Friday, May 22, 2015

Teaching Your Child to Get Dressed from Infancy On

We all want our children to be independent. But sometimes we don't realize our child can't do something that other kids his age can do until your child reaches that age and is already behind. So we need to be proactive and allow our children plenty of opportunities to acquire the tools necessary to accomplish his life skills in a timely manner. For such an important and rather complicated daily task as dressing one's self, it's best to start early so that by the time your child is in kindergarten, he would have had plenty of opportunities to learn and would be well on his way to getting dressed on his own. 

The first list is the order in which children usually learn how to dress as far as being able to physically and cognitively perform the skills. The second list has tips and the steps in which you can teach your child to dress himself.
Jett dressing Bessy.
Find out where your child is on the first list and go from there as far as helping him to acquire the skills needed to properly dress himself. If your child can do things in a different order than is shown, go ahead and rearrange the list to best fit your child. For instance, all the ones that I marked (FM) for fine motor, Jett did in a later order than is shown here. One child with DS that I know did all the FM's earlier than the other tasks. Much to his single mom's "delight" his fine motor skills made him quite the escape artist. She'd often get a hug from him while driving even though he had been well strapped in his car seat! 

The list allows you to notice where your child is and what the next step may be so that you can let him give it a try the next time you go through your dressing routine. And then you can add supportive activities like practicing buttoning on a doll like "Dressy Bessy" or on a busy board. Our local library has a developmental center where we can check out developmental toys such as a giant book that has big buttons, zippers, etc. You can make something for your child to practice on by taking an old shirt and stapling it onto an unused frame. Here is a great list of items you can make at home to help your child acquire these fine motor skills related to dressing. One of my favorites is the Button Snake.

Different types of therapy can help with gaining these skills. Kay Ness' Tactile Sequence, part of neurodevelopmental therapy, helps your child to integrate his tactile senses. MNRI is another type of therapy that releases the blocked reflexes so your child can move more easily. One exercise Jett does directly relates to holding a pencil, for instance.

If your child has difficulty cooperating, check out How I get Good Behavior from Jett. And, of course, I can't help but mention the importance of supporting your child's health and thereby supporting his cognitive development with proper nutrition and supplements. For instance, B12 helps restore sensations in the nerves, which means your child would be able to feel his or her fingers better, allowing him to use his fingers more accurately.

Order of skill acquisition related to dressing
  1. Holds arms out for sleeves and puts foot up for shoes
  2. Pushes arms through sleeves and legs through pants
  3. Pulls socks and shoes off
  4. Removes unfastened coat
  5. Removes shoes when laces are untied
  6. Helps push down pants
  7. Finds armholes in t-shirts
  8. Pulls down pants with elastic waist
  9. Tries to put on socks (FM)
  10. Puts on front-buttoned shirt (without doing up buttons)
  11. Unbuttons one large button (FM)
  12. Puts on t-shirt with little help
  13. Puts on shoes without fastening (might be wrong foot)
  14. Puts on socks (might have trouble getting heel in the right place) (FM)
  15. Pulls down pants on his own
  16. Zips and unzips without joining or separating zipper
  17. Removes t-shirt without assistance
  18. Buttons large front buttons (FM)
  19. Finds front of clothing
  20. Snaps or hooks clothing in front (press studs and zips) (FM)
  21. Unzips/zips front zipper on jacket (separating zipper) (FM)
  22. Puts on gloves (FM)
  23. Buttons series of 3-4 buttons (FM)
  24. Unbuckles shoes or belt
  25. Removes t-shirts on her own
  26. Buckles shoes or belt (FM)
  27. Connects jacket zipper and zips up zipper (FM)
  28. Puts on socks the right way (FM)
  29. Puts on shoes with little help (FM)
  30. Knows front and back of clothing
  31. Steps into pants and pulls them up
  32. Puts belt in loop (FM)
  33. Dresses without your help or supervision
  34. Puts on t-shirt or sweater correctly each time
 This list is adapted from Dunn Klein, M. (1983). Pre-dressing skills (rev. edn). Tucson: Communication Skill Builders.

How to Teach Your Child to get Dressed
    Oh, the hat's the easiest, Jett! But you do look cute!
  • First, teach him how to undress. Once he can do that fine, then he's ready to dress himself.
  • Give yourself plenty of time so you don't have to rush or feel anxious. He'll feel the anxiety and can effect him as well.
  • Find the same spot to do it every morning. Lay out his clothes with shirt flat and face down, then pants face up, then underwear face up.

1) Slowly go through each step w/him yourself, quietly. Use only the key words described below for each action. Show him what you are doing w/out expecting him to do it. Use hand over hand for all of the actions, which means to put your hand over his hand and do the action with him. Use the verbal cues according to what processing level your child is at. For an auditory processing of one, use one word "foot." For two, say "Put foot." For three "Put in foot," etc. You don't want to keep a constant flow of words going or he might lose the key word you want him to remember. You can get an explanation of auditory processing here.

The steps:
  1. Say, "Where's your clothes?" or "Where clothes?" or "Clothes?"
  2. Say, "Oh, here are your clothes!" "Clothes, here!" or "Here!"
  3. Say "sit." Sit him down in front of the clothes.
  4. "Oh, here's your underwear!"
  5. Put on underwear: Have him stick his thumbs in and pinch each side w/both hands. Just say "thumb" to get his thumb there and then "pinch" for one side and "thumb" and "pinch" for the other side.
  6. Pull the underwear open (not tight though). Say "open."
  7. Say "foot". He puts one foot in one hole. Say "foot". He puts the other foot in the other hole.
  8. Then you say "pull" and pull the underwear up past his knees.
  9. "Stand" Then he holds on to you and stands up. If he can't yet stand, you can have him lay down.
  10. "Thumb front" Then he puts his thumb at his waist band in the front and pinches. Say "pinch front" and puts his thumb at his waist band in the back and pinches. Say "pinch back."
  11. The "pull up."
  12. "Sit" Then he sits back down and does the same process with the pants.
  13. For the shirt, I like head first, then arms, saying "Head" and "arm" "arm"
2) You actually start teaching him with the last thing first. Depending on the processing level, kids usually only remember the last thing you say, so that's why you start with last task first. Have you noticed that you tell your child "Blah blah blah... don't touch the dog." And then they go and touch the dog? It's because they can only remember the last part of what you say. That's why I also never use the word "don't...." because they might not catch the "don't" part!

Day 1, you do the whole thing hand over hand for every action.
Day 2, he does the arms part by himself in Step 13, you say "arm" and pause to give him a chance to do it.
Day 3, he does both arms himself.
Day 4, he does head and arms himself. Once he gets the entire sequence of putting on his shirt, then he will automatically group the actions together in his mind, called "chunking". Then you can just say "shirt" and he can do all the steps involved with putting on his shirt.
Day 5, he pulls up the pants himself and then puts on his shirt... etc.
Say things like "good try" or "great pinch" each time instead of "good boy." He's always a "good boy", no matter the situation. This activity isn't about his self worth, it's about practicing new skills. :) 

3) In real life, things are never carefully set out for you each morning! So, after he has the whole sequence down, then you do things like mess up the clothes and ask him to lay them right. Then once he can do that, you have him choose between two different outfits starting with an obviously poor choice and an obviously correct choice, depending on the weather, time etc. Like pajamas verses a raincoat. Then you have him decide which clothes to wear out of several choices and eventually, the entire drawer. 

Before you know it, your child will be one step closer to independence. And you'll have your mornings back! (Or at least enough time for a second cup of coffee.)

Mãe de criança com síndrome de Down explica como ensinar os filhos a se vestirem desde pequenos. Confira: