of helping you understand the why. What you can do, and then the resources will help you choose what you think might work for you or child. In particular, and I am always open to emails. If you have any questions, or need any strategies. All right, thank you all very much. All right. Thank you everyone and have a wonderful evening, day, whatever it is in your part of the world. Bye.