In this blog, Curtin University Occupational Therapy student Julia Than discusses how to make nail care an important part of a child's self-care routine.
Nail care is an important part of a child’s self-care routine, as it not only contributes to their hygiene but also provides them with a sense of independence and responsibility.
Some children may experience difficulties with tolerating having their nails trimmed. This may be due to a variety of reasons, including being hypersensitive to touch and noise, which can make the experience too overwhelming for them. This may result in distress for both the parent and their child.
Below are some tips to help your child to be set up for success with cutting their nails and to help them cope better with their sensory challenges.
Preparation is key
- Help your child understand the process by explaining the steps they can expect before starting the task. For example, you may say “we’re going to cut your nails now; I will use the clippers and it won’t hurt you”. This can be supported using visuals and/or a social story to further support your child’s understanding of the task and reduce their anxiety. You may be able to find sample social stories on the internet and adjust them to suit your family; or ask your teacher or therapist for advice.
- It may be helpful to demonstrate and model the task on yourself first. This will also help to reduce your child’s anxiety, as they can observe your reaction and learn that it will not be painful for them.
- Emphasise the importance of cutting nails by highlighting that long nails can be dangerous as they can scratch/hurt people. Autistic children often respond well to literal explanations and reasoning. It is best to agree with them on what you are going to do together before starting the task.
When should I cut my child’s nails?
- Choose a time when your child is calm and ready. It is crucial that you don’t force them to do it and don’t rush them during the process. You need to go at their pace and monitor their comfort levels, as you want this to be a positive experience for them. Think back to a time where you’ve had to do something new or difficult, you can appreciate that it helps to feel calm and ready to give it a go.
- You need to respect your child’s requests when they show you (with words, gestures, or facial expression) that they want to stop or take a break.
- It is best to attempt nail cutting at a time when your child is not sleepy, hungry or irritated as this will increase the chances of success. You may wish to try jumping on the trampoline or playing on the swing set to support their regulation before trying to cut their nails as this can be helpful.
Where should I cut my child’s nails?
- Ensure your child is in a comfortable position before starting. This will promote relaxation and co-operation during the nail-cutting session. Some safe environments could be the bedroom, bathroom, in the bath or living room.
- Sitting with your child between your legs or on a beanbag and applying gentle but firm pressure down their hands, arms, legs and feet may help get them used to physical touch and reduce sensitivity before getting their nails trimmed.
Tips for successful nail trimming
- Use large clippers or scissors: This will ensure that each nail can be trimmed in one or two clips, as opposed to a series of smaller clips.
- Take a bath beforehand: Cutting your child’s nails after they have had a bath will make them softer and easier to cut.
- Use distractions: Use your child’s strong interest in toys to your advantage to create a suitable environment for cutting nails. Distractions could be as simple as singing a song together, getting another adult to read to them, or giving them their favourite toy to hold onto. Putting their favourite TV show or a video on can also be helpful.
- Sing a song: Using the same short song every time you cut your child’s nails may help them to cope better. Saying things like “Almost done,” are abstract terms to a child and won’t give them a good indication of when the activity will finish. Choosing a nursery rhyme that your child is familiar with such as “Twinkle twinkle little star” will help your child become more comfortable with this activity in their routine and give you enough time to cut their nails before the song ends.Leave a white edge: When you cut your child’s nails, always make sure to leave a small white edge rather than cutting right up to their skin as this can be painful and cause discomfort.
- File first, then cut: If resistance is high, filing your child’s nails before cutting can provide a gradual approach to ease into this activity. Smoothing a nail down instead of clipping can reduce anxiety and sensory overload.
- Cut on a specific day: The timing of cutting nails can be tricky for children to understand as typically we only do it every now and then. Some children may prefer to have a specific day for cutting nails to make it a structured and predictable routine in their week e.g. every Sunday we cut nails after breakfast.
- Keep it short and predictable: Many children benefit from routine and consistency, and so your child may benefit from cutting one finger nail every day. This allows it to be a daily task that is part of your child’s routine (e.g. every day after brushing teeth). This strategy ensures the task is short, making it easier for them to tolerate.
- Experiment with different clippers or scissors: Some children are sensitive to the sounds that nail clippers make, so trying various nail clippers or scissors may be helpful. Electric nail clippers or an electric nail file may be a suitable alternative due to the reduced noise.
- Try during sleep: If it causes a lot of stress for the family, consider cutting your child’s nails when they are asleep.
Nail cutting is an essential part of a child’s grooming routine and promotes a sense of independence, good hygiene, and quality of life. As their caregiver, you can create and transform their nail clipping routine into one that is calming, reassuring and predictable. It is best to keep in mind that it may take trialing several strategies until you find the ones that work for you and your child. In general, by preparing your child well in advance for the task, being gentle and praising their efforts, this task will hopefully soon become a quick and easy addition to the self-care routine.
References
Schiavone, N., Szczepanik, D., Koutras, J., Pfeiffer, B., & Slugg, L. (2018). Caregiver Strategies to Enhance Participation in Children With Autism Spectrum Disorder. OTJR (Thorofare, N.J.), 38(4), 235-244. https://doi.org/10.1177/1539449218786713