Hand Washing and Sensory Difficulties The Little Treehouse London

Proper hand washing is a necessary self help skill, essential for personal hygiene and disease control.

Sensory integration or processing difficulties can make washing hands a difficult part of the day, which can lead to discomfort and anxiety. Sensory processing difficulties can affect the way you process the smell, touch, sounds, and visual information associated with washing hands and the environment you are in when you washing. Processing difficulties may also affect your balance, and the coordination needed in order to carry out effective hand washing.

During this course, you can learn a number of methods to ensure that hand washing is both an effective, rewarding and necessary part of the day for all.

  • Develop an understanding of the NHS guidelines regarding hand washing that have emerged due to the spread of COVID-19
  • Learn about sensory processing difficulties
  • Develop an understanding of why hand washing may be aversive for some
  • Learn new ways to encourage hand washing, making it a positive experience

Above is an NHS infographic demonstrating how to wash your hands. Due to the CoVID-19 pandemic the CleanYourHands campaign also recommends the following that hands are washed every 2 hours. When this isn't possible hand gels containing alcohol should be used.

Source: NHS

Due to the novel coronavirus, the NHS have recommended that hand gel's must contain at least 60% alcohol. Wherever possible, hand washing is the most effective preventative measure.

So, what do sensory difficulties look like?

We experience the world around us using all of our senses. When we perceive too much, we may feel that our senses have been overloaded and find ways to reduce that sensory experience or avoid it altogether. On the other hand, we may enjoy a certain sensory experience and try to increase the chances of receiving that sensory feedback.

Many of us will experience sensory processing difficulties at one time or another whilst others experience it much more frequently, also known as sensory processing disorder. This can make being in certain environments more enjoyable or more anxious.

Activity 1: Can you name all the senses?
We are were all taught about our five senses. If you said smell (olfaction), taste (gustation), touch (tactition), hearing (auditory), and seeing (vision), you were correct. However, there are more.

Consider the rules of a game of hopscotch. There are a number of other senses necessary to hop on one leg from one number to the next.

Balance: When navigating any environment independently we need to be able to balance. Without the ability to balance, we will find walking/running/hopping difficult and require assistance.

Proprioception: This is our body awareness and our understanding of where our body parts are in relation to our body. In the case of our hopscotch example; we need to have an understanding of where our arms are, in relation to our body, in order to raise them when we need to balance on one leg.

Interoception: This is a much newer concept. it refers to the sense that helps us understand and feel what's going on inside of our bodies. For example, if we fall whilst playing hopscotch and cut ourselves, our interoceptive system allows us to feel the pain.

In addition to our five senses it is important to consider what other senses are needed to carry out the task of washing hands and whether any of them are negatively impacting the individual.

What kind of responses might we output?

Hyper-responsive - This refers to an exaggerated behavioural reaction, we may avoid the stimuli causing the response

Hypo-responsive - This refers to the absence of an expected reaction. For example not realising that the sensory input has occurred, or having a delayed reaction. The individual may experience low arousal due to a high threshold.

Sensory seeking - Sensory seeking behaviour may occur when the individual wants to intensify that sensory experience further.

Can you think of some of the sensory differences that might make washing hands difficult or more enjoyable?

Visual aspects of the bathroom environment can be adapted to suit the users needs and make the task more rewarding. Visual cues may also be necessary and helpful when following steps. This may be especially true for individuals who are visually sensory seeking or who struggle with their coordination. The visuals aid them in recalling the steps necessary to complete each step.

  • A bathroom/toilet that is too cluttered may be aversive or a rewarding depending on responsiveness.
  • You can introduce a favourite item into the bathroom/toilet.
  • The NHS guidance visual chart/posters are perfect for this, however written or child-friendly images can prove just as useful.
  • Timers can provide a visual reminder of the time taken to complete the task, if the steps are already known.
  • For some, the lighting in the bathroom may be perceived as too bright (hyper-responsive) or not bright enough (sensory seekers). Adjusting these to suit the needs of individuals in the household may make washing hands a more enjoyable experience.

There are many sounds that can be heard in the bathroom from the sounds of flushing to the dryers. These can be distressing for some. As you may have noticed, making the bathroom environment a positive environment encourages us to use it more often. Let's look at some changes.

  • When entering bathrooms and public toilets with noisy dryers, using headphones or ear defenders can muffle unpleasant sounds, reducing the sensory overload.
  • You can also carry your own hand/paper towels for hand drying.
  • In response to the NHS guidelines regarding COVID-19, to reduce the likelihood of touching the face and to reduce skin contact with possible contaminated surfaces, wear gloves when outside.
  • Temperature of the bathroom/toilet, may also make it a place to avoid. Determine whether the temperature of the room is appropriate or causing aversion.
  • Children may find it difficult to change the temperature of the water. Encouraging children to adjust the temperature so that it is warm, as outlined by the NHS, is very important for disease control and hygiene. Practice this, incentives such as stickers can make the task more rewarding.
  • Keep doorhandles, worktop surfaces, bannisters and light switches clean. Keeping surfaces clean, is important particularly for those who frequently touch them.

For some who are hyper-responsive to smells and scents, washing hands can be difficult. For some who are sensory seeking, using more pungent sensory information can encourage more hand washing. Let's look at some solutions.

  • You can opt to purchase mildly scented or odourless hand washes, soaps and gels if they are too strong. Often more natural and/or sensitive hygiene products, have less of a scent.
  • For those of us who enjoy this type of sensory information, why not create your own? There are many recipes for hand gels, soaps and washes. Choosing your favourite scent will encourage more frequent use.

Making a sensory-friendly bathroom environment is likely to make the experience more rewarding. We advise assessing needs to ensure that the right measure is put in place

  • For those with SEND (Special Educational Needs and Disability, if you are out and about trying to avoid public toilets altogether, and public toilets cause too much distress, you can apply for a RADAR key. RADAR keys give you independent access to over 9000 accessible toilets in the UK.
  • Adaptions in your own bathrooms/toilets can be a great start. Like any room in the home, the more comfortable we feel there, the more time we are likely to spend more time there.
  • Reward charts and stickers are another great addition, particularly with children.

Thank you for completing this training, we hope you found it useful. If you have any questions or would like to learn more about us you can visit us here:

  • website: www.littletreehouselondon.co.uk
  • email: info@littletreehouselondon.co.uk
  • instagram: @littletreehouseteam
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Little Treehouse London Doyley