Bathing with sensory processing difficulties

By Louise Sharp, Occupational Therapist

What are sensory processing difficulties?

We experience the world around us through our senses, and most people can block out unnecessary sensory information to focus on the task at hand. For children with sensory processing difficulties, they are unable to do this and can become overwhelmed quickly.

Our sensory systems are touch, taste, smell, hearing, vision, vestibular (balance) and proprioception (body awareness).

Some children will be sensory seeking, and some will be sensory defensive. But what does that mean?

• Seeking – They are under-sensitive and seek out more sensory information because they need a lot to notice the sensation.
• Defensive – They are over-sensitive so avoid sensory information because they only need a little to notice the sensation.

How sensory difficulties affect bathing.

Bathing is a very complex sensory experience that encompasses undressing, submerging in water, washing and drying. Being naked can be a very challenging experience for children with sensory processing difficulties and they may feel frightened because they don’t feel secure in the bath.

Here are some examples of difficulties:

Strategies to help

Once you’ve identified that your child is sensory seeking or sensory defensive, there are some simple strategies to put in place that can help make bathtime go more smoothly.

Sensory seeking

Touch

• Give a deep pressure massage or bear hug before using the bath
• Have a deeper bath so the child feels covered by the water
• Use firm pressure when washing
• Leave a wet flannel or small towel over their shoulders whilst in the bath
• Use a big, heavy towel to dry after the bath
• For oral seeking children, use a straw to blow bubbles in the water
• Have lots of toys in the bath that are different textures and play with sponges that they can squeeze

Smell

• Use strong smelling soap such as lavender or peppermint
• Have strong smelling air freshener in the bathroom and spray before and during the bath

Hearing

• Play music or sing whilst using the bath
• Run the bath when they are in the bathroom

Vision

• Fit extra lighting to make the room brighter
• Take lots of colourful toys into the bath or use light up toys that are suitable for use in water
• Have colourful bathroom products and towels on display

Vestibular (balance)

• Do some physical games before having a bath such as dancing, obstacle course and jogging on the spot
• Fit handrails and a footstep to help with balance
• Use a non slip mat in the bath
• Dry in front of a mirror after the bath

Proprioception (body awareness)

• Do some physical games before using the bath such as dancing or yoga
• Wear a swimming costume in the bath
• Play with toys that provide resistance such as pouring jugs
• Wash and dry with firm pressure

Sensory defensive

Touch

• Use a small towel to dry after a bath
• Use a non slip mat in the bath so the bottom of the bath feels less hard to sit on
• Wear goggles to prevent water going into their eyes
• Have a shallower bath
• Encourage independent washing so they have control over the amount of touch
• Allow time for wet sensory play outside of the bathroom for children to explore textures such as water, soap, bubbles

Smell

• Use scent-free soaps and cleaning products
• Keep the bathroom window open to ensure smells do not linger

Hearing

• Use waterproof ear plugs, this reduces echoey bathroom noises and also prevents water going into their ears
• Run the bath before they enter the bathroom and empty the bath after they leave
• Soften bathroom sounds with mats, towels and fabric blinds

Vision

• Simplify the bathroom by storing bathroom products and towels out of sight
• Cover mirrors if they are opposite the bath
• Use task lighting to create a calming environment
• Use sunglasses if your child finds the bathroom extremely visually distressing

Vestibular (balance)

• Do some calming physical games before having a bath such as, rocking side to side, or rolling their tummy on a gym ball
• Fit handrails and use a step to help with balancing
• Use a non slip mat
• Warn them before you move them whilst in the bath

Proprioception (body awareness)

• Do some calming heavy work before a bath such as carrying heavy bags and hoovering or give a deep pressure massage beforehand
• Fit handrails and use a step to help with balancing on the toilet

And finally….

For any child with sensory processing difficulties, it can take time for them to get used to the bathing experience.

Consider using a handheld shower nozzle as this will promote independent washing skills and help children feel they have control over the pressure and duration of the washing time.

Reading stories and talking about bathing can help children understand the concept and meaning behind taking a bath, which could help to motivate them.

And most importantly, make a bath part of their routine. By providing structure, stability and predictability children know what is coming next and what is expected of them which can be very empowering for children who struggle with their sensory environment.