School Readiness Series. Physical Development (Self-care) part 1 (cert-4-£1)

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As part of our 'School Readiness' series, today's post will look at 3 important self-care skills that early years practitioners can encourage once settings re-open and parents can encourage during lockdown and the summer holidays if applicable. These skills are bottom wiping, nose blowing and self-feeding. I’ve been fortunate enough in my work to see some fantastic activities for encouraging self-care and over the years I’ve collected hundreds of ideas from SENCOs, occupational therapists, early intervention teams and of course the internet but I only want to share the very best activities that I know work!

Bottom-wiping

As explained in my introductory post last week, a key skill that Reception children need but often lack is the ability to wipe their own bottoms. This post is very useful for Early Years Practitioners because some of the activities can be carried out in settings but please note: some of the activities outlined below can only be carried out by parents at home due to the intimate nature of this topic and potential safeguarding issues. Early Years practitioners – I recommend you add this to your range of tips and advice for parents as part of your usual transition preparation and share with parents during lockdown so that they can work on these skills before September if and when school starts.

Parents and Early Years Practitioners - Can the child wipe themselves independently? Flush the chain, wash and dry their hands thoroughly? Your immediate answer will either be ‘yes’ or ‘no’ but think about each and every step involved in this and how it will be different at school – door handles, light switches, locks, different types of flush pulls, different types of toilet paper and ways of dispensing, clothing, fastenings, different taps, different soap and ways of dispensing, different ways of drying hands. (I don’t know about you, but I’m exhausted already! – these steps highlight just how complex using the toilet can be for little ones!)

You won’t be there to check their bottoms, or offer a ‘just in case’ wet wipe so we need absolute confidence that the child can perform these tasks as second nature. Reception teachers and classroom assistants are great at introducing the new toilets and helping children get used to things at first but they won’t have time to start with the very basics – that’s where parents and early years practitioners come in!

Many children have difficulty with learning how to wipe them-selves. This is because it is a very complex task and as such, it is a skill that needs to be taught, unlike other skills that children seem to naturally acquire as they develop.

As adults, we are so used to performing this task ourselves that we often give little thought to the various skills needed to perform it successfully.

So, what does bottom-wiping require?

1. Good balance

2. Good proprioceptive feedback (Proprioception is the awareness of where the body is without using vision e.g. aware that hands are behind back even though we can’t see them)

3. Good sense of touch and fine motor skills

4. Good range of movement in the shoulder and arm to be able to reach behind them

5. Motivation to want to be independent in bottom wiping

Let’s take each of these steps and consider the most useful ways to support and encourage them.

1. Good balance

Both feet should be placed firmly on the floor, providing the child with a stable base. If this is not possible, provide a step for the child to place her feet on. Having a hand rail or something to hold on to provides stability to begin with but children will need to practise without steps and rails eventually.

2. Good proprioceptive feedback (bodily awareness)

Any physical activity will encourage bodily awareness. The more active the child is, the better. So continue to encourage rough and tumble play, sports, garden play, dancing and releasing energy in their usual way according to the child’s needs. Some more specific activities that really hone in on the proprioception required for bottom-wiping, include the following:

Crab walking – This requires a lot of co-ordination and is particularly useful at encouraging children to co-ordinate their shoulders, arms and hands without seeing them.

Mirror play - In front of a mirror, ask the child to close their eyes then move one of their arms to a position and ask them to copy it with their other arm without looking. Then ask them to open their eyes and see how close they got to getting the same position.

Bum bag Games - Fill a bum bag up with familiar items such as key, coin, peg, cotton wool ball, teaspoon, etc. Put the bum bag on the child and have it loosely positioned around their waist with the bag hanging over their bottom. Sit them sideways on a chair so that their bottom is hanging just off the side and the backrest is not in the way. Call out one item at a time and see if they can search for it behind their back using their “wiping” hand.

3 Good sense of touch and fine motor skills

The sense of touch plays an important role so anything that encourages children’s senses in their hands will be useful. Continue to encourage children to manipulate different textures with their hands (playdough, clay, mud, shaving foam etc) and use a multitude of tools and fine motor equipment (interlocking blocks, crayons, knife and fork, tweezers etc)

How does it feel? - Children need to know how it feels to wipe their bottom, so help them consider how it feels to wipe their bottom properly and in the right place, rather than just wiping their cheeks or lower back.

Bath time - Parents can help children develop a better awareness of their bottom by encouraging them to use a thin wash cloth to wash themselves in a way that mimics the wiping action with toilet paper. Also encourage them to dry their own bottoms with their towel after washing.

Hand over hand - Parents can use the hand over hand technique: hold the child's hand and help them wipe their bottom

Practise using toilet paper – Practise tearing off the correct amount, folding and the wiping action. Introduce them to the right amount of toilet paper - a whole roll is too much, one piece is not enough. Practise tearing off 3 squares, folding them and wiping. Encourage the child to use a new piece of toilet paper after one wipe and to keep wiping until the toilet paper wipes clean.

The peanut butter trick (check allergies first!) - Try practicing with something they can see in front of them. E.g. Wiping peanut butter or chocolate sauce off a plate, then off of a balloon to make it even more fun!

Practise on a doll -Show them exactly how to do it – front to back – you can use peanut butter or chocolate sauce here too!

Helping with chores -To really reinforce understanding, practise wiping lots of other things around the house or early years setting, ask them to wipe down the table after dinner, you may have to demonstrate first. A great one is washing up after baking – the flour mix is always tricky to wipe off of utensils and provides great practise for getting poop out of little crevices. This will also encourage tidying-up skills in time for school and general independence and sense of achievement.

White board - Practise wiping other surfaces using toilet paper, such as wiping pen off a white board, chalk off a blackboard or finger marks off the windows.

4. Good range of movement in shoulder and arm to be able to reach behind them and under their legs.

Again, this is a skill we take for granted and some children can struggle with getting the full reach, resorting to wiping from the front which can cause urinary tract infections – try the following:

Stickers -Parents can stick stickers on the child's bottom (whilst clothed) and then ask them to reach round / under and find them – play this one together for lots of giggles.

Body-ball - move a ball/balloon around the body – tummy/back, under legs, around the legs in a figure of eight and over-head. Adults and children can do this together, encouraging them to copy you. Play ball games where you vary the way the ball is thrown. Include throws from behind the bottom/through the legs. Pretend to juggle by passing the ball as fast as possible around the waist, upper thighs and through the groin area.

Pin the tail - Put a ‘tail’ in the back pocket or waist band for the child to reach for and pull out, take it in turns and turn it in to a game of tag for lots of giggles. (Make a tail together or use a small scarf, hanky or piece of cloth)

5. Motivation:

If the child is not motivated to learn to wipe their bottom then it will be difficult to encourage them.

As with any new skill, it is vital that you do not force the child. This will create too much pressure around the topic and can create the problem of demand avoidance which will take even longer to overcome.

Reward charts - these can help children initially but you really want the motivation to be internal and this will happen with time as they begin to want to be a “big girl or boy”

Learn from others - Encourage them to watch older children or siblings if appropriate, and parents – there’s nothing wrong with showing them how you wipe!

Books – In my opinion, books are the BEST way of introducing tricky subjects and getting the conversation started – There are several great toileting books, but there aren’t many books that focus specifically on bottom-wiping but I have come across this rather strange but useful book “So you think you can wipe!” It addresses the issue in a good-humoured manner to increase motivation and interest. (I do change some of the words when I read it to my little girl though – you’ll see why). Better still, early years practitioners can make their own for the setting and so can crafty parents!

Hand-washing -During the Covid-19 outbreak, early years practitioners and parents have been showing children how to wash their hands properly and thoroughly so if they haven’t quite mastered the complex art or wiping, you can be sure that they will be able to fix this by washing and drying their hands thoroughly.

Acceptance – Parents, I’m afraid you will have to accept that dirty underwear may be a part of everyday life when your child starts school, there’s nothing wrong with this so don’t make a big issue of it and just be mindful that children will need to wash, rinse and dry their bottoms each day so a shower or bath before bed is highly recommended, particularly after a long day at school!

Nose- blowing

Nose-wiping can be taught early on. Early years settings will have a nose wiping station with a mirror, bin and tissues to encourage independence, Parents: why not recreate this at home? All you need is a mirror, tissues and a bin at the child’s level. This way the child will get used to taking care of their own noses and finding a tissue without needing to rely on an adult! A real confidence booster in preparation for school. And remember catch it, bin it, kill it! And wash your hands!

Nose-blowing on the other hand can be challenging! If I had a pound for every time I’ve heard a parent say “If only they could blow their nose, they’d feel much better!” I’d be a rich woman! When children have colds and sniffles, it can seem impossible to clear their noses – lots of parents resort to the very unpleasant squirt of saline solution up the nasal passage which in my experience results in even more snot and tears, defeating the object entirely! One of the reasons children suffer so badly when they have a cold is the inability to blow their nose. Children tend to sniff with their nose rather than blow. As children are concrete learners, its useful to remember that they respond better to cause and effect. If children can see a physical thing, they are more likely to understand it. So encourage activities that show the child what happens when they blow through their nose. Next time we see children blowing something through their mouths, try doing the same but through their nose and comment on how they can make things move with their nose-blowing. For example, blow bubble wands with their nose, birthday candles (with care!), sheer fabrics, petals, dandelion seeds, feathers - commenting on how they sway, move or disperse, eventually moving on to tissues!

Self-feeding

Lunch time at school can be a stressful time for children. We want to try to reduce any potential anxiety they may have by encouraging various self-feeding skills.

Using a knife and fork

Self-feeding is a very complex task and it is common for children to have difficulty using cutlery to feed themselves. It usually takes until a child is 7 years old before they can successfully use cutlery to feed themselves without being too messy. Some children will have had practise at preschool/nursery but during lockdown it’s a good idea to continue with this! Here are some handy hints and tips:

Is the child well supported? It is important that the child is well supported when they are learning any new skill. Whenever possible ensure that the child is sitting at a table. It is important that their feet and back are supported so that they can use their hands freely. You could use a sturdy box under their feet and cushions on the chair to make sure they are well supported.

Here’s an easy 3 step guide:

Step 1 – Get those pointy fingers ready!

Step 2 – Starting with easy grip cutlery- Pointy fingers go into the finger scoops, the other fingers curl round the handle

Step 3 – Stab with the fork – then keep the fork still! Saw back and forth with the knife while the fork holds the food steady

Gradually move on to more ‘grown up’ cutlery – a great tip – practise cutting play dough sausages with adult cutlery and use blue tac or stickers to help the child know where to put her pointy fingers.

Eating from a lunch box

If the child takes a packed lunch to school, please allow plenty of practise every day at opening ALL the contents - including the tricky items! Some snack packaging is so hard to open that I suggest opening them yourself and putting them in a pot/ sandwich bag that the child can open later!

Drinking water from a cup

If the child is not used to drinking from a cup – now’s the time to start! Avoid spillages and frustration at school by offering water in cups at home. A good way to start is at meal times because the motivation to drink from a cup will be increased. Then gradually phase out the straws/ sippy-cups/ various bottles and (my pet hate) Fruit-shoot type bottles (other brands are available) because these don’t give the child a chance to practise this very important skill.

If the child is not used to drinking water – now’s the time to start! Again, introducing it at meal times will increase motivation.

As always, if the child is just not interested in using cutlery or drinking water from a cup, do not force the issue and just re-introduce every so often until they are ready. Remember – nothing works better than peer pressure – so when they see their friends at school using cutlery and drinking water from cups – they’ll soon learn how to do it!

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