There are a wide range of resources and top tips for you to try.

• Encourage the person to choose their nightwear garment.
• Try to avoid synthetic materials and try using a very loose cotton t—shirt — this will also help with
  temperature regulation.
• If unable to tolerate the movement of clothing on their skin, consider close fitting garments which can
  offer a slight calming compression element.
• Remove tags and labels where possible from nightwear and bedding if they are causing distress.

Environmental considerations:

• Dim lighting where possible. Consider using a red nightlight as this imitates natural lighting and
  promotes the production of sleep hormones.
• Keep the bedroom cool as this helps to slightly lower the body temperature and helps the
  transition into sleep.
• Tightly tuck the bedsheets in to provide a constant firm pressure which will help to calm the person but please make sure they are able to get out if they choose to.
• Consider offering a body pillow to hug or a large soft toy.
• Consider reducing visual distractions, for example
  having pastel coloured walls rather than heavily patterned wallpaper or plain, simple curtains. Use
  blinds and lined curtains to block out unwanted light. Try to eliminate excessive background noise where possible such as TVs, radios, and household
  appliances.
• Encourage exposure to natural daylight around breakfast time to help regulate sleep wake cycles.
• Enable the person to have regular opportunities during their day to incorporate heavy work activities which will help to regulate their sensory systems.

Preparing the person for dressing:

Before getting dressed, encourage the person to engage in some heavy work activities.

For example, encourage pushing and pulling heavy objects, such as a laundry basket, back and forth across the floor. This will help to get their bodies ready and focused for dressing.

Deep—pressure activities can help calm their nervous system. Try other activities such as:

• A firm massage before getting dressed
• A firm scalp massage can be helpful to do before wearing a hat.
• Bear hugs with firm pressure whilst rocking gently back and forth-
• If developmentally appropriate, sit facing one another with the soles of your feet touching and holding hands whilst gently pulling and pushing backwards and forwards and singing along to Row, Row, Row Your Boat.
• Try sucking a thick liquid, such as a smoothie or yoghurt, through a straw.

Allow plenty of time to get ready in the mornings:

• Pick out clothing ahead of time.
• Encourage the person to be involved in the selection of clothing options.

Seasonal wear advice:

• Transitions between seasons – consider using social stories to help ensure the appropriate clothes are picked for the weather.

Consider reducing audio and visual distractions:

• Turn off the TV or radio.

Some people with sensory processing challenges may struggle with their balance:

• Encourage the person to sit during dressing so that they can concentrate on getting ready rather than trying to maintain their balance.

Before bathing / showering:

• Consider trying showering or bathing at different times of the day as having a shower in the morning may feel more alerting. A bath in the evening may feel calmer and assist with bedtime routines.
• Try to work out what routine works best and maintain a regular time slot.
• Encourage participation in heavy work activities half an hour before getting ready to have a bath or shower. Heavy muscle work activities, such as, pushing and pulling a laundry basket or doing wall push ups can have a calming effect.
• Where possible, offer  a choice between bathing or showering. Generally showering is often an alerting experience and bathing can be more calming and relaxing especially before bedtime.
• Consider giving a firm body massage before having a bath/shower. Providing firm pressure to the shoulders can be helpful.
• If noise is difficult then run the bath water before the person visits the bathroom, or consider using ear defenders while the water is running.
• Agree in advance the water temperature, some people may prefer a cooler water temperature than you think. Use a temperature gauge to check if the water temperature is appropriate. Once at the desired temperature, encourage checking with their fingers to ensure they are happy to proceed with having a bath.
• Encourage the person to take more control in the selection of personal care products if they struggle to deal with certain smells or the feel of hygiene products.
• If showering and the touch of water on the skin is difficult to tolerate consider adjusting the spray type on the shower head
• Try using social stories to aid understanding of the importance of going in the bath/shower.
• Try reducing clutter in and around the bathroom to prevent becoming overstimulated.

Before the dental appointment:

• To reduce anxiety: at home, role-play going to dentist. Also, ask if you can visit the dental practice with the person before the appointment.
• Keep scheduled check-ups.
• Consider telling the person about the appointment as early as you can and discuss any worries they may have.
• Social stories can be helpful to explain what is going to happen at the appointment and why it is necessary.
• Try a facial massage, applying firm pressure around the mouth to help desensitise the area.
• Drinking thick fluids through a straw or eating a chewy snack on the way to the dentist can provide a calming and regulating input.
• Heavy work activities or wearing a backpack filled with toys or books whilst walking to dentist can help to calm and regulate.
• Also consider planning a lovely activity to do after the appointment.

Before the haircut:

• Try to keep a consistent haircutting schedule, for example, on the same day. If possible, try to have the same professional each time.
• Try to familiarise the person with the environment first and get them to watch someone they know get a haircut before they do.
• Massage the person’s scalp regularly to help reduce scalp sensitivity or encourage them to rub their own hair dry with a towel.
• On the way to the appointment try wearing a weighted backpack to provide a calming and regulating influence.
• Make appointments at the beginning or end of the day when the environment is calmer.
• Consider washing their hair at home before the appointment to reduce appointment time and avoid unfamiliar scents.
• Ensure the person knows how long the hair cut will take. Consider bringing a visual timer to the appointment.

Before nail cutting:

• Encourage engaging in heavy work activities (activities that stretch the muscles), for example, animal walks, wall press ups or pushing and pulling toy boxes. This helps to calm the nervous system and aids self-regulation,
• Playing with Thera-putty or play dough provides heavy work to the hand muscles to help reduce sensitivity to the hands.
• Try giving a firm hand/foot massage to reduce tactile sensitivity,
• Keep when and where you trim the person’s nails consistent and set up a routine, for example, Tuesday after bath time is nail cutting time.
• Consider the use of child-friendly nail clippers that have softer, rounded edges and can be more visually appealing for children or try using a nail file instead.
• Pay attention to the environment, for example, if noise is distracting or distressing, pick a quiet place to trim nails.

Some people may experience anxiety when having to go to the toilet or bathroom. They could be worried about their balance when sitting on the toilet or the motor skills required to perform the task.

Alternatively, they could be scared of sitting on the toilet as it might feel too cold or too hard. The lighting maybe too bright or too dark or the noise and smells may make them feel overwhelmed or they have difficulty in understanding the sensations of when they need to go to the toilet.

Please see below strategies to consider and try:

• Make sure the person is supported with their posture when sitting on the toilet – this will provide more stability and control to be able to go.
• Consider using a foot stool to help increase stability and mark out where the feet need to be placed on it.
• Think about the design of the toilet seat, is the gap too large could you help to reduce anxiety by using a smaller toilet seat.
• Think about the feel of the toilet seat, is it too cold or too warm. Could you try a padded toilet seat? Is the bathroom temperature too cold or too warm, could you adjust the heating?
• To support a feeling of security when sitting on the toilet, consider installing a rail on both sides of the toilet.
• If the person is scared of sitting on the toilet, demonstrate to them by sitting on the toilet and explain there is nothing to worry about.
• Some people can be particularly anxious around using the toilet or even scared of poo.

The following links provide further information from external sources around supporting children to feel comfortable.

1. ERIC – Supporting children to feel more comfortable around poo.
2. ERIC – Toilet anxiety and toilet phobia in children.
3. Made for Mums Blog – 10 of the best potty training books.
4. Bladder & Bowel UK – https://www.bbuk.org.uk/wp-content/uploads/2022/09/The-impact-of-sensory-issues-on-toilet-training-paediatric-Bladder-Bowel-UK.pdf

• If they dislike the feel of toilet paper on their skin, consider using an alternative softer brand, cotton cloth strips or try using wet wipes.
• Please think about the environment — most wipes aren’t flushable — but you could consider biodegradable wipes.
• Does your child find the lighting too bright and overwhelming, consider using a dimmer switch or smart bulbs to alter the lighting? Additionally, consider changing any heavily patterned walls or flooring and think about painting walls with pastel colours or using a plain slip resistant mat to cover up any patterned floors.
• Does the person require additional lighting as they may prefer increased amounts of visual stimulation. Please also be aware that too much visual stimulation could end up being too distracting.
• Sometimes people can find scents in the bathroom overpowering from cleaning products and air fresheners. Try changing these to unscented products.  If using a public or shared toilet try and be prepared by bringing a preferred scent on a handkerchief to mask unpleasant smells.

If the person struggles with noise levels in the bathroom, consider the following:

• Placing towels on the radiators or place slip resistant mats on the floor to help reduce the noise volume in the room.
• For younger people trial ear defenders during toileting or for older people try Earbuds or Flare Audio buds to reduce background noise.
• Encourage the person to put the toilet lid down before flushing as this will reduce the noise level. If need be, allow them to leave the bathroom and give them a warning you are about to flush the toilet.
• If the person is scared of automatic flushing toilets, please consider placing a sticker or a sticky note over the sensor on the wall.
• If the person is fearful of urine or water splashing them from the toilet bowl, try placing a piece of toilet paper in the toilet bowl before they use the toilet.
• If in the community, you may want to consider using a disabled toilet. Some disabled facilities in the UK need to be accessed via a specialist key. These keys are referred to as RADAR keys. The following link below provides information on RADAR keys and how to apply for one: RADAR Key Application.
• Disabled toilets will often provide you with a quieter environment, increased space, and handrails. If the person is noise sensitive, you may be able to turn the hand dryer off at the fuse switch on the wall to prevent it being accidentally activated.
• Some people can find it confusing to recognise the sensation of when they need to go to the toilet. Being unable to recognise internal body sensations is often referred to as Interoception difficulties. The following link will provide further information on interception and toileting difficulties Interoception and toileting — ERIC.
• When people have difficulty in recognising the sensation required to go the toilet it is helpful to have an actual picture of the toilet they use at home or school to help connect the sensation and the environment, Please ensure that this toilet picture is included in their visual timetable.
• If the person is struggling to communicate when they feel the sensation of needing to go to toilet, please pay attention to nonverbal cues such as increased fidgeting wriggling, passing wind or moving away from you which may indicate they need to go to the toilet.
• If the person is struggling to initiate bladder or bowel movements, try blowing games and activities on the potty or toilet this will naturally encourage the stomach to push to help pass urine or motions, e.g., bubble blowing, blowing party whistles, blowing bubbles with a straw into a cup,
• To help increase body awareness when going to the toilet encourage resting hands on the lower tummy and this will help with noticing stomach movements and help to increase awareness of a full bladder.