Issues With Cutting Of Hair And/Or Nails
And With Brushing Of Teeth...
Many autistic children did not like to have their hair cut. This was another issue that was so easily explained by my theory of the role of "the partial" verses "the whole" in the autistic child. If you think about it, when you were cutting hair, you were "removing a part of the child"... taking a "part" from "the whole". This, for the autistic child created an extremely stressful situation. Not only was the part being separated from the whole, but in this particular case, that "part" came from the child himself and thus, the stress created by this simple act could certainly be overwhelming for the child as he could sense and see that he was losing "a part of himself" and he just did not know how to cope with this. Only once did I take Zachary to a barber. The unexpected sound of clippers (a new part to the whole) further intensified the stress of the situation. That experience was described in my book, Saving Zachary: The Death And Rebirth Of A Family Coping With Autism. That experience had been so stressful for Zachary, I then only cut Zachary's hair while he slept... not always the best job... but, it was certainly the least stressful method for doing this task... for both of us. :o)
Once I started to truly understand the issues of order, partiality and labeling in the life of the autistic child, I could explain this task and label it in great detail for Zachary as I also provided a coping mechanism to get him through it.
I explained to Zachary that hair could grow to be "too long" (words expressing quantity) and that when it was "too long", you could not see. This was easy enough to explain as I used my own hair and covered my eyes with it. What I found worked in helping tremendously with this issue of cutting hair was to simply find a way to bring order to the process... to show "parts" to cutting hair. I took a plastic bowl and simply asked Zachary to hold the bowl and "count" the clumps of hair as I put them in. That took his stress away from the removal of "the part" and focused him on an ordered process... counting! :o) As he counted, I encouraged him and reinforced his "good counting". Cutting his hair had never been a problem since... he actually enjoyed it now! :o)
The same concept applied to cutting nails.
I knew a lot of parents out there still had a problem with brushing the teeth of their autistic child. I think I just happened to stumble upon what worked with Zachary...and, again, I can see why "what I did" worked based on Zachary's need for order and his inability to cope with partiality. If you think about it, a toothbrush, toothpaste, a sink, a tap, water, teeth and an open mouth... all are necessary parts to a process... brushing teeth. All these "things" need to somehow "fit together" for the child to understand the concept of "brushing teeth".
Furthermore, the child needed to understand "dirty teeth" verses "clean teeth". Thus, there were many "parts" that must be made to "fit together" for this process to make sense to the autistic child. The fact that this was also "a process" posed specific issues also for the autistic child as the "sequence of each task/activity within the process" also had to "fit together properly" to arrive at the desired outcome. Process issues and issues with sequencing were difficult concepts for the autistic child in that, by definition, a process involved many steps, many activities, many "things", many “parts” within each activity that had to somehow "properly fit together". For more on this, see my section on: Teaching A Process To The Autistic Child.
For the autistic child, each "thing" was an individual "part" and he had to first understand each "part" in order for the "whole" to make sense. In addition, issues with touch also came into play. The toothbrush was not "part" of the "whole"... the teeth or the mouth - and as such it created a stressful situation when the toothbrush was placed near or in the child's mouth. As such, the toothbrush needed to be labeled as a toothbrush and its function identified as being "for brushing teeth" or for "cleaning teeth". That label greatly helped Zachary to understand that "a toothbrush" and "teeth" actually did "go together" in this process.
The simplest thing was not to require the child to brush his teeth by himself at first... but to do the brushing for him. As Zachary learned to cope with the overall activity, he was more easily able to do the "process" on his own based simply on the first part to the process, a "verbal prompt" to "go brush your teeth".
The key to brushing teeth was in bringing order and a coping mechanism to this process and in explaining the difference between “clean” and “dirty” teeth.
So, how do you bring order to a process such as brushing teeth?
I found with Zachary, what worked was simply making sure I used the toothbrush he liked (just letting him pick one out of the group available to him, providing variation in color for his choice) and then, taking that toothbrush and slowly counting his teeth as I brushed them... working my way in a very orderly manner from one end of the mouth to the other, first doing the bottom, then the top teeth... and always doing it this way. As I worked from one end to the other, I slowly counted the teeth as I brushed them. That worked like a charm. Zachary could anticipate how long the process took...since he came to know he had 10 teeth on the bottom, and 10 on top... so, when I did the bottom 10 and got to 9, I would let him call out the final number and say "10"... and then we would do the top teeth. Counting brought order to a process and so, for him, it made the whole task of brushing his teeth, ok. For those interested, Kirkman Labs, at http://www.Kirkmanlabs.com, offered a casein free and gluten free toothpaste! Miss Robens, at http://www.missrobens.com/ offered a casein and gluten free hand soap and laundry soap.