KK Women’s and Children’s Hospital (KKH) Paediatric Neurology Service and Occupational Therapy Service share tips on how to facilitate participation in basic daily living activities in children.
Participation in activities of daily living (ADL) or self-care tasks, such as feeding, showering or dressing, is an essential part of a child’s daily routine. The ability to carry out self-care skills is an important aspect in the development of a child as the child gains opportunities to practice his or her motor skills and achieve mastery in self-care tasks. This also contributes positively to the child’s self-concept.
Click/tap on the links below for examples of self-care tasks for children, with possible adaptations to support a child’s success in his/her activities of daily living (ADL). If your child presents with neuro-developmental concerns affecting ADL participation, your child’s occupational therapist will be able to advise on appropriate activities or tasks to practise at home.
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Feeding: Strategies and activity considerations
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Dressing: Strategies and activity considerations
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Personal Hygiene: Strategies and activity considerations
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Household chores for children
1. Facilitating feeding skills in children
Feeding skills include the ability to manage cups or bottles for the task of drinking and the use of hands/fingers or feeding utensils for self-feeding of food items.
Self-feeding abilities begin when younger infants develop an interest in food items and common feeding utensils (i.e. spoon play or cup play), followed by the emergence of finger-feeding skills. As their fine motor coordination improves, children develop increasingly skilled use of their fingers, and later, the use of utensils in self-feeding.
Strategies and activity considerations
a) Cup drinking
Choose a cup of a suitable size and width, or with appropriate handles, for easier grasp
b) Self-feeding
Consider size and shape of finger food when encouraging finger-feeding
Begin with food items (e.g. fruits, vegetables) cut in thick strips/wedges or long biscuit pieces for easier grasp, before progressing to small food pellets (e.g. raisins, cereal, puffs, blueberries)
Explore suitable utensils and appropriate meal set-ups
Try utensils with thicker or broader handles at the start, as these are usually easier to grasp in hand
If your child has difficulties scooping up food with a spoon or poking into food items with a fork, consider the following:
Encourage self-feeding with preloaded spoon or fork
Practise use of spoon with food of lumpy/sticky textures (e.g. porridge)
Practise use of fork with soft food (e.g. banana) cut into bite-sized portions
Consider use of non-slip mats or suction bowls/plates if your child has difficulty stabilising bowls/plates when self-feeding
2. Facilitating dressing skills in children
Dressing skills typically start with children learning to undress, before learning to dress. These include the ability to put on and remove shirts, pants or skirts, inner wear and outer wear (e.g. hats/caps, jackets), as well as socks and shoes. Dressing practice is usually incorporated within a child’s daily routine, for example when a child puts on his/her school uniform to get ready for school, or when a child is required to remove his clothes for shower or toileting.
Strategies and activity considerations
Donning on tops, bottoms and shoes
Identify suitable clothing types
Practise with larger clothing or stretchy materials when learning dressing
If your child has difficulties managing fasteners (e.g. buttons, hooks), consider the following:
Consider use of slip-on shoes or Velcro shoes instead of shoes with challenging buckles or laces
Modify how dressing is done
Provide help where necessary, and allow your child more time, if needed, to complete the dressing task
Consider dressing in sitting if standing balance or endurance is a concern
Dress the weaker side first if your child presents with one-sided weakness (e.g. when putting arms through sleeves or threading pants up legs)
Use a shoe horn if there is difficulty sliding feet/heel into shoes
3. Facilitating personal hygiene in children
Daily living activities, such as basic grooming, toileting and showering/bathing are basic routine activities which are important to maintain personal hygiene and cleanliness. In younger children, these tasks are usually assisted by caregivers although children begin to participate in simple parts of the activities. As children get older, achieving independence in these personal hygiene activities, through daily exposure and practice, becomes an important milestone in self-maintenance.
Strategies and activity considerations
a) Grooming and oral care
Encourage participation in simple, motivating tasks
Allow your child to actively participate in hand and face washing or cleaning (e.g. with use of wipes or cloth towels)
In hair grooming or oral care, break down activities into simpler tasks to encourage success
Choose suitable items or tools
Use toothbrushes or hair combs/brushes with a thicker or broader handle for easier grasp
Consider use of an electric toothbrush if your child has difficulties moving his/her toothbrush effectively in the mouth to ensure cleanliness
b) Showering and toileting
Consider environmental set-up
Explore need for grab bars or non-slip mats in shower/toileting areas
Perform showering in a seated position if your child has reduced standing balance
Use a foot stool as feet/leg support if your child is unable to place his/her feet on the ground while seated on the toilet seat
Place soap/shampoo bottles or toilet roll within easy reach of your child
Use sequencing cards/charts if suitable, to reduce the need to provide your child with frequent verbal reminders during tasks
4. Household chores for children
Participating in household chores helps children feel that they are contributing positively to the family, hence developing their sense of competence and confidence. These day-to-day tasks also provide children with constant opportunities to work on their motor skills and simple problem-solving at home.
Here are some examples of household chores which you may consider incorporating in your child’s daily routine. Choose chores which are developmentally-appropriate for your child and best suited to your family’s routine and rhythm. Do ensure your child’s safety while engaging in these tasks, and provide adult supervision and child-safe tools where necessary.
Activity Ideas
a) Meal preparation
Setting up/clearing table and sorting utensils
Washing and drying dishes
Plucking, peeling or cutting fruits and vegetables
Washing fruits, vegetables or rice/grains
Scooping rice/pasta/grains
Preparing simple snacks (e.g. bread with spread/dips)
Simple cooking or baking
b) Home organisation
Keeping away toys in boxes or toys/books on shelves
Wiping common surfaces or spills
Mopping and/or vacuuming of floor
Putting clothing into laundry basket, sorting laundry, running laundry in washing machine etc.
Folding linen and clothes and/or hanging up on hangers
Making the bed
Disposing trash and sorting out recyclables
Watering plants or feeding/grooming pet
Ref: K21