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Daily Living — Hygiene

Hygiene Problems in Children

Little girl washing her hands.

Anna Kroncke


Last modified 12 Oct 2023

Published 24 Feb 2022

What is Hygiene in Childhood?

Hygiene in childhood is self-care skills, such as bathing, dressing, handwashing, and brushing teeth. 

Hygiene is important in child health. If parents can start early in developing healthy habits, most children will have appropriate hygiene. Some children do not pick up self-care skills as quickly as others. You may have no concerns academically, but you wonder, without your support, if your child would ever brush their teeth, bathe, or choose proper clothing for the weather.

Children mature at different rates, and often people say that girls mature faster than boys. In younger children, it can feel like a challenge to have to walk your child through every step of a self-care routine. Hygiene is one arena we can sometimes use peer pressure as a good thing. ‘Honey, let’s brush your teeth so you can be clean and smell great at school.’ This process can work for some kids as young as 4 or 5 years. 

If you have a teenager, you may be frustrated. Your teen is almost an adult, yet you may still have to tell them to brush their teeth. As children get older and enter puberty, they have more odors and thus more hygiene to manage. Suddenly, it feels like you have to worry about smelly feet and bad breath. To peers, it stands out drastically if another student smells bad, wears the same clothes repeatedly, or has dirty hair.

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Symptoms of Hygiene Concerns in Children

Here are some symptoms or indicators that hygiene is a concern in children.

Not showering or bathing: your preteen or teen will not shower or bathe without continual reminders or sometimes not at all 

Smelly: your child stinks due to not having proper hygiene 

Messy uncombed hair: your child is not aware of how they are presenting, and their hair is in disarray even when going out in public

Mismatched and dirty clothes: your child does not care what they are wearing and will leave home in dirty, unkempt clothes 

Fails to use deodorant: your child is of the age where they need to use deodorant, and they refuse to do so

Age seven or older and unable to bathe themselves: your child is now old enough to know how to bathe by themselves, and they are not able to 

Not brushing teeth: your child is not keeping up with their dental hygiene, either forgetting or refusing to brush their teeth daily 

In this short video, Dr. Kroncke discusses hygiene issues in childhood and what you can do to help.

Causes of Poor Hygiene in Children 

Developmental Age and Stage: Many young children will go through phases where they do not care as much about hygiene. As a parent, you may feel like a nag, constantly reminding your child to brush their teeth or take a shower. These reminders may simply be a sign that your child needs more hand-holding or organizational support to get the job done and may not be cause for long-term concern.

Disabilities: Clinically, we must consider that children with disabilities often have adaptive challenges. Children with Autism may have delays across all adaptive domains. Children with ADHD may struggle with receptive communication, domestic, and self-care skills. Children with emotional challenges may also be delayed in their adaptive skill development. 

Depression: A child who is depressed is likely to have a sudden shift in hygiene practices from typical hygiene to a lack of self-care, sleep, and eating hygiene. A depressed child may have low self-esteem or stop engaging in daily activities they used to enjoy. Some children will suddenly drop their self-care routines due to recent changes at home, inability to get out of bed, and lack of interest in things they used to love.

Trauma: A child who has experienced trauma or abuse is likely to have poor hygiene because of the overall impact of trauma on a child’s mental health and well-being. A child may say they are doing okay following trauma like the death of a parent, but their hygiene and day-to-day presentation may say differently. If the home life is in disarray, teachers may be the ones to notice a change or concern for a child and may need to step in and help.

ADHD: A child who struggles with hygiene may generally miss cues from you that it is time to get things done so they can be at school on time. ADHD or attention challenges may be a cause of hygiene challenges. Your child may be found staring out the window, half-dressed with a dry toothbrush beside them. They may be thinking about what that noise is coming from the house next door. They may be planning a dance routine for recess or reliving the plot of a favorite show.

Poor hygiene may be related to attention to detail, organization, and planning for task completion. Children who struggle with attention often do not get things done in an organized and timely manner, impacting whether they make it to school on time with their teeth brushed and hair combed.

Autism: Often, children who are high functioning on the autism spectrum care less about hygiene. One issue is that your child may not have as much interest or practice socializing. Lev Vygotsky’s social learning theory posits that social interaction underlies typical learning and development. Children learn from engaging with one another. If your child does not engage as much socially, they are less likely to focus on grooming and self-care.

If your child is not in tune with what other children are doing, they may not care if they show up to school unkempt. They might not care if they smell bad or kids are teasing them. They might not even pick up on subtle teasing. Your child’s thought process could be, “If I shower, I have less time for Minecraft,” or “Showering isn’t fun; I just don’t have time for it.”

Other children with autism may refrain from brushing teeth or hair and bathing because of their sensory sensitivities to certain textures, tastes, or smells.

What to Do About Hygiene in Childhood 

If your child is struggling with the daily living skills needed for self-care, there are strategies you can try. Start at an early age if you can. This process is much easier to work on with a 4- or 5-year-old than a child who is 10 or older. 

It can be helpful to determine whether lack of hygiene is due to an aversion, to the feeling that it’s a waste of time, or simply to a skill deficit. Some children need more support to instruct their bathing and hygiene. 

What to Do for Hygiene Aversions or Perceived Waste of Time

If your child sees hygiene as an aversion or a waste of time, an intervention will be most effective by tying the hygiene routine to direct and meaningful reinforcement

A token jar or chore chart that results in a coveted Lego, trip to someplace special, or activity they really want to do may increase the likelihood that they do the self-care task. In this case, you must make sure the task is within their skill level and that the reinforcement is valuable enough to them

What to Do About Hygiene Skill Deficits

Consider a gradual release approach to help your child with a skill deficit related to their hygiene. Help your child only as much as needed and not more. You can, for example, shape your child’s behavior in doing a morning routine.

  1. First, go with your child, and do every step in the routine. You can make a checklist of tasks for your child to follow. At first, you will follow the list together. Help your child pick out clothes and get dressed, put toothpaste on the toothbrush, brush teeth, rinse the sink, locate and put on socks, and then locate and put on shoes. 
  2. Do every step side-by-side with your child. You may feel silly helping your older child with these tasks, but your support is needed if they are not yet successfully independent.
  3. Next, remove your verbal directions but still provide support. Go through each task together with little verbal direction, only pointing to the checklist.
  4. Then, expect your child to get dressed independently, but walk them through the toothbrushing and putting on shoes. 
  5. Praise successful completion of getting dressed, noting that your child remembered to wear clean and matching clothes. 
  6. Check off the checklist together to ensure that the list is complete.
  7. Next, remove the support for the toothbrushing routine, praising the completion of getting dressed and brushing teeth.
  8. Finally, withdraw your help for getting on socks and shoes. Praise your child for completing all steps independently.

You will often find that your child can do much more on their own when you are willing to be patient and persistent in providing support for their independent performance. This approach takes more time and effort than either doing the tasks for your child or heading off to school with none of them done. In the long run, though, your child will benefit.

When to Seek Help for Hygiene Concerns in Childhood 

If your child is struggling in multiple activities of daily living, including self-care, chores, and participation in school, even after you have tried the strategies above, a developmental concern may be evident. 

Children who fall behind significantly in daily living tasks may have a disability and may require therapy. Hygiene concerns could be a sign that your child is struggling in other ways. Seeking support may be a huge help to them.

Professionals Resources to Help Hygiene Issues in Childhood 

If your child is struggling with this symptom to the point that it is getting in the way of their learning, relationships, or happiness, the following professionals could help.

  • ABA Therapist: to treat behavior; can help improve behavior, increase adaptive skills and improve communication. In-home treatment plans make addressing self-care and domestic skills easier. This therapy is often covered by insurance for Autism Spectrum Disorders but can be helpful for other diagnoses as well
  • Psychologist or Neuropsychologist: to conduct a full assessment to examine symptoms in mental health and behavioral context and make a diagnosis for your child or refer them to treatment
  • Psychotherapist or Play Therapist: to treat emotional symptoms as needed; to work on social skills via a social skills group or CBT interventions
  • OT or Speech Pathologist: to treat motor or language deficits. In combination with ABA, this approach may be most effective for children with Intellectual Disability or Autism

Similar Conditions to Hygiene Issues in Childhood 

Your child may be struggling with a similar problem. See the list below for information about other related symptom areas.

  • Social Skills: difficulty socially interacting with others impacts adaptive skills because peers can be our children’s guide for the clothes to wear and the general expectations for grooming and self-care. Children with poor social skills may miss these cues from peers
  • Intelligence: difficulty with thinking and reasoning can cause various delays that would encompass areas like communication, daily living skills, socialization, and motor development
  • Inattention: difficulty paying attention can lead a child to miss cues from other peers about appropriate grooming and behavior

Book Resources for Hygiene Issues

Barkley, Russell A. (2013). Taking charge of ADHD, 3rd edition: The complete, authoritative guide for parents. 

Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

Siegel, Daniel J. & Bryson, Tina Payne (2012). The whole brain child: 12 revolutionary strategies to nurture your child’s developing mind.

Seigel, Daniel J. & Bryson, Tina Payne (2014). No drama-discipline: The whole-brain way to calm the chaos and nurture your child’s developing mind.