Steps to cleanliness

Emma McKinney
By Emma McKinney
4 Min Read

Maintaining personal hygiene is important for everyone. Here’s how to encourage and assist children with disabilities to do so.

Some children with disabilities experience difficulty performing everyday activities of daily living (ADLs), such as dressing, mobility, positioning, transfers and personal hygiene.

It can be a challenge for them to wash their hands or bodies independently and they might require support or assistance. While it may be easier and quicker to assist a child, we need to encourage children to be as independent as possible. Bathrooms are often the most dangerous areas of the home or school, and it is important to be aware of potential hazards.


Some children require verbal cues from an adult to remind them of the steps they need to follow. An alternative is to use a sequence of pictures or simple sentences to remind children of the steps. For example, if a child has difficulty remembering or following the steps in washing their hands, you could select pictures of a bar of soap, tap, water, hands and towel. You could take photos of these objects and print them, or find them and cut them out of a magazine or sales advertisement, or draw your own pictures. Show the child the picture, ask them about each object, and discuss the steps you need to follow (i.e. first we open the tap and wet our hands. Then we take the bar of soap and lather our hands. Then we rinse our hands under the water. Then we dry our hands on the towel.) Put the pictures in a sequence and place them above the sink or basin where the child washes their hands.

Making the bathroom accessible

Helpful modifications include:

  • A bench placed in the bath or shower to sit, rest or lie on
  • Grab bars
  • Hand-held shower
  • Hoist or lift
  • Roll-in shower
  • Roll-in shower chair
  • Shower chair
  • Transfer bench
  • Non-slip mat and flooring
  • Long-handled lever taps
  • Long-handled brushes and sponges
  • Squeeze bottles and soap pumps (rather than bars of soap)
  • Containers secured with suction pads, Velcro or mounted directly on the walls
  • Cut-out or roll-under basins, which provide room for legs while in a seated position (pipes should be covered or insulated to avoid leg burns).

The issue of safety needs to be addressed at all times. We’ve probably all heard horror stories of children being burned in shower that is too hot or falling into buckets of water. Children should be supervised when near water. For example, they cannot always judge the temperature of the water. Some children with disabilities require extensive physical assistance and cannot sit or stand independently in the bath or shower.

If possible, offer the child options and let them select whether they would like to bath, shower, have a bed bath or sponge bath, use certain products, or have a male or female to help them.

Dr Emma McKinney is a “children with disabilities” specialist, a post doctoral fellow at Stellenbosch University and owns a company called Disability Included. email:

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Emma McKinney
By Emma McKinney Children with Disabilities Specialist
Dr Emma McKinney is a “children with disabilities” specialist, a post doctoral fellow at Stellenbosch University and owns a company called Disability Included.
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