According to the Centers for Disease Control and Prevention (CDC), most children can begin to dress and undress themselves somewhat independently by about age three. For children with autism, this can present more of a challenge. Children with autism typically experience sensory processing issues and can regularly be hypersensitive to textures or the sensation of clothing touching the skin.
People with autism also often experience difficulties with fine and/or gross motor skills, including coordination and balance impacting their ability to dress independently. Children with autism can also be resistant to change, and shifting from one season of clothing to another can present a challenge. Children with autism can learn this important life skill with persistence and patience.
Developing a Routine for Getting Dressed
Children with autism often thrive on structure and daily routines. Make getting dressed a part of this routine by breaking up the task into smaller, more achievable goals. In this way, getting dressed can be less overwhelming and easier for them to grasp each step.
Some helpful hints for coming up with a dressing routine include:
- A weekly or daily plan. Plan ahead of time what will be worn the next day or even for the entire week. This takes the guesswork out of the equation and can be soothing to the child. Offer simple choices, such as do you want the red shirt or the blue shirt? You can lay the clothes out on the bed (right side out) and in the shape of a body so that it is visually clear what goes where and how to put it on.
- Picture charts. Children with autism commonly excel at visual cues. Using picture charts or a visual checklist can help a child understand what item of clothing goes where and which to put on first. Picture charts for daily routines can be helpful for a child to know what to expect when. For example, the chart could include pictures of getting dressed in the morning and getting undressed at night.
- Backward chaining. Backward chaining is a common occupational therapy technique that effectively teaches individuals how to complete complex tasks in reverse order by starting with the last step and working back to the first. For getting dressed, this can mean having the child start by putting an arm in one sleeve of a shirt, then the other sleeve. Then they can pull it over their head with reinforcement occurring at each step until they can complete all steps independently.
- Consistency. It is important to keep all tasks and routines consistent and repetitive. It takes time to build a new habit and learn a new skill. Break down bigger tasks such as planning an outfit or getting dressed into more actionable steps. Keep repeating each step consistently until the skill is learned.
Working With Sensory Processing
Sensory processing issues are common in children with autism, making certain types of clothing less desirable than others. It is important to understand what types of textures and fabrics might be overwhelming for your child.
Tags and seams are common sources of discomfort. Choosing clothing that is loose-fitting and soft, and with elastic waists for the most comfort possible. Check the clothing for potentially irritating tags ahead of time and wash items several times to soften before having the child wear them.
Offer simple choices and choose your battles. Give only choices that are acceptable and weather appropriate. Changing seasons, and therefore types of clothing, can also present difficulties for children with autism. It can be helpful to say “goodbye” to coats in the summer, for example, and put them in an inaccessible place.
Rewards can help here too. Praise the child for putting it away for the season. Telling the child the coat is currently “unavailable” either through a picture chart, visual, or verbal cue can be more effective than saying “no coat” as well. Most children do not enjoy being told no, and this can be a helpful alternative.
Managing Motor Skills
Almost all children with autism, close to 90%, will have some form of motor difficulty ranging from gross motor problems such as coordination issues and an unsteady gait to fine motor issues like manipulating small objects. Low muscle tone, hand-eye coordination difficulties, and troubles with body awareness are also common. All of these can play a role in getting dressed independently.
It can be helpful to start small when managing gross motor, balance, and coordination issues while teaching a child to dress. Have them sit down and choose loose-fitting clothing that is easier to manipulate.
Clothing with Velcro fixtures can be easier for a child with autism to manage than buttons as this requires less fine motor control. A zip pull or key ring added to a coat zipper can be easier to grasp also.
It can be beneficial to have the child get dressed in front of the mirror to see their body working.
Keep practicing. Work on fine and gross motor skills through additional activities to help enhance dressing abilities too.
Using Rewards
Rewards, praise, and positive reinforcement can go a long way when teaching new and important skills. You should find what works best for your child.
For example, will they do best with a sticker chart and earning a sticker each time they get dressed in the morning? Or will it be more effective to allow them a few minutes with a favorite toy or activity after completing the task?
Older children can earn “points” that can be traded in for screen time or another popular activity or action.
Tips for Specific Types of Clothing
Different types of clothing come with variable methods for learning how to put them on and take them off successfully. It can often be helpful to start with learning how to undress before moving on to getting dressed independently. Tips for certain clothing items include:
- Shirts. Use loose-fitting shirts that are simple, so it is less noticeable if the child puts it on backward or inside out. Clothing should not be tight or restrictive. Tagless and seamless clothing is optimal.
- Pants. Choose pants that are loose and with wide elastic waists. Buttons and zippers can be more challenging to manipulate, and small-banded elastic is often too restrictive.
- Socks. Loose-fitting, short socks typically work best initially. When using longer socks, teach the child how to bunch them up first. Socks with colored heels can provide a good visual for putting them on correctly.
- Shoes. Shoes that slip on or have no tie or elastic laces are often ideal. Be sure to keep shoes in the same place every day, so they are easy to find and put on.
- Coats. Start with a larger and looser-fitting coat. Consider adding a pull or ring to the zipper. The flip-flop over-the-top method of putting on a coat can be helpful for younger children in particular. Lay the coat flat with the sleeves and hood out. Have the child stand behind the hood, put their arms in the sleeves, flip arms out straight, and then flop it over the head.
Aiding Children With Dressing at Specific Ages
Each progressive age can come with a different set of dressing challenges for a child with autism. It is important to understand that each child is different, and what works for some may not be ideal for your child.
Toddlers:
- Use visual aids
- Buy autism-friendly clothing
- Use clothing with no fasteners
- Offer simple and acceptable choices
- Lay clothes out in a body shape
- Be patient and consistent
- Start backward
- Break dressing down into small steps
- Help them through the first steps and work together
Elementary age children:
- Create a plan and routine the night before
- Organize the closet or drawers into types of clothes for easy choices (i.e., school clothes, play clothes, and fancy clothes)
- Continue to work on activities that enhance fine and gross motor skills
- Keep clothing simple
- Help to teach them how to recognize the front from the back, the inside from the outside of clothing
- Allow extra time for dressing
Older children and adolescents:
- Put a schedule/routine in a visual place and include dressing
- Help teach the child about weather-appropriate clothing and how to recognize this
- Stick with clothing that they like and are comfortable in
- Continue to foster independence and offer help when needed
Getting dressed is an important life skill that children with autism can require a little extra attention and time to learn. It can be achieved with time, repetition, consistency, and patience.
References
Important Milestones: Your Child by Three Years. (February 2022). Centers for Disease Control and Prevention (CDC).
Q & A Help: My Child is Hypersensitive to Clothing. (August 2021). Autism Parenting Magazine.
Principles Behind the Lessons. (2017). Flexible and Focused.
Sensory Issues. (2022). Autism Speaks, Inc.
Autism and Resistance to Change from Winter to Summer Clothes. (June 2017). Autism Speaks. Motor Difficulties in Autism, Explained. (August 2020). Spectrum News.
