To be tearing my hair out at autistic DS's refusal to wash his hands?

[HalebiHabibti]

DS is 11yo and autistic. He manages ok in mainstream secondary school but it is safe to say he doesn't mask particularly well. I am autistic too (recent diagnosis) so have some sympathy with this, but do think a baseline level of rote politeness and cleanliness makes everyone's lives much nicer and so have encouraged him to learn these skills. It has been (and continues to be) a struggle.

The most recent battle is over handwashing, which he avoids whenever possible. I know this because if he gets close enough I can smell his hands (although tbf I am hypersensitive to smells). I've tried explaining about bacteria, I've tried explaining that people will recoil from him, I've tried explaining that job recruiters tend to prefer people whose hands are clean - none of it works as he doesn't think there is a point. We have similar battles over clothing presentation, hair brushing, washing ketchup off your face, etc.

I don't want him to be dirty. I don't want him to be teased/made fun of. I don't want him to be embarrassed.

What on earth do I do please?!

I agree, find out what motivates him. My DS is EXACTLY the same and I hate the smell of his hands. I used to give him a sweet everyday after school AFTER he'd washed his hands. Now he has to wash them before he plays computer games instead of the sweet. It's still a bit painful but works better than anything else and at least gets them washed once a day.

I don't agree with giving food/sweets as a reward and I know it's highly frowned up.on MN but sometimes you just gotta do what works.

@PosteriorPosterity "Much to MN chagrin, I very rarely wash my hands. I’m talking once a day, or I will rinse them after using a public toilet."

once a day? So not even after you use the loo?

@HalebiHabibti too drastic/scary?

https://www.amazon.co.uk/Ultraviolet-Flashlight-Blacklight-Detector-Batteries/dp/B00GU55270/

Would this storybots video help?

beetr00 I think we have one of those somewhere!! Worth a punt!

As to what he's doing to make his hands smell: rubbing his nose, probably picking his nose, eating food, picking things up.... he also has a nervous habit of licking the tips of his fingers so they feel right. Thus gradual transfer for spit over the day.... ew ew EW.

I know I am being slightly unreasonable but only slightly!!

Some stats as well if that helps
https://www.cdc.gov/handwashing/why-handwashing.html

Or the history of handwashing (someone twigged that doctors moving between the morgue and the maternity ward without washing their hands was a bad idea)
https://www.theguardian.com/world/2020/mar/18/keep-it-clean-the-surprising-130-year-history-of-handwashing

This might be too much but what about one of those germ detectors to shine on his hand to show before and after? Or does he not believe the germs are a problem? It's so difficult and tapping into why he doesn't think it's an issue is a good place to start. Maybe the smell thing might work. Has he ever smelled a smell on someone and not liked it ?

If he's interested in science would the petri dish experiment work? Have him touch a medium on the dish, seal it and wait and see what happens? Then do the same with your washed hands? Or take swabs from around the house and see what grows?

PDA is another thought as has been mentioned, and obviously the sensory aspect. Would he use hand gel? It may be a compromise for now. If the sensory impact is more than he lets on, would he be willing to work out what elements are an issue?

"Hygiene is one of those things that is non negotiable in my house. Same as teeth brushing. They do it willingly or I pin them down and do it for them. They quickly learnt that it gets done either way but doing it themselves is a lot more pleasant."

That doesn't work with an older child or teenager.

It seems a lot here fail to realise that what will work for a neurotypical child will rarely work for an Autistic child.

I don’t have any suggestions op, I have one who only rinses her finger tips. Whilst the other over washes until her hands are dry and chapped. Occasionally I’ll catch the finger rinser and ask that palms/ between fingers are also washed and she’s generally compliant.

I've got a friend who still works in labs... I quite like the idea of doing the petri dish experiment :D

Good grief. That's pretty extreme.

My 15yo has been awaiting an autism assessment since 2020, but am almost certain he will be diagnosed. His hygiene is hit and miss. He has to be firmly reminded to shower. He will usually agree, then will need reminded again. And again. I have discovered that he likes to be given a time as a sort of deadline and that seems to work. Not always, but more often than not.

To me ( as a fellow ASD parent) this is a non negotiable.

We have a few things that I’ll allow the circumnavigation of, for calm or for ease but there is no way in hell I’d be allowing this.

This is a basic, this is one of the things to potentially die in a ditch over! It soap and water is a no, hand wipes? Hand gel? Hand foam?

He cannot and should not be walking around and spreading germs everywhere , it’s not fair on him and it’s not fair on anymore else.

Try rewards maybe? Choose a special soap? Try everything and never stop trying! Try doing it together ? Or for him?

The most recent battle is over handwashing,

When did it start? Can you try to pinpoint what may have triggered the change?

Time for tough love, be it hand gel or soap and water. No meals at least when at home until he washes hands.

Yep. Get tough. Starve your disabled child.

WTF

Sorry to get a bit grim but what about worms OP?

The finger licking in particular sounds like a great way to catch threadworms. I wonder if mentioning this might either encourage handwashing or at least stop the fingerlicking?

Another angle: if he is licking his fingers so they “feel right” does he perhaps have dry skin and doesn’t like it? And handwashing makes it drier (he may not have made this connection consciously) Will he use handcream, might that help?

Unless it’s a public toilet, no. And even then I only use soap if the toilets don’t seem to be kept clean.

(I’m prepared to be told I’m disgusting, but I don’t actually see why it’s an issue - I’m hardly ever ill (like once every 3-4 years) and neither is anyone else in my family, so I don’t see how washing my hands more often would benefit anything).

Touching every single surface transfers bacteria. Although i don't believe you should wash your hands after touching anything surely washing before you eat should be a priority and washing ( not rinsing) after using the loo, do you really want to touch your children with manky hands ?

Well, you're spreading germs outside, but if you don't care, nothing anyone can do.

OP if you want I can send you a social story that we use at work - might not work, but sometimes having it as a bit of a paper makes it more of a "rule that doesn't get argued with" for some individuals.

Similar to the Petri dish thing, we've done something similar with scouts where they put their unwashed hands onto a slice of bread then we seal that in a clear sandwich bag, do the same with washed hands, and watch the progression! It's amazing and disgusting all at once.

Would you consider sending it to me as well as OP?

Wow I LOVE this idea, I am going to try this. Thank you!

Said by someone with no understanding of autism I imagine. Sorry this attitude really annoys me, even towards neurotypical children.