Teaching Handwashing to Children with Autism

Children with autism can face obstacles when it comes to handwashing.

Battling the flu, One Handwash at a Time

As a mother of four, I've come to accept that the stomach flu is the uninvited guest that shows up faithfully each season and loves to overstay its welcome. Just when one child recovers, another brings it home from school, turning our household into a chaotic shuffle of blankets and disinfectant wipes.

As annoying as it is it is also a good reminder of the importance of one simple habit: handwashing. Though if you have an autistic or neurodivergent child you know this is much easier said than done.

In this blog post I'll discuss a few strategies for making handwashing just a little easier if you have little ones who are resistant.

Table of Contents

• Battling Germs, One Handwash at a Time

• Why Is Handwashing Challenging for Children with Autism?

• Practical Tips for Teaching Handwashing to Children with Autism

  • Teach the “Why” Behind Handwashing

  • Use Visual Supports for Handwashing

  • Incorporate Handwashing into a Visual Schedule

  • Address Sensory Sensitivities with Choices

  • Model and Practice Washing Hands

  • Use the ABC Song for Handwashing

  • Incorporate a Favorite Song for Autism Handwashing

Research consistently highlights the importance of teaching handwashing as a foundational life skill, especially for children with autism. Studies show that structured methods like visual supports and social narratives significantly improve hygiene routines and compliance.

Why Is Handwashing Challenging for Children with Autism?

Children with autism can face different obstacles when it comes to handwashing. These challenges often stem from sensory sensitivities, unfamiliar routines, or difficulty understanding why handwashing is necessary.

• Sensory Sensitivities: The sensation of water on their hands, the smell or texture of soap, or the sound of running water can be overwhelming. Something as small as the water temperature can make a big difference. Providing choices wherever possible can help reduce sensory stress. For example, let them decide if they want liquid or bar soap, choose a specific paper towel, or even pick which sink to use.

• Resistance to Change: Children with autism often dislike any changes in routine. Although this is very helpful once you have convinced them they always wash their hands after the bathroom or before they eat, they may be very resistant if they have not done this previously.

• Lack of Understanding: Without understanding the “why” behind handwashing, some children might see it as an unnecessary interruption.

Social skill stories like this one help autistic children understand why washing hands is important.

Practical Tips for Teaching Handwashing to Children with Autism

1. Teach the “Why” Behind Handwashing

Children, like anyone, are more likely to cooperate when they understand the reason behind an action. Explain how germs are tiny and invisible but can make people sick. Demonstrate how washing hands gets rid of germs and emphasize how this keeps everyone healthy.

Using a handwashing social story can make this explanation more relatable and effective. Social stories combine simple, clear language with visuals, which is particularly helpful for children with autism who are often strong visual learners. This pairing makes the information easier to understand and retain.

If you'd like to create your own social story, consider including:

• Clear and Simple Language

• Visuals to support understanding

• Personalization for relevance

• Positive Tone to reassure

• Step-by-Step Instructions

You can learn more about social skill stories and how to write one here or check out my ready-made story available on Etsy or TPT.

Visual supports like this can make abstract concepts easier to grasp and help children understand the steps involved in handwashing.

2. Use Visual Supports for Handwashing

Visual supports can make abstract concepts easier to grasp and help children understand the steps involved in handwashing. Additionally, they can be an effective way to combat children who are resistant to following adult requests. When children see visual guides, they perceive them as consistent rules for everyone, rather than generating a feeling that they are being singled out or directed by an adult. This removes some of the tension and makes the process feel more objective and routine.

Creating a step-by-step visual guide with pictures can act as a helpful reminder.

Create a step-by-step visual guide with pictures or icons showing each part of the handwashing process. For instance:

• Turn on the water.

• Get hands wet.

• Use soap.

• Rub hands together (front, back, between fingers, under nails).

• Rinse off soap.

• Dry hands.

  
  

Place these visuals near the sink as a helpful reminder.

Adding handwashing to a visual schedule can help them see it as a normal and predictable activity.

3. Add Handwashing into a Visual Schedule

If your child is reluctant to wash their hands because it’s unfamiliar, make it part of their daily routine. Adding handwashing to a visual schedule can help them see it as a normal and predictable activity. For example:

• Wash hands before meals.

• Wash hands after using the bathroom.

• Wash hands after playing outside.

By tying handwashing to specific events, it becomes an expected part of their day.

4. Address Sensory Sensitivities with Choices

Sensory issues are highly individual, meaning that what works for one child may not work for another. Because these sensitivities vary so much, it can be impossible to predict what will help in every situation. However, by offering choices, we can help children become more in tune with what feels right or wrong for their unique needs. This not only empowers them to take control but also teaches self-advocacy and adaptability over time.

 By offering choices, we can help children become more in tune with what feels right or wrong to help address sensory needs.

Here are some ideas for involving choice in handwashing:

• Bar Soap or Liquid Soap: Allow the child to choose the type of soap they prefer.

• Lights On or Off: If the child is sensitive to bright lights, let them decide whether to have the lights dimmed or on.

• Cold Water or Warm Water: Offer a choice between water temperatures to find what feels most comfortable.

• Scented or Unscented Soap: Let the child pick between lightly scented or unscented soap based on their sensory preferences.

• Song or No Song: Give the option of having a timer song play during handwashing or allowing for a quiet experience.

Practicing handwashing together gives children an easy way to imitate handwashing steps.

6. Model and Practice Washing Hands

Show your child how you wash your hands, step by step. Practice together so they can follow your lead. Use positive reinforcement—praise them for each step they complete independently. If you have a child that is resistant to watching you demonstrate, look up videos on Youtube of handwashing. There are many available and most children with autism are receptive to short videos and they often learn well from watching them repeatedly.

Download this free ABC Washing hands poster to encourage children to wash hands the time it takes to sing the ABC song two times

7. Use the ABC Song for Handwashing

Encourage children to scrub their hands while singing the ABC song twice. This ensures they’re washing long enough for it to be effective while keeping them engaged. For an added fun element, consider placing the ABC letters near the sink. An adult can point to each letter as the child sings. This is not only educational but also adds a visual element, which can be highly motivating for children with hyperlexia. [Learn more about hyperlexia in this blog post.]

8. Incorporate a Favorite Song for Autism Handwashing

Consider using a favorite song on your phone or tablet that is about the right length of time for proper handwashing. Pick something highly motivating for your child and use the same one each time, such as a beloved nursery rhyme or a popular tune they enjoy.

This approach serves two functions: the song acts as a fun motivator, making handwashing a more enjoyable activity, and it also provides a clear signal for how long to wash hands. Over time, the song can become a natural cue that it’s time to wash hands, integrating the habit into their routine.

Making Handwashing a Habit for Children with Autism

Helping children with autism learn to wash their hands is about more than just teaching the steps—it’s about creating a positive experience and building a habit they can carry into adulthood. Research reinforces the value of combining visual supports, consistent routines, and positive reinforcement to encourage lasting habits. For children with autism, these tools are especially impactful, helping them not only complete the task but also understand its importance.

Have you struggled in your own home or classroom with handwashing? What strategies have you found helpful? Don't forget to download your free ABAC Washing Hands poster!

"Teaching Hygiene Skills to Children with Autism," Minnesota Autism Center