Terror of having toenails cut/Autism

[birdynumnums]

My 4 year old is being assessed for his needs at the moment. The doctors are wondering if he may be autistic.

My greatest concern at the moment is his toenails. He gets so distressed when I try to cut them, he physically shakes and struggles so violently, I am unable to cut them. I used to do them when he was asleep but now wakes up and gets very upset. He is now worried about going to bed because he thinks I will cut them. To cut a long story short, I now have a 4 year old with long toenails digging into his feet and I am so worried.

He was assessed by occupational therapy and asked for advice. They discharged him and then sent a letter with advice but none related to the toenail cutting. I asked the health visitor who told me I needed to speak to the school nurse. She came to see me and was flummoxed when I said reward charts and the likes would not work. She then said I just needed to get it done somehow as it would damage his feet. I know this but what can I do? Please does anyone have any advice?

Sounds terrible when I write it in b&w but I sort of scared my ds (ASD) into accepting it. He's pretty prone to phobias about health (eg terrified of germs, being sick etc) so I think I gave him lots of horror stories about what might happen if his nails grew too long, so the fear of something disease-related outweighed the worry about cutting them.

I know it's still uncomfortable for him to sit and let me cut them, but he now does it willingly as the thought of some gross septic sores full of germs is even worse

Would something like that work?

What's he like about his fingernails?

Hqve you shown him what happens when you cut yours? It occured to me at one point that the language we use about this is quite likely to scare them, as we talk about 'cutting' them, and perhaps until it's explained explicitly that the nail is not like the skin, they might think you're just going to cut them to make them bleed.

Btw off-topic but I love your name - love that film!

Ds2 was/is the same. I used to go Ito his room in the middle of the night with a headlamp on and cut his nails as he slept.

He now bites them off (I know, disgusting) himself, and I can't stop him doing this, so have not had to do it in years.

Same here, though oddly fairly ok about finger nails.

I just use brute force ,and do it quick

I mean holding his feet - brute force sounds awful i just realised!

We had the same problem and used brute force too. Dh would hold him down and I cut the nails. Difficult to use this technique if you don't have another adult available, I know.
Ds would scream the place down all the time, begging Dd (who was 1-3 years old at the time) to save him and I would not have been at all surprised if the neighbours had reported us to SS for child abuse.
It has gradually got better and Ds who is now 16 will do them himself if I remind him and give him the scissors.
One thing he has said that bothers him is that his nails feel rough afterwards so he now uses an emery board on them as well. I don't know if that was a problem when he was younger but can't imagine him letting me use an emery board as well when things were at their worst.

Dd3 is the same, she used to scream the place down. She also bites hers now. Yuk, yuk, yuk.

We've been through this, and I did the horror stories and the brute force. It's awful, but the alternative isn't too nice either .

At that age, I used to wrap him up very tightly in a towel, so he couldn't kick or hit me, then DH and I would work together, one of us holding and the other one cutting. Usually managed about two nails per evening, so it took a week!

Also, always do it after a long soak in the bath, so they are softer.

In our case, it suddenly became easier, and it's no longer an issue at all (he's 9 now), so don't give up hope!

Brute force here too, I'm afraid, but with sweets as the motivator and something he likes on the television. He is getting better, still has quite a few sweets after, but we find it better if he takes control now. eg which one shall I cut next? and he tells us the order to do it.

Thank you so much for the advice. Will try your ideas. Scaring him into having them cut may work as about 6 months ago ago, he was refusing to brush his teeth until he came across someone with brown teeth and I told him that would happen to him if he wouldn't brush. It worked a treat so will find out some pictures of bad feet to show him. Failing this, will enlist people to help with the brute force. I do feel bloody evil but it must be done.

Yet another one here whose ds bites and tears his nails! I haven't had to cut them since he was one!

Even as a baby I had to cut his nails when he was asleep as he hated it!

DS3 is the same but it now takes THREE adults to hold him down. Oddly he enjoys having his fingernails cut, but if you even look like you are going anywhere near his toenails, he goes booloo...

I don't quite know what to do tbh, he's only 2.2yo, but even as a tiny baby, you couldn't cut his nails without two adults, one to hold and one to cut, but now even two adults can't hold him still.

Me and my Ex are very that by our fourth DC, a tiny 2yo at that, that we can't bloody cut his toenails.

I can't even do it when he's asleep, as he wakes instantly.

I barely ever have three adults here, so (and this sounds awful) he hasn't had his toenails cut for over two months. We've tried, don't get me wrong, but we haven't actually managed to get any cut.

I guess it doesn't help that my joint problems mean that I'm not a 'full strength' adult now tbh, but I'm the 'cutter' and Ex is the 'holder', but if even a 6ft bloke can't hold him still...

When he had bloods taken, it took FOUR adults - one to attempt to distract, one to hold him on their lap and hold one side, one to hold the other side, and another to actually take the blood...

I use firm pressure with holding hand at the base of nail and finger, this helps the sensation when cutting. Give him lots of reassurance that you are not going to hurt, ds is always scared I am going to cut his finger off so I reassure him that I am not going to.

I have this with my two. I had some adoce from an OT who suggested little and often may be the best way as it would help make it a routine job. She suggested doing one or two nails per day, always doing in same place as part of a routine. I have similar issues with teeth cleaning. I have found ds has got better as he has got older. I think it's definitely sensory. Dd flinches at the noise of the nail being cut. I empathise with the screaming. I am always worried that people will think we are terrible parents when in fact were just trying to do normal everyday things like clean our ds teeth!

I wonder why my DS is ok with fingernails but freaks out on toenails, anyone out there who can ask their autistic child for insight on that?

We are going to start brushing soon, a friend has had amazing results with her LO so I am quite hopeful. I will let you know how I get on

For any phobias, writing out a hierarchy and building up can work. So you'd start (for example)
by looking at his toes nightly,
then touching them,
then waving a scissors near them,
then letting it touch (not cut),
then pretending to cut,
and so on.

Trouble is, it's often very slow as with ASD you have to do each step a million extra times. The 'flooding' brute force might work better if you need quick results. Wildcard: NHS Paediatric podiatry can be impressive.

Lots of good advice from everyone You could also try doing 1 toe nail each night to desensitise slowly. Would he be better or worse if a podiatrist male or female did it? My ds was always better for the hairdresser than me even though he hated going and getting his hair cut the process itself was easier.