Skills for Independence

Your child should be able to take off their clothes by themselves. They might need help with fastenings.

They should be able to put on loose fitting clothes like pyjamas or shorts and t-shirt by themselves. They can unzip their jacket and might be able to manage large buttons if they can see them.

At nursery there are usually adults around to help children with dressing tasks. Make dressing as easy as possible by thinking about what your child is wearing.

Planning your Child's Nursery Wardrobe

Thinking about the clothes your child wears to nursery can make it easier for your child and the nursery staff. Below are some things to think about:

• Shoes/Boots
  • Slip on, Velcro or zip fastenings
  • Find out more about Choosing Footwear for Children on the Association of Paediatric Chartered Physiotherapists website.
• Trousers/Bottoms
  • Elastic waist bands
  • Loose fitting
  • Avoid tights, try leggings and socks instead.
• Jacket/Coat
  • Loose fitting
  • Large sturdy zip; add a zip pull to make the tab easier to grasp and pull up
  • Velcro or snap fastenings.
• Hats
  • Loose fitting or stretchy
• Scarf
  • Try a neck tube
• Gloves
  • Try mittens that go over the coat sleeve
• Bag
  • Rucksack or crossbody bag, big enough to hold change of clothes, water bottle and a book
  • Zip closure, add a zip pull to make grasping and opening/closing easier
  • Find out more about Choosing the Right School Bag on the Association of Paediatric Chartered Physiotherapists website.

Putting On and Taking Off a Jacket

By 2 years your child might be able to take off their unfastened jacket. Between the ages of 3 and 4, your child will be learning to put their jacket on themselves. They probably won't be able to do the zips or buttons themselves for a little bit longer.

Here are some tips to help you to teach your child to take off and put on their jacket:

• Practice taking off their jacket first – it’s easier!
• Start with a jacket that is a bit too big. Loose-fitting clothing is easier to manage than tight-fitting clothing. Let them practice putting on your jacket. Make it into a game.
• Your child needs lots of practice putting their arms into sleeves. So practice with shirts, cardigans, pyjama tops, etc.
• If your child is struggling it can be tempting to take over - don't! Give your child time to work it out for themselves. Give them lots of encouragement and hints if you need to. If needed, talk them through what to do and only step in if they get really stuck.
• Make sure you have got plenty of time to practice.
• Instead of correcting a mistake (like a twisted collar or hood) why not encourage your child to look in the mirror. Now get them to work out what's wrong. You may need to ask them some questions and give them some hints.
• There are different ways you can put on your jacket. Try them all to see which way works for your child. Once you have found the way that suits your child share this with other people. Make sure nursery/school staff, grandparents, child minder etc. all help the same way. Try these to find out what one works for your child:

Socks and Shoes

Babies love to take their socks off. They can usually manage this by themselves by the time they are 15 months old. Learning to put socks on is much harder.

Children learn to take their shoes off first. They can usually pull on wellies, slippers and slip-on shoes by the time they are 2 years old.

Socks

• Practice using loose fitting socks that are too big, they could even practice putting on your socks.
• Avoid socks which have overly tight elastic at ankles.
• Socks with different coloured toes and/or heels can make it easier for your child to get their socks the right way round.
• Encourage your child to sit when putting their socks on their feet, as they will be less likely to lose their balance.
• It is often helpful for you to sit next to or behind your child when they are completing this task as it will give you a more realistic view of what things they are finding difficult.
• You can start by putting the socks over your child’s toes and heels and getting them to pull the socks up. Once they can do this just put the socks over their toes and they need to pull them up over their heel and all the way up.
• Encourage your child to place their thumbs inside the sock to help them pulling the socks up or on.
• Teach your child to gather up the sock from the top to the heel using two hands, before placing the socks on their toes.
• Some children don't like the feeling of wearing socks and can be particularly bothered by seams, you could try turning your child's socks inside out or buy seamless socks.

Here is a video from our OT colleagues in NHS Forth Valley for helping children put on their socks.

Shoes

• Practice with slip on shoes, slippers and wellies first.
• If your child has to change shoes in nursery try to avoid laces or buckles if you want them to be able to do it for themselves.
• It helps if you sit next to or behind your child when they are putting their shoes on as it will give you a better view of what they are finding difficult.
• Put the shoes in front of your child the right way round and try the sticker trick (cut a sticker in half and stick one half in each shoe) to help them work out which shoe goes on which foot.
• Encourage your child to sit when putting their shoes on, as they will be less likely to lose their balance.
• Get your child to look at their feet to check the shoes are on the right feet.
• Once they have mastered slip on shoes move on to simple fastenings such as Velcro or zips.

Every family's mealtime is different. Some families sit at a dining room table, others kneel at a low table, some families sit on the sofa and some families eat at different times. Some families use cutlery and others eat with their hands. Whatever works for your family is best for your child. 

If they use cutlery regularly they should be able to use a fork and a spoon. If they use chop sticks regularly they should be able to do this by the time they go to school. Some children at this stage will still enjoy using their hands. You can encourage your child to learn simple kitchen skills like putting snack foods into a bowl, putting toppings on a pizza base or stirring cake mix.

Children in Early Learning and Childcare (ELC) settings often eat together around a table. Most ELC settings don't expect children to sit down for long periods of time but snack and lunch times are often exceptions to this rule. When eating in an ELC setting children will usually sit in a child sized chair at the table. It might help to practice this at home if this is new to your child. Start with a really short time (less than 5 minutes) and then build up the time little by little. Often part of the process at snack and lunch times is about serving themselves and others food. It can be helpful to practice this too.

Sitting to eat and drink

Being well supported when you are sitting at a table makes doing tasks easier as you don't have to think about your balance. If you don't have a child sized table and chairs you can help your child to feel secure by:

• putting a cushion behind their back so that their back is supported
• giving them a firm cushion or booster seat to sit on so that they can reach the table
• giving them a chair with a footrest or putting something under their feet to make them more stable
• letting them kneel on the chair.

Using cutlery and drinking from an open cup

There are lots of ways you can help your child learn to use cutlery and to drink from an open cup (this is what they usually use in ELC settings).

• Always set the dishes and utensils out in the same way to develop a routine and help your child find items at each meal.
• Think about the utensils you are using:
  • Spoons/forks with thick and/or textured handles are easier to hold
  • A spoon/fork with a short handle is easier to control
  • Heavier spoons/forks can be easier to control
  • Bowls or plates with a raised edge stop the food from falling off
  • A non-slip mat underneath the bowl/plate stops it from sliding around
  • Try a cup with a rim
  • Using a cup with a weighted bottom can be easier
  • Try a cup with a handle.
• Think about the food/drink:
  • Foods that stick to the cutlery (like yoghurt, porridge, mashed potato) are less likely to spill
  • Soft foods are easier to stab
  • Aim to fill a cup halfway to avoid spills.
• A good way to teach your child a new skill, is to break down each task into small steps and teach them the last step first. Once they can do the last step of the task, teach them the second-last step, then the third-last step and so on. This is called backward chaining.
• Take your time and be consistent. Learning a new skill takes time so persevere with giving support until you feel that your child is making progress.
• Make it fun. Practice using a spoon/fork during play such as when playing with playdough, during bath time or when playing with dolls/soft toys.
• Practice, practice, practice! Give your child opportunities for practice every day.

Safe Foods

Some children have limited diets for lots of different reasons. This might mean that they do not want to eat what is provided at nursery. If this is the case it is important that they can access their safe foods and drinks (the ones you know that they will eat) so talk to nursery about your child's safe foods and drinks.  

If your child is taking a packed lunch or snack to nursery then there are some things to think about to help them be as independent as possible:

• Choose the right lunch bag
  • make sure it is big enough to hold lunch, snacks and a plastic drinks bottle with extra room to make it easy to put everything away when your child is finished
  • look for a lunch bag with a zip and add a zip pull to make it easier if you need to
  • avoid a lunch bag that is too small and needs things packed in just the right way to fit everything in.
• Choose the right drinks bottle
  • most nurseries will prefer a plastic bottle
  • look for something that your child can open easily, a flip up straw might work
  • avoid pouch drinks/drinking cartons with straws.
• Think about containers and packets
  • snip corners of pre-packaged foods (bars, small bags) so your child can open them
  • look for easy to open and close plastic containers.

Your child might be interested in doing some of their personal care themselves. They might want to try brushing their hair or washing their face. They can dry their body with a towel but will still need your help after a bath or shower. They can wash and dry their hands.

Teeth Brushing

Brushing your teeth is an essential part of looking after your body. You should be brushing your child's teeth at least twice a day. You can find out more from:

• The British Society of Paediatric Dentistry (BSPD) A Practical Guide to Children's Teeth
• Childsmile Oral health for 3 to 5 year olds

Going to the toilet is part of everyday life. It is important for our health and wellbeing. Not all children in nursery will be toilet trained. Make sure to speak to the Early Learning and Childcare (ELC) setting before your child starts so that you know what is expected. 

Toilet Training

Toilet (potty) training is an important milestone in a child's life. Lots of children find learning this skill challenging. For children with additional support needs the journey might look different and may take longer. Many children with physical or learning disabilities can achieve a level of continence with the right support.

For toilet training typically developing children look at:

• Potty training from ERIC
• Nappy changing, potty training and toilet tips from Parent Club
• Toilet Training in the Information Library from Bowel and Bladder UK

Toilet Training Children with Additional Support Needs

Many people wait for signs of readiness before starting toilet training. Don't wait for your child to show signs of readiness, as some children never will. Even if they don't show signs they may still be able to achieve a level of continence.

If your child has additional support needs look at:

• Potty training children with additional needs from ERIC
• Children with additional needs and disabilities under Toilet Training in the Information Library from Bowel and Bladder UK
• Potty and toilet training from Contact.

Positioning for Successful Toileting

It is important to be in the right position when we wee or poo. Toilets are designed for adults and children sometimes don't feel secure. Using a toilet step and a toilet insert can be helpful. There are lots available. Some children with physical disabilities might need other equipment to be able to successfully use the toilet. An occupational therapist will be able to provide advice.

Cleaning Ourselves After Using the Toilet

How we clean ourselves after using the toilet varies across cultures. Whatever the method, learning to clean yourself is a complex task that needs an adult to teach the child what to do. They will then need lots of practice before they master this skill. Some children may require additional support to adapt the environment or the activity to help them to be successful.

The following strategies talk about wiping with paper but can be adapted to teach different methods of cleaning ourselves after using the toilet. There are several ways to help your child learn to clean themselves.  Choose what works best for you and your child. 

Hand over Hand 

You place the toilet paper in your child’s hand. Then you guide their hand to their bottom and wipe together. Some children do not like having their hand touched in this way. Only choose this method if it works for you and your child. 

Take turns 

Some children are reluctant to start trying a new skill. Encouraging them to take turns with you can help them adjust to this new step of being independent. 

Backward Chaining 

Backward chaining is where you do all the steps of bottom wiping but leave the last one for your child to complete. The steps of bottom wiping could be: 

1. tear off paper
2. scrunch paper into a ball
3. reach behind body
4. wipe bottom 2-3 times
5. throw paper into toilet 

Therefore, the step you want your child to do is to throw the paper into the toilet. Once your child can do step 5 every time, get them to do the last wipe and then throw the paper in the toilet. Keep going like this until they are doing all 5 steps. 

Forward Chaining 

Forward chaining is where you get your child do the first step and then you complete the rest of the task. You want your child to tear off the paper, then you do the rest of the steps. When they can do the first step every time get them to do step 1 and 2. Therefore, your child would tear off the paper and scrunch it up and you would do the rest. Keep going until they are doing all the steps. 

Adapt the steps

Remember that sometimes what works for you might not work for your child. You can adapt the steps of the task if your child is finding one step difficult. For example, scrunching the paper into a ball might not work, so have your child try folding the paper instead or wrapping the paper around their fingers. Some children will need more specific instructions like tear off 2 squares of toilet paper. Some will need you to remind them to repeat the steps until the paper is clean. Some children might find using a cloth to wash easier. Some children might prefer a visual task list easier than verbal instructions.  

Hand Washing

Hand washing is a essential skill for children and young people of all ages.

The National Infection Prevention and Control Manual has a number of ideas and materials for you and your child to use to help with hand washing.  The Children's Pack is full of materials and ideas to encourage children to make hand washing part of their everyday routines.

This cartoon animation helps to explain why, when and how hands should be washed.

The Health Hub has created an animation with the 'Washy Washy Clean' song to help young children wash their hands.

You can find more information about How to wash your hands on the NHS UK website.

e-Bug has lesson plans, activities and resources to teach children and young people from 3-16 years old about hand washing.