Why Cutting Nails Is Such a Challenge for Autistic and Sensory Kids

Most children resist nail trimming.  You are not alone.  Kids on the autism spectrum, kids with sensory sensitivity, and children with significant language delays can turn this simple grooming task into a contest of wills.  Here are some reasons why cutting your child’s nails can be so difficult for them.  If you can identify the “why”, you can often adapt the experience to help your child handle this grooming task.  Even if your child doesn’t immediately calm down, you may be calmer and more compassionate when they squirm.  And a calmer parent can inspire calmness in their child.

BTW, even though some of my links are to previous posts with the word “toddler”, these techniques work equally well for older kids on the spectrum or with SPD.  In fact, they work pretty well with any child who is upset or demanding during grooming, haircuts, etc.

  • Most typically developing young children do not enjoy nail trimming.  They put up with it because they have the following abilities:  they understand your explanation, they tolerate the frustration of sitting passively, and they tolerate the awkwardness of having their finger held by another person and don’t mind the pressure applied to each nail.  In addition, they do not see the nail as an essential part of themselves, and they do not fear that you will injure them by accident.  If your child doesn’t yet have some of these skills, then you are going to have problems when you want to trim your child’s nails.
  • Children with ASD,SPD, global developmental delay, or significant language delays do not have most or all of the above skills.  They may genuinely find your touch irritating, and they often have very little frustration tolerance for the things that they do not want to do or struggle to understand.
  • Nail trimming is usually an occasional event, not a daily part of a familiar routine.  Rare events are almost always seen as unwelcome or even threatening.

There are some things that parents can do to make nail trimming less aggravating.  Here are my most successful strategies:

  • Build your child’s frustration tolerance for other small events and annoyances with Patience Stretching, Dr. Harvey Karp’s wonderful technique from Happiest Toddler on the Block.  I wrote a post on this technique, Stretch Your Toddler’s Patience, Starting Today!, and it gives you some insight into the how and why of this simple strategy.
  • Use Dr. Karp’s “toddler-ese” language and Fast Food Rule techniques when you get some push back; see  Taming Toddler Tantrums Using Sympathetic Reframing.  Simplifying what you say, and empathizing but not agreeing with a toddler who balks at nail trimming can reduce the resistance.  Children will then understand that you get their point of view: they don’t want to do this.  Most kids are well aware that they will be asked to do things they do not want to do.  Diaper changes, clothing changes, tooth brushing (see my series of toothbrushing posts for specifics on that subject.)  Just hearing that you know they don’t like it is sometimes enough to help them allow you to trim their nails.  They feel heard.  Most kids will not assume that you understand them by reading your tone and body language alone, and ASD kids struggle with this more than the average child.  You are giving them information about your mindset that they cannot understand unless you spell it out in this manner.
  • Choose a comfortable position for both of you.  Some kids really like beanbag chairs as they feel cradled while the chairs also supporting them.   All that deep pressure helps them stay calmer and they can’t squirm as much.  Some prefer to be lying down, and some want to be watching Paw Patrol.  I don’t know that using distraction is so terrible.  You might sweeten the deal with a special DVD like home movies that feature them!
  • Use good technique and equipment.  There are nail cutters that protect children’s fingers better than the standard clippers you buy for yourself.  Buy them now.
  • Try a little hand massage.  Nothing too hard, but never use light, flighty touch.  Light touch is always stimulating to the nervous system, and light moving touch is even more stimulating.  Use firm grasp that doesn’t roam on-and-off their hand during nail trimming.  If you don’t believe me that light touch is irritating, imagine getting a massage of flighty fingers up and down your back. Can you feel that?  It is alerting and a bit annoying, right?  Certainly it is more stimulating than relaxing.  Well, when you hold a child’s fingers loosely, and then grasp/release their hand over and over….their brain perceives it as light touch. Oops.
  • Pair the experience of nail trimming with something your child enjoys.  You could try offering a healthy but tasty snack right after nail trimming.  Read a beloved book after nail trimming.  Something that they like and can look forward to.  My trick: have it visible but out of reach, so that an upset child who is more literal and less likely to understand your words will see evidence of the positive experience he will have immediately after nail trimming.  You might be surprised that even though your child is calm enough to speak, his response to nail trimming is so much better with the visual cue of the actual treat.
  • Try to do a small trim on a weekly basis so that it can be expected and part of a routine.  Familiarity really helps all of us.  That is why tax time can be stressful.  It only comes once a year.  And here in the U.S., we are about to enter into the least happy time of the year!

And remember to be patient with yourself as well. The challenges of parenting a child with sensory sensitivity and modulation issues can really affect how you see the world . It is important to acknowledge how you feel as well as how your child feels.

Good luck, and if these techniques help you and your child, please post a comment and let other parents know what worked for you!

 

 

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