For most of us nail cutting is such an ordinary experience that we don’t even give it a second thought. But for many children with autism, this simple activity can be quite challenging. Some children may display some challenging behaviour even at the sight of the nail clippers. We have heard of parents cutting their child’s nails while they are sleeping, and although this works it doesn’t really teach the child to overcome their fear of having their nails cut nor the skills needed to allow someone else to do it.
The good news is, using the principles of Applied Behaviour Analysis we can teach children and adults to tolerate nail cutting. We start by breaking down the skills needed and providing reinforcement for the appropriate behaviours. Reinforcement is key! Remember to reinforce every step.
Step 1 – Begin by having your child tolerate having the clippers near them. When your child is comfortable seeing and having the clippers in their presence, gradually bring it closer to them. At this point the child does not have to touch or hold the clippers at all.
Step 2 – Once your child is happy to have the clippers near them, you can start to hold the clipper in one hand and the child’s hand on your other hand. Gradually bring the clippers closer to them but make sure that it doesn’t touch the child at this point.
Step 3 – Now that your child is happy to have you hold his hand and is tolerating the nail clippers getting closer, it’s time to work on having the nail clipper’s touching their hand, then their fingers, then their nails. Start with one finger at a time. Remember, still no clipping!
Step 4 – Once your child is tolerating the nail clippers touching their nails, it’s time to attempt clipping. We will work on one nail at a time. Once the child is happy to have one nail clipped, you can then attempt two nails, then three, etc.
This process can take a few days, if not weeks. It is important to follow your child’s lead and not rush them. We want nail cutting to be a pleasant experience and as successful as possible.
We have also found that for many children, counting whilst you do each step can work very well.
By Sara Silva-Neagle