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Dressing - Steps to building independence

In​ this blog, Occupational Therapist Tarryn Culverhouse provides some tips to help your child increase their independence in dressing.

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Dressing is a task that contributes to the daily self-care routines that carry us through life. Participation in dressing supports a child’s ability to make choices and develop autonomy in looking after themselves. To dress in a uniform is part of the occupational roles that we identify with through life, such as becoming a school student or belonging to a club.

As children get older there is an expectation they can complete the steps of dressing independently to complete tasks such as: managing their clothes for toileting, taking shoes on and off for play in the sandpit, dressing and undressing for school swimming, playing dress-ups with friends and making the morning routine easier for families.

Dressing uses physical and cognitive skills such as locating body parts, planning the orientation of clothes, sequencing steps to achieve a goal and maintaining attention.

Below are some tips to help your child increase their participation and number of independent steps in dressing.

Identify the goal and plan for practice time

Consider what time you will work on this goal and what the goal will be. For example, dressing for school, putting pyjamas on, or dressing for the weekend activity. Find a time that suits your schedule, where everyone is relaxed and ready to learn. Keep this time consistent until the goal is achieved.

Set up the environment

Have a consistent dressing place with a child-sized chair, sit on the edge of the bed or a place to sit on the floor. Sitting down to complete certain tasks is easier than having to balance on one leg.

Have a designated spot to put clothes that are undressed and clothes to be dressed.

A consistent environment sends us a cue as to what we are expected to do!

Assist with the task

When we feel success, we can be more motivated to do the task again. You can help this by starting the dressing sequence so your child can finish it. This is called ‘backward chaining’. Backward chaining is a strategy used by OTs to help in learning.  Backward chaining considers the steps that are needed to complete the task and then support is given to master each step at a time. By working backward, the child has instant success as they are the one to finish and achieve the goal. 

For example, dressing in pants (while sitting) typically involves the following steps.

  1. Pick up pants by the waistband
  2. Lower pants towards legs
  3. Lift leg into pant hole
  4. Lift other leg into pant hole
  5. Pull pants up to knees
  6. Stand up and pull pants to waist

Step 6 is the final step of the task, which is performed by your child after you have completed step 1-5. You will provide positive feedback after your child completes this step. Once confidence is established and the steps of dressing are consistent and predictable, have your child complete step 5, then 4 and proceed until they can complete all of the steps independently.

Keep going

It can be hard to change a habit and most parents find it quick and easy to dress their children. Keep giving your child consistent opportunities to practise in a calm and relaxed space.

If you are coming across more obstacles than expected, talk to your OT. Together you can analyse what is happening and identify the steps for your child to achieve their goal. 

Tips for dressing

  • Undressing is an easier skill to learn than dressing. Start with helping your child to undress by themselves.
  • Loose-fitting clothes are easier to manage than tight-fitting clothes.
  • There is no one ‘correct method’ for dressing. Try different methods and find one that is suitable for your child. Be aware that this may be different to your preferred way.
  • Practise this at a time of day when your child can tolerate a challenge. Avoid practising when your child is tired, hungry, sad, or sick. Holidays or weekends can be a good time when you are not rushed to get out of the house on time.
  • Start with the child’s strongest side of the body if you know what this is.
  • Timing is important. Leave extra time so your child does not feel rushed. This can reduce frustration.
  • Try to minimise distractions and interruptions e.g. TV off.
  • When your child is ready, this may be a good opportunity to encourage vocabulary such as up/down/in/out/front/behind. These concepts are important for following directions during dressing.
  • To help your child distinguish the front from the back, identify one side, such as T-shirt logos are usually on the front, or the tag is at the back.
  • Dressing is also an opportunity to reinforce the names of body parts. When learning to dress it is beneficial to know the difference between an ankle, a knee, and a shoulder.
  • For some children it can be helpful to get dressed or undressed in front of a mirror as they can see what they are doing. For other children this may be distracting. See what works for you and your child.
  • Remember to end each practise with a success and praise your child for their efforts. Some children may enjoy a sticker chart.

A visual schedule can be helpful to support consistency in relation to getting dressed/ undressed in the same order every time. Ask your OT if you think a visual schedule would be helpful.

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 Source: www.pinterest.co.uk     

PANTS:

  • Start with shorts if you can.
  • Start with elastic waist.
  • Leave fasteners for later in the child’s development.

SHIRT/JUMPER

  • Begin with short sleeves which can be easier to manage.

SHOES

  • Start with gumboots or slippers, slip on or velcro shoes as these are easiest to put on.
  • If shoes have laces, teach the child to loosen the laces and pull the tongue before putting them on.
  • Leave laces until later in the child’s development.                                

BUTTONS

  • Start with large buttons first.
  • Buttons are a two-hand task. Show your child how to hold the button with one hand, locate the buttonhole with the other hand and push the button through.

Good luck and remember to contact your OT for individualised supports with dressing. 

If you think your child may benefit from Occupational Therapy at CliniKids, please phone (08) 6319 1133 or email clinikids.reception@thekids.org.au