LIZELLE KEYSER Paediatric Occupational Therapist

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1 SENSORY STRATEGIES TO IMPROVE DRESSING Always looks unkept/sloppy Create a visual schedule for getting ready Wear clothing that is snug fit to provide increased awareness Teach person a sequential strategy for evaluating appearance, e.g. when leaving for the bus stop, check mirror for combed hair, no toothpaste on mouth, shirt buttoned correctly, pants zipped and shoes tied) Can t stand sand in shoes or bumps of seams in socks Turn socks inside out so the seam is on the outside or get seamless socks Try different socks where the seams are not so prominent Be aware of the type of shoes the person is wearing Select shoes for comfort, not style Wash shoes before wear, to make them softer Try laced shoes as they can be more effectively tightened Dislikes certain clothes Respect the person s desire for certain textures when appropriate Consult a trained occupational therapist regarding the Wilbarger Deep Pressure Prioprioceptive Protocol (brushing program) Encourage deep pressure activities prior to dressing to decrease the tactile sensitivity Massage the person with a vigorous towel rub to increase tolerance to certain textures of clothing items and then introduce a new item or texture Remove clothing tags that may cause irritation Wear undergarments inside out to prevent scratching seams and tags Use one detergent consistently 1

2 Consider a fragrance-free detergent Dry clothing in a dryer to decrease stiffness Use loads of fabric softener. When buying new clothes, wash it many times over with lots of fabric softener, for it to get rid of its newness and become softer. Consider/trail buying clothes from a charity shop, where the clothes had been worn and washed many times over and thus would be softer than new clothes. Let the person choose the clothes when going to the shop. If he tries the clothes on in the shop and then choose. Another option is to buy different clothes, then let him try it on at home and return the clothes he does not like. Choose softer fabrics like fleece, pure cotton or silk, which might be more tolerable if he is sensitive to textures, than rigid items like denim Be sensitive to the length of sleeve and pant leg the person likes, due to sensitivities they might like long sleeves even in hot weather Be aware of patterns in fabrics and distraction the pattern may cause Takes off clothing If the person likes to strip, try the Wilbarger Protocol for sensory defensiveness and massage (discuss with the OT) Use augmentative communication strategies to encourage understanding of the consequences of taking clothing off Refuse to go barefoot, especially on grass Try rubbing person s feet with a cloth or towel first Introduce new textures to the person s feet such as sand, beans, rice, bubble wrap, or Contact Paper. Offer but do not force activities. Trouble dressing, especially clothes with fasteners Have a person practice with Velcro fasteners 2

3 Begin with larger fasteners or buttons, when these are mastered move to smaller ones. Buy clothes that have few or no fasteners Choose shoes with Velcro fasteners and add Velcro to button backs and hoops to zippers Use trousers with elastic waistband Tell the person to look when they fastens Instruct the person to start with the bottom fastener, button or snap and work their way up Use activities to increase hand strength, e.g. therapy putty Dress the person in front of the mirror to add visual cues to assist with motor planning Wears clothing inappropriate for situation no boots or coat in snow Ensure that clothes apply the appropriate pressure and are of a texture that is comfortable for that person Make allowances for individual preferences, when appropriate Gradually introduce new clothes. Increase hat tolerance through massage of the scalp and putting the hat on in front of the mirror Discomfort & fiddling with bra Make sure the person has the correct size and fit bra. Certain clothes shops such as Marks & Spencer s provide a measure and fitting service, which would provide you with advice regarding the correct size and type of bra It is worth trailing a few different types of bra s e.g. some people might find sports bra s more comfortable than wired bra s 3

4 Firmly rub shoulders and back with a towel (to desensitise) before putting on the bra Try to wear more loose fitting shirts, rather than tighter fitting T-shirts; as this can also give an uncomfortable feel to wearing a bra General strategies Organise clothes the night before and lay the clothing out on the bed Encourage the person to put away clothing so that he knows where it belongs If balancing is a problem, let them sit to put on their socks and shoes Colour code clothing to help the person know right from left Put labels in person s clothes to identify him if he gets lost Sing the steps of dressing Try dressing dolls or teddy bears to practice opening and closing fasteners or doing buttons References Yack, E., Aquilla, P. & Sutton, S. Building Bridges through Sensory Integration Myles, B.S., Cook, K.T., Miller N.E., Rinner, L. & Robbins, L.A. Asperger Syndrome and Sensory Issues Please do not hesitate to contact me, if you require further information, guidance or advice. Kind regards, Lizelle Keyser 4

5 Independent Occupational Therapist 5