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?!

Could I have this too please? God daughter is barely speaking to brother on account of similar issues and is very distressed.

we need to calm the rhetoric and find another way of acheiving an outcome which works for all.

Ross Greene's Collaborative Problem Solving is excellent for this if you can really get your head around the framework.

It's laid out in The Explosive Child and Raising Human Beings, or on the Lives in the Balance website there are some explanatory videos, the podcast is good too.

There's also a facebook group called The B Team although it annoys me because IMO they have much too militant of an attitude, insisting that it can be used for every possible problem and that it should be the only parenting tool you're using at all, which I find unrealistically dogmatic and unhelpful.

But, if you can look past that it's quite good at getting the nuances of the method.

The good thing is that it doesn't involve battling about what is "right" as you just include everyone's concerns and somehow find a way for it all to work out. A lot of solutions people are giving here are ways to persuade him that hand washing is really necessary, or attempts to persuade you that it's not that bad if he doesn't wash them.

My Dd is also autistic and has sensory issues which are also affected by water, as she says it makes her skin feel dry.

She uses hand cream every time she washes her hands or she cannot tolerate it, so the hand cream goes everywhere with her.

She also uses it on her body after a bath or shower.

Maybe worth a try if it's sensory.

My dc refuses also. It was down to temp of water and differing soaps all over. She'd never know what her hands would be like. And she also hated the blowers.

I'd buy a selection of fragrance free soaps for at home and give up whilst you're out. Perhaps if there's no blower ask dc to rinse with water only.

To add my autistic DD who is 5 is similar although our biggest issue is hair washing. In terms of hand washing it sometimes works to buy those hand soaps aimed at kids (might not work on an 11 year old though!). She also has had worms & hated it so we remind her about that too & it sometimes does the trick. She also doesn’t like getting ill so that’s another incentive.

My DS is 12 and also has ASD OP, He perhaps isn’t as stubborn about not washing as yours is but over the past few months I’ve been having chats about the importance of washing, especially as he’s getting older. That means washing hands after using the toilet, showering or bathing daily and targeting arm pits, legs, feet rather than letting water drip down to them. Also discussing washing under the willy as dirt can build up. I think the best approach is having little bit often conversations about hygiene, going on too long will only cause him to switch off or perhaps get annoyed

Does he have any special interests? Wonder if you could get a hand wash foam in a novelty bottle that he chooses (my ND son loves Toy Story and has Toy Story toiletries to encourage him towards good personal hygiene) Foam is more sensory and he can take one to school maybe in his school bag to use that’s just for him.
It’s an absolute no to tough love imo.

I came to suggest the Petri dish experience.
We did it during my a levels and discovered we were all terrible and washing and drying our hands as our plates were worse after washing our hands and swaps from the floor and door handle. We repeated the following week making sure our hands were properly dried and as expected washed hands were better that unwashed.

You could get some cotton wool swaps and swap the door handles and the toilet flush and other place we would generally touch. To see how dirty they go. I would do a test without him there is possible to check something shows up! If water doesn't work try something like mouth wash or nail varnish remover.

When try to change someone's behaviour you usually have to figure out how their brain and mind works first to see what they respond best too

Also ND with an autistic and ADHD son. This would also be a non-negotiable to me.

Like washing and teeth brushing and wearing clothes that fit (yes, a massive issue!!!).

I would work with them to find as an acceptable solution as possible sensory wise but not doing it is not an option.

I would accompany to bathroom and literally nothing else would be happening until hands were washed.

As you say this is not just an issue for you (as it's pretty disgusting), but could make him a target for bullying. My DS already experienced enough of that and I know personally how damaging it is. I moved heaven and earth to ensure that anything that made him a target that could be changed, was changed.

OP I just want to say that while this must be absolutely doing your head in, you come across as a very committed, compassionate parent. You’re absolutely right to help him learn this stuff as it is necessary for adult life.

You’re trying to unpick the relationship between whether he thinks it’s necessary/worthwhile and whether he just hates the experience-keep trying!

If sensory, would a basin filled with warm water be easier for him to use?

Hand cream does sound like it might help.

I didn’t wash my hands as a child/teen/young adult as I never liked them being wet afterwards.

If he sees it as pointless you're not going to get his cooperation. My youngest (22) has autism and ADHD with PDA and the only way we get him to do stuff is to convince him that he wants to do it. And we have to be subtle about it. He doesn't give a flying fuck about other people's wants so there's no point appealing to the social side. It sounds like your son is similar.

NT methods just don't work. It's like giving someone directions in a language they don't speak. It's just a waste of everyone's time. I do love the 'they have to... You make them... It's non negotiable ' stuff though. Try that with an aggressive severely autistic massive 22 year old and see how many teeth you lose. (Is there a laughing and crying at the same time emoji? )

You need to find something that makes him want to build it into his routine. I liked the Petri dish idea. Worth a shot.

Are there things he does that he will find better, nicer or easier with clean hands? That's your angle.

Would he use a babywipe type handwipe? Terrible for the environment but I think perfectly understandable in this situation. I grew up in a house with an old fashioned hot water tank so sink taps were cold unless you waited a few minutes for them to run warm and used to try to avoid washing my hands as a child as I just didn't have the patience.

Mine has pda (diagnosed) in the mix, and washing is an issue- although he does wash his hands a lot but doesn’t want to wash the rest of him (he is only 9 so doesn’t smell yet therefore doesn’t see the point, and it’s a Demand, and it’s a horrible sensory experience).

I don’t have any tips I’m afraid- just solidarity!

I get him to shower by bribery/having absolutely no other demands that day/catching him in a good mood…

Has he ever had worms? My autistic son has finally accepted that the worming medicines could be excluded if he washes his hands before eating. It really was a case of the greater evil in sensory terms.

@Balloonhearts would love to see you try to pin my 12 year old down to brush his teeth. As if I don’t have a hard enough job with comments like that. I have a pda asd child very similar by sounds to op son. He doesn’t like water/washing teeth brushing and also toileting is also an issue it’s tough.

do people think we don’t try to instil good hygiene etc? Or we just let them get away with anything? I’m a nurse so I know he needs to be clean, he needs to brush his teeth however the battle to get those done is real. Interested to hear some strategies on here as obviously I can try them with him. Would referral to ot help? It’s been mentioned in the past. It’s diffuse as you don’t know what to try and trying some things can make them more resistant, bit of a vicious cycle,

Hello! I have an early teens daughter with disabilities, who is also on the ASD assessment pathway. This (and hygeine generally) has been a real ongoing issue for us too. Eventually I was able to get a referral to the children’s learning disability nurse - even though dd didn’t meet quite meet the ld criteria - just because of the impact the difficulties we’re having. Although the nurse was working with dd saying essentially the same things I had been, having another (and by this time more patient) voice going through it and taking time to deep dive some of the issues with us really helped. Not totally fixed but much better.

The history thing would work here- mine needs to know the reasons why and the history or every buggering thing before he will accept it.

He refused to learn any numbers/maths at school (he did up to year 2) because no one could tell him why a number 3 is that shape, who invented numbers, why they are in the order they are, why one is called one and two called two etc 🤦‍♀️

Yup. My eldest (also autistic) needed to be pinned down by two people when he was a toddler for teeth brushing and medication. He's had to have several teeth removed because they were so badly decayed. No fucking chance anyone's pinning down an autistic teenager / young adult who doesn't want to comply unless they're professionals trained in manual restraint and there's a few of them.

If he likes the shower he should be having one every day not just occasionally. His hands wouldn't smell then. Has he tried wet wipes?

Sounds like mine.
All I’ve ever been able to succeed with us creating a routine and enforcing it.
Some are positive, teeth brushing at x time leads to x.
Others I’ve occasionally had to have consequences for more persistent issues. Eg if you haven’t showered in two days on the third you lose devices.
Eventually these routines become natural and embed without monitoring.
He doesn’t place value on certain things, he cannot put himself in some one else’s shoes. Telling him I think it’s smelly means nothing, he doesn’t. Explaining reasonably is dismissed completely, even when it’s logical

WTAF?! You would starve a disabled child because you don’t like a symptom of their disability? That is abuse.

I empathise with you @HalebiHabibti . My DD currently can't go to school because she's so concerned about germs. It would be nice if we could meet in the middle!

Btw I also in the teenage years tried the touching bread and Petri dish experiments.
I just got back LOADS of facts about bacteria. Examples like ‘your mouth is full of essential bacteria, seeing bacteria isn’t bad’. ‘If you heard the bacteria in your water bottle had multiplied lots but there was a small change of bacteria left on your toilet seat, which would you lick? Lots doesn’t mean bad nor does smell’ or ‘your immune system is anti-fragile…’ or ‘I’m less likely to develop allergies…’
Honestly, autistic logic and NT logic aren’t simply exchangeable

No meals at least when at home until he washes hands.

Yeah, mine would just go without food.

It’s funny that posters with no lived experience of Autism keep suggesting tactics that are akin to abuse of a disabled child. Consequences or bribing won’t work if the issue is a sensory need or avoidance that isn’t being met.

I agree with @caringcarer if he’ll shower then encourage doing so daily or even twice daily if he can handle it.