Tag Archives: sensory processing and toothbrushing

Special Needs Kids and Toothbrushing, Part 3; The Sensory-Motor Experience and the Behavioral Strategies that Support Success

Now that you know what issues your child have that made toothbrushing difficult, and you have made brush and paste/rinse choices, it is time to think about the influence of timing, the environment, and the approach to the task.

I often recommend that families practice skills outside of their natural timing.  Let’s face it; running off to school and bedtime are highly charged times of the day.  Almost any child is going to feel it, and certainly any rushed or exhausted parent.  No one is at the top of their game.  Try practice on an off-hour, make it short and if possible follow it up with something fun.  Human beings cannot help but associate events, and if brushing is followed by games or outdoor play, it is going to have a subconscious effect.  I really like the practice concept in “The Kazdin Method for Parenting the Defiant Child”.  Even though most of his techniques are more suited to a slightly older child, the idea that you can practice a skill at a calm time is a great one.  Both parties are in a different mindset.

Think of the bathroom the way a designer would.  No, you don’t have to buy new towels, but you might want to use a dimmer on bright lights and think about the noise the running water makes.  Sensory sensitive and poor modulating kids can be just stimulated enough to push them into irritability. I love the calming power of lavender, and your child might too.  There are children who cannot handle much in the way of scent, and even your plug-in deodorizer irritates them.  Move it out before starting your routine and see if that has a positive effect.  If you are not a sensory sensitive person, you might not even notice how odorous the dryer scent on the towels or the fancy soaps are.  Your child might.

Use softer tones in your voice, especially if there is an echo in your bathroom.  The same reason you sound so good in the shower could be a contributor to your child’s difficulties.  Sound bounces off tile in a different manner, and the lack of sound-absorbing carpeting and draperies could be a factor.  If your child has postural issues and is unsteady or is known to dislike his head tipped back, then re-think your position too.  A child standing on a wobbly stool with his head in your hands and tipped backward is likely to resist.  I know it sounds bizarre, but the first position and technique with a very upset toddler can be to cradle him in your arms, fully supported up to the top of his head, and use those xylitol wipes while terming it “toothbrushing”.  Do the singing, low lights, the whole deal.  You won’t be doing this when he is 12, but sometimes you have to make things really safe and comfortable to move forward.

Put a positive spin on toothbrushing.  Even if this has been a source of stress, your smiling face and positivity can help.  Do your best Oscar-winning performance if you can (another reason to practice on the off-hours).  At the very least, firmness and a sympathetic “Fast Food Rule” type response is useful.  For people who haven’t been reading my blog, that is the cornerstone of Dr. Harvey Karp’s Happiest Toddler on the Block approach.  You want your child to know that you understand what he is saying and feeling, but you don’t necessarily agree that we don’t do toothbrushing.  You acknowledge his aversion and express positivity and how there is something good at the end of the task.  If you are too emotional, even too sympathetic, you risk adding more emotion to the experience, something a sensitive and upset child really does not need.

Some children really love to hear you sing a brushing song, some like to use a sticker reward chart, some like a felt board where they move completed activities to the other side of the board.  It is risky to reward a child for something that is really a daily life skill, but at first some parents give it a try and then fade out the reward.  Every family is different.

This is my final post on the subject of toothbrushing.  I hope this helps some families turn around a common source of frustration and have a better day!

Kids With Sensory Differences and Toothbrushing, Part 1: What You Need to Know

Brushing your child’s teeth and/or teaching them to brush can seem overwhelming.  Toddlers with special needs are even more likely than typically developing kids to throw monumental fits when the toothbrush comes out.  Parents can tell themselves that this isn’t the issue to battle over tonight.  Or the next night.  Or tomorrow morning.  It can get to the point that dentists have to pull toddler teeth due to decay or kids have pain from dental cavities.  If a child cannot communicate, it is hard to know if the tears are from the brushing or the discomfort of dental problems.

I thought I would write a single “helpful hints” style post, but then I did some thinking.  This might need to be a short series.  Sometimes a little trick like singing a song while brushing will work, but sometimes the situation calls for more adaptations.  Once you figure out what the issues for your child might be, then can you make a plan that saves everyone’s sanity.  Take a look at the specific brushes, toothpaste choices, timing, sensory environment and the positive spin you need to put on this experience to help your child.

Children with sensory differences are as different as their fingerprints, but there are some commonalities among them.  Not every child has all of these issues, but here are some of the major stumbling blocks that interfere with getting those teeth brushed:

  •  Children that have aversion to putting food into their mouths often dislike and fear toothbrushing as well.  Seeing a toothbrush loaded with paste coming into their mouth can be as alarming as a fork with food.
  • Sensory sensitive kids can resist the texture of the brush, the flavor of the paste, the touch on their face as you help them, the bright lights, the towels and water splashing, or the head and body positioning for brushing.  Bet you never thought about toothbrushing in that much detail!
  • Children who transition poorly often resist doing a task they don’t value in any way at a time when they are stressed.  Brushing is usually done at times that can be minefields for them (getting ready for school and bedtime).
  • Children with balance and movement issues, even the kids who are just a little unsteady, can be fearful of being held with their head tipped back or while standing on a footstool.
  •  Kids that have issues around control, who feel more comfortable and safe by dictating what happens and when, will either struggle with the task demands or the scheduling of toothbrushing.
  • Toothbrushing can become a power struggle for typical kids as well as special needs kids; it’s an opportunity to “draw a line in the sand ” after a day in which a young child feels (right or wrong) that they haven’t been able to make decisions and allowed choices.  Special needs kids often have full days of therapy and home programs.  Their day is regularly filled with things they must do.  At times a desire for autonomy will be expressed as refusal to participate in daily living tasks such as toothbrushing.

Next:  How your choice of brushes, toothpastes, and other equipment can improve the experience.