How do you get a balance between reducing anxiety and teaching to cope?

[parrotonmyshoulder]

Does that make sense as a question? DS (13) current big anxiety is dirt on his clothes. From a child who until recently never wanted to wash, this is a fun new development! He wants every item washed if it has been worn at all. I’m struggling to know where to draw the line. Obviously, underwear, anything dirty, shirts worn all day etc. But he doesn’t wear clothes all day! They will be worn for a few minutes sometimes and changed, or certainly if he’s been outside or to a shop or something. Never the same outfit all day.
He needs some autonomy over his clothes, I know. And up to him to decide what’s comfortable and what isn’t. But the excessive laundry, water and time wastage is a problem.
Hard to quantify WHEN something needs washing. Not as simple as just telling him, or saying no it can’t be, or usual NT strategies I’m afraid.
I think I need a sort of decision tree/ diagram!
While you’re here, does anyone have any brilliant ‘putting clothes away’ strategies for ND young teens? He doesn’t like mess, but can’t put things away. Contradicts his need for ‘clean clothes’ but if I put too much emphasis on that he’ll never wear any! I have labelled all drawers etc but this isn’t working for him anymore.
Thanks!

Over time, I think you learn the signs in your child that tell you when you can push and when you need to back off otherwise you will cause harm.

Has DS has a MH assessment and is he receiving any MH support?

Has DS had a sensory OT assessment?

Your idea of a decision tree might work. It could look something like:

1. Have you worn the item for more than X hours? If yes, put it in the wash. If not, move to no.2. (OK, this will mean some items such as jackets will be washed more often than they need to be, but I think you could accept that whilst working on the wider issues.)
2. Would mum say it is visibly dirty? If yes, put it in the wash. If not, move to no.3.
3. Would mum say it smells? If yes, put the item in the wash. If not, move to no.4.

You get the idea.

Does DS have somewhere separate from his clean clothes to put the clothes he has worn that aren’t ready for washing?

Thanks. I probably do know when to push and when to back off in general. We’re just back from holiday which highlighted some of it (although very carefully planned around his needs and preferences!) - explaining to other people eg relatives how to support is hard, and he’s very good at masking at school/ with less familiar people.
I’ll keep looking at the decision tree. It’s always a new thing - at the moment it’s crumbs and laundry, a while ago it was people watching him etc.
He can’t verbally express anxiety or any other emotions really. It’s all in the behaviour - diagnosis of DLD but not ADHD as too contained at school. We do a lot to help manage it. There’s a lot of demand avoidance too, but I think that’s strongly rooted in anxiety, probably in itself exacerbated by his language challenges.

No MH support - masks so well with professionals. He has had some private counselling which he liked but as the issues change from day to day it hasn’t had any real impact, apart from being enjoyable.
Referral for OT not accepted.

I think DS needs a mental health assessment. Also, an ASD assessment.

Is DS’s school providing any support with expressing emotions and emotional regulation? Does DS have an EHCP? Is he receiving SALT support?

SALT just diagnosed DLD but would not give ongoing support. He gets some support for his dyslexia at school and they follow recommendations from the SALT report quite well. He has some mentoring support. No EHCP as LA rejected at primary and he is in a small independent secondary now that meets his educational needs much better than mainstream with EHCP would.
Autism assessment - maybe. I wonder if it would have the same barriers as the ADHD referral - not meeting threshold because he apppears to ‘cope’ so well in some settings.
I think it’s the language that needs external support but I can’t get SALT for him. Can’t even find anyone privately.

Request another EHCNA. Appeal if refused. Independent schools can be named in an EHCP.

DS needs far more support than he is currently receiving, including SALT, OT and MH therapy. All of which an EHCP can provide.

A good ASD assessment will recognise masking for what it is.

I appreciate you may not want to but if you want to post or message where you are in the country, I will give you some suggestions of SALTs. No worries if you would rather not.

Sorry @parrotonmyshoulder what do you mean you can’t find anyone privately

sounds like OCD (we have similar) a child psychiatrist can help out

DS is on a specific med for his adhd it has helped massively with ocd behaviours but there are other non adhd meds that focus on this

I would also say this sounds like OCD. You need to see a child psychiatrist for assessment and then meds in combination with exposure therapy.