Hygiene battles: Tips from an ADHD expert

Brushing their teeth. Taking a shower. Cleaning up after themselves. What’s going on when kids seem to ignore these must-do tasks? And what can parents and caregivers do to change that? 

In this episode of In It, hosts Gretchen Vierstra and Rachel Bozek talk with Brendan Mahan. Brendan is an executive function coach and the host of the podcast ADHD Essentials. 

He offers tips and strategies to help parents and caregivers understand why some kids avoid working on their personal hygiene.

We love hearing from our listeners. Email us at init@understood.org.

 Related resources

• Washing hands: How to get kids in the habit 

• ADHD and messiness

• A day in the life of a child with slow processing speed

• Brendan’s podcast, ADHD Essentials

Timestamps 

(01:51) Cleanliness and self-care

(06:43) Executive function, room cleaning, and more

(18:07) Social concerns

(21:07) Reward systems

(23:07) Hygiene late bloomers

Episode transcript

Gretchen: Hello and welcome to "In It," a podcast for families with kids who learn and think differently.

Rachel: Here you'll find advice, camaraderie, stories of successes, and yes, sometimes failures from experts and parents and caregivers like you.

Gretchen: I'm Gretchen Vierstra, a former classroom teacher and an editor here at Understood.org.

Rachel: And I'm Rachel Bozek, a writer, editor, and mom who has definitely been in it. Today we're getting real.

Gretchen: We sure are, because it's time to talk about hygiene.

Rachel: Dum dum dum.

Gretchen: Oh boy.

Rachel: OK. Brushing teeth, towering, putting on deodorant, wearing clean clothes. What do you do when a young person in your midst is refusing to do one or all of these things?

Gretchen: For lots of families, hygiene avoidance can become a major source of conflict.

Rachel: And let's face it, pretty stinky.

Gretchen: Luckily, we've got someone with us today who's very skilled at tackling this kind of thing.

Rachel: Brendan Mahan is an ADHD and executive function coach. He has his own podcast called "ADHD Essentials."

Gretchen: He's raising two teenage boys and he has ADHD, so he really gets it.

Rachel: He's been a guest with us before and we're so glad to have him back. Brendan, welcome to "In It."

Brendan: Yeah, I'm excited to be back.

Gretchen: We are so excited to talk to you. And today, as you know, we're talking about what we can do to get our kids to stay on top of their hygiene. But it occurs to me before we start solving that problem, maybe we need to take a step back and understand why lots of kids may have trouble with hygiene and may inadvertently end up, you know, going to school being a little less than squeaky clean sometimes.

(01:51) Cleanliness and self-care

So, what is it that gets us here? Why do some kids seem to have trouble with cleanliness and self-care?

Brendan: Yeah, I think there's a lot of reasons. And that makes it tricky because we don't know which one it is, especially when we're just sort of talking on a podcast, right? It's not as though you're a client that I'm consulting with.

Gretchen: Right.

Brendan: So, moms and dads who are listening to this are going to have to do a little bit of their own research and digging when it comes to their kids. They're gonna have to talk to their kids, ask them questions, pay attention to what might be happening, depending on how easy this is even to talk about. Because some kids this is not a comfortable topic. Some parents this isn't a comfortable topic. So, I just, I want to honor that element of this, that it can be more challenging than we might make it seem.

In terms of reasons, one reason that jumps out that is not as obvious necessarily is just the sensory experience of it, right? Like the sensory experience of taking a shower or cleaning my body, right? Clipping my toenails, getting a haircut, that stuff can be really challenging as a sensory experience for some kids, so that might be a part of it. And if that is a part of it, we want to wonder and speculate, how can we make it gentler?

One thing that I love, this is I'm going to sort of go problem solution if that's OK...

Gretchen: OK.

Brendan: Because that way I won't, I'm less likely to forget. But one solution that I found specifically for showering, it works for sensory stuff, it's going to work for a lot of the challenges that I bring up is making a playlist for the shower.

Gretchen: Yes.

Brendan: If we just let our kids listen to a playlist while they take a shower, it can make the sensory experience a little bit more gentle. This can also help support kids with timing issues, right? The kid who will take a shower, but when they take the shower it's forever.

Gretchen: Yes.

Brendan: Yeah. Often that's because they lose track of time, right? They just, because the sensory experience of the shower can make time get weird for neurodiverse folks. And if we have a soundtrack to our shower, we can know "All right, when this song plays, that means I'm done. Like, I got to wrap it up." Another thing that can happen is you might have a kid that will take a shower, but they never wash their hair or they never use any soap. They just stand in the shower with the water running well.

Well, if you identify certain songs on the playlist as "This is the song like that is telling you to wash your hair. When this song comes on, that means you got to scrub your hair up with soap or shampoo, and then when it's over, rinse your head off." So, we can also use the playlist to sort of provide some cues at whatever level of obnoxious we need to be, right? If we need to play songs that are about hair.

Rachel: I'm sitting here thinking about what songs would be great.

Brendan: Yeah, your kid might be able to listen to the songs they like. They might not be able to, right? We might have to play a song about hair so that they know, and it's more obvious, I don't know. Or it might be they get a song that they like in the beginning, and then the next song is one that they're not a big fan of so that they'll kind of come out of the music and pay attention to what they need to do. So, the music stuff is, it can be a pretty big deal.

Gretchen: I love that idea.

Rachel: That is, yeah, that's really great.

Gretchen: OK, the sensory thing, I mean, it's huge, right? For lots of kids. What might be another reason why kids might have trouble with hygiene and self-care?

Brendan: It could be a control thing where you can't really make your kid take a shower. Not really. So, there might be a layer to this that is the kid needing control, the kid recognizing they get some power in this. That stuff often is about relationships, so it might be worthwhile to pay attention to how you're interacting with your kid around these personal hygiene things: brushing teeth, taking a shower.

Are you doing it in a way where you're trying to wrest control away from your child and force them to do whatever it is that you're asking them to do? Are you sort of taking control in places where if someone were to do it to you, it would offend you and really bother you, but because you've got a kid, you're not seeing that it's obnoxious? A good example of this would be when the kid does the thing you want them to do, and then you're like, "Oh, you finally took a shower, huh?"

Gretchen: Well, yeah.

Brenda: It's like, why are you discouraging them? Like, you're not, you don't think you're discouraging them, but you're doing this like judgmental kind of finally thing that makes you a jerk. And the kid's like, "Well, now I'm not going to do it again." So, like this power and control piece, it plays out in a lot of different ways. And the more we give our kids some agency and the more we give them dignity and let them kind of do their thing and give them credit for being the wonderful kid that they are, the less this stuff is in conflict and the more likely they are to do it.

(06:43) Executive function, room cleaning, and more

Rachel: Yeah, that makes a lot of sense. And what about when it's an executive function issue? Can you talk a little bit about when that's the obstacle?

Brendan: Yeah. Because that's certainly another component to this, right? Is did they lose track of time in the shower and didn't wash anything? They just stood there getting wet. Because they lost track of time and now they have to get out. You're banging on the door saying "We got to go, we got to go." And now you're like "Wait you still smell. Like you're just wet."

Rachel: Or did they come out with dry hair, right?

Brendan: Or dry hair, yeah, yeah.

Rachel: Yeah, I've never seen that happen.

Brendan: So, some of it is like that's inattention, potentially, that certainly time awareness. It's maybe distractibility. It depends, right? Like, but those are all things that get in the way, and moving on to another level of sort of self-care and hygiene, there's also cleaning of room. It happens to me, I'll be cleaning my office and I'll pick something up and I'm like, "Oh man, I remember that conference. That was a great conference."

And now I'm thinking about the conference and what I did there. And it was like five years ago. And it's not the least bit pertinent to what I'm supposed to be doing right now. But my memory got hijacked and I started drifting down this rabbit hole.

The same thing happens to your kids. They pick up a toy, they pick up a picture, and now all of a sudden they're wandering off somewhere in their mind. And it's not that they don't want to clean the room, it's just that they got derailed and there's no one there helping them to stay on track necessarily. Not that we need to be on top of them the whole time, but we do need to support them if it's a thing they struggle with.

One thing I did with my guys when they were, they were little. This was when "Thor: Ragnarok" came out. That's how long ago this happened. I gave them a clipboard and I was like, "All right, this is what we need to do. You need to clean your room so we can go to see 'Thor: Ragnarok.'" And on the clipboard, I stuck a piece of paper and I just made a T chart. And on one side, it said on task, and on the other side it said off task. And I was like, "All I want you to do is make a checkmark on task or off task. That's it. Just put a checkmark in the right column whenever you hear Alexa say, 'How are you doing?'"

And I set a bunch of Alexa reminders — I think it was like every 5 or 10 minutes, I don't remember. I made it really clear to my kids I was really kind to them. I was treating them with dignity. I was not, this was not a "gotcha!," right? I was clear on that. I was like, "This is not a "gotcha!" This is just for you to pay attention and see how you're doing. And then if it turns out you're off task a lot, what kind of figure out why, and then next time you clean your room, we'll be able to work around that. And if you're on task then great."

One of the things that that activity does is it forces you to stay on task because you get a little competitive. You get a little like alert to the fact that...

Gretchen: You want to say you're off, yeah.

Brendan: Yeah. So, you want to check the "on task box," so just by doing it I was keeping them on task and they had one time they were off task. I was like, "Whatever." But they got their room cleaned and that was all I wanted.

Gretchen: Do you think it was helpful because it was Alexa doing the reminding versus you?

Brendan: Yeah, I love Alexa as a reminder tool. I don't have to remember to do it. And it personalizes the prompt. It's not "Dad's a pain in the butt and constantly asking me to do whatever it is that he is asking me to do." It's Alexa's doing it, and my kids set their own reminders in Alexa, and they've been doing that since they were like seven. They're 15 now.

Gretchen: And I'm assuming for folks who don't have an Alexa device, there's other little apps and things you could download on phones or whatnot to use as like a virtual reminder.

Brendan: You can just set an alarm. Both of my kids have alarms...

Gretchen: Yeah.

Brendan: They set on their phones for stuff, stuff that they don't want Alexa to say out loud at home when we've got friends over or something, you know.

Gretchen: Right, right, that's true.

Brendan: Just the alarm goes off.

Gretchen: So, you brought up something really important that a lot of these hygiene issues could be about power struggles, right? And like kids wanting to make their own choices and not be told when they're going to do things, their own dignity, they're going to take care of themselves. So, that could be true with a lot of kids. And if so, as a parent, how do you pick your battle, right?

Like if you list up all the things that kids are supposed to do, for example, before they leave the house, like brush their teeth, wash their hands, you know, make sure their clothes are clean and laundered, have deodorant on, how do you start to tackle this? If you don't want to be the nag, you don't want to have power struggles with them, but you would really like them to go to school with at least a few of these things done.

Brendan: I would take over the things that I can take over if they need to be taken over, right? So, if I have to take over laundry for a little while, I'll take over laundry. And I can eventually pass that over to them again or for the first time. But it's not a big deal if you're doing their laundry in order to give them a little more space to take a shower, brush their teeth, that kind of stuff.

I would also systematize as much of this as I possibly can if I want my kids to brush their teeth, cool, let's set an Alexa reminder that reminds us to brush our teeth. And I say us on purpose. Because if my kids never see me brush my teeth, they're not going to brush their teeth.

Gretchen: Right.

Brendan: So, I need to brush my teeth in front of my kids, even if I go to bed later than they do. And it might be helpful to systematize it and use the excuse of we only have one shower or two showers — I don't know how many showers you have in your house — but we have more people than showers and we have to make sure that everybody gets to take a shower. So, that means I need you guys or you child or whatever, taking a shower in the morning or in the evening, because we just need to divide and conquer. We might need to set it up that way, and that's totally fine.

It might also be useful to talk to your kids about the timing of it because that's here too, right? Sometimes kids take showers at inconvenient times and then we're like, "Oh, we were supposed to be eating dinner, and why do you take a shower? Right? But that's discouraging them. Instead of being a grump about it, just go "All right, I'm really glad you took a shower. Can we try to figure out a way to do this that's not at 5:30 at night? Because the last couple of times you took a shower, it was at 5:30. That's dinner time to kind of message stuff up a little bit. When might make more sense?"

We might need to talk to our kids about that, too. We might need to sit down as parents and reflect on "Does our schedule give them enough time to take a shower? And if not, how do we create that space? And when is the best time for that space to be made?" Maybe your kid doesn't want to go to bed with wet hair. And so even though you're like, "You could just take a shower at 9:30 right before you go to bed."

Gretchen: Right.

Brendan: But your kid who was long hair, whether it's a son or a daughter, is like, "I don't want to go to bed with a soaking wet head, because then I wake up and my hair's a mess and all this kind of stuff." Maybe in middle school, they're great at it. And then high school started, and all of a sudden they get up a half an hour earlier and now they're not showering anymore.

Often this is just a problem to solve. But instead of looking at it as a problem to solve, we look at it as a moral failing or "Oh my God, no one's going to like my kid because now they're smelly. What's wrong with my kid?" and all this kind of stuff? It doesn't have to be that. It can just be "There's some problem hiding inside of this that we don't know about, and we have to talk to our kid to find it."

Gretchen: Yeah, I really like that advice. I feel like parents in general go like to your kid is 15, but now you're imagining them at 25, right? You're like seeing them living in, like, this apartment that's like, filled with garbage, and they're not taking showers when you have so many years before that's going to happen, right?

Brendan: Yeah, but our brains completely do that. We completely overreact and are like, "Oh my God, my kid. How are they ever going to get married if they don't take a shower? Who will put up with their stench? How are they going to have friends? Like, no wonder my kid doesn't have any friends like they don't. They smell bad." That's probably not what's going on. And they probably do have friends at school that they talk to. Because...

Rachel: Who also smell.

Gretchen: Right! Who also smells bad.

Brendan: Who also smell, right. Yeah. Because like, let's not forget Covid happened and it impacted a lot of kids pretty significantly. And I can't ever stop saying that. Like I bring it up all the time — theoretically we're years away from that, but we're not.

Gretchen: No.

Brendan: Because these kids were, a lot of the kids that parents are thinking about right now were at significant developmental stages when Covid hit and it's, we're still seeing echoes of that. And some of that might be, "Hey, you know what didn't matter so much during Covid for a lot of kids and families? Personal hygiene. A lot of families didn't care because they weren't leaving the house.

If your family is one of those families that personal hygiene just went off the map and your kid was like in elementary school, middle school, well, now that they're in middle school or high school, guess what? There's echoes if your kid is struggling with personal hygiene.

We might need to recalibrate and have an actual conversation about this instead of just saying "Take a shower." We might need to say, "Hey, you know how we didn't really prioritize that stuff during Covid because we weren't seeing people? Well, now we're out and about and it's really important that we put on deodorant, take a shower, brush our teeth because like, smell matters again.

Rachel: So, it seems like we've got kind of two different areas of concern when it comes to hygiene, right? We've got the physical health, the actual like taking care of yourself, and one that has more to do with social norms and which we've talked a lot about now. Do you find that it's more effective to lean into one of those angles than the other? Like what for you has been the best argument you can make that will get a kid to want to take care of their body?

Brendan: It depends on the kid, and some of it is talking to the kid about how they feel, right? Like, "Hey, you went for three days without taking a shower. Like you haven't taken a shower in three days" — oh kid that I'm coaching in my imagination right now. I do this with young adults too, and sometimes adults. I'm just like," How do you feel?" And usually they're like, "I don't know, kind of tired, kind of gross, kind of not so great." I'm like, "All right, cool. Here's what I want you do: At some point today or tomorrow morning, take a shower."

And then if it's an adult, I'm like, "I want you to text me about how you feel after you take that shower." And if it's a kid, I'm like, "Just talk to Mom and Dad, have him write it down." Something like, sometimes a kid writes it down on their own. "How do you feel?" Right? I've had kids brush their teeth and young adults too. I'm like, "Go brush your teeth and come back." And they're like, "I can't just do that. I can't just, that's a waste of time," because they're like on the clock with me, sort of. And I'm like, "But it's not that big of a deal. Like it's not going to take so long."

Gretchen: Yeah.

Brendan: Because some of this too is with ADHD especially, and other executive functioning areas that are challenged. That time component, that time awareness, plays a prominent role. And often we conflate emotion with time, with we have executive function challenges. If we have a lot of anxiety about something, it can feel like it's going to take longer than it actually takes. And that happens with toothbrushing.

If I've got a kid that doesn't brush their teeth enough and they know it and they feel bad about it, but they also don't really want to do it because for some reason it doesn't appeal to them, then I have them brush their teeth and they're like, "Oh, that was fast."

Rachel: Yeah.

Brendan: And even if it only takes 30 seconds, that's 30 seconds more than you've been doing.

Gretchen: Right.

Gretchen: Right, right. That's true.

(18:07) Social concerns

Gretchen: Well, I want to talk a little bit about mostly, probably this is with older kids, but we know that families often worry about their kids' hygiene, and they're not taking care of their bodies because they worry about sending them to school and having kids say things, right? About what they might smell or how they might look.

And so, should we be telling our kids, like, "You know, you haven't showered in three days and I can tell you haven't used deodorant. You know, you might want to..." or should we not talk about this at all and just let it play out? Like, what is your advice when it comes to kind of like the social pressures of this?

Brendan: I think you have to know how to talk about it. It's not useful to not talk about problems. Problems don't get solved if we don't talk about it. But problems also can become conflict if we don't talk about it in a way that is kind and that is caring. So, you can go over to your kid and give him a hug, right? And go, "Hey kid, I love you, but you're getting a little ripe. Just heads up, man." You know, like you can do it that way. Depending on your kid and what their sort of temperament is, maybe joking about it will work. Maybe it won't.

And it's an act of love to tell them so that they can address it and they're not embarrassed out in the world. Better for them to be mildly embarrassed at home, than for them to maybe be bigger embarrassed out in the world, or for them to not be embarrassed, but also not be engaged with socially.

Gretchen: Right.

Brendan: And if you can have that conversation in an honest way, in a gentle way, in a safe way, then you're good. And this goes back to the whole idea of like, don't discourage the stuff you want, right? Don't be a jerk about it. Just be kind. So much of this is just being kind to our kids.

Gretchen: Right. And I think even, like, sometimes just like modeling it, right? Like, I've come home from a run and I've been like, "Oh, like, I'm certainly, like, I'm sweaty today. I'm definitely going to take a shower."

Brendan: And maybe if you have a partner, maybe you can set it up so it's not as embarrassing for you as a person. It's not as intense for you as a person, but maybe you have a conversation with your partner and you're like, "Hey, I'm going to go for a run and I need you to call me out on being smelly when I get back."

Gretchen: Right.

Brendan: And then I'll go take a shower. Because that also normalizes being called out, right?

Gretchen: Right. Yeah, I don't, I don't unfortunately, I'm thinking about that scenario of like, yeah, I actually don't have to have my husband call it out because my teenage daughter will without me asking her to.

Brendan: Well, and you also get the opportunity to model how you receive that information.

Gretchen: That's right. Yeah.

Brendan: When you receive it, right? You can say, "Oh yeah, no. Cool. Thanks for letting me know. I'll go take a shower," and receive it in a way that's sort of balanced and not overwhelmed and not having an emotional storm, just like, "OK, cool. Thanks."

(21:07) Reward systems

Gretchen: Yeah, exactly. You know, a lot of times we think, "Oh, a checklist will help our kids," right? Like, these are the things you need to do before school, like brush your teeth, brush your hair, blah, blah, blah. And sometimes we associate checklists with, like, maybe some kind of reward system. Does that work or no?

Brendan: Don't, don't. Please, please don't.

Gretchen: I wanted to ask this.

Brendan: Please don't do that. That is control. That's "I'm trying to control my kid."

Gretchen: Yeah.

Brendan: A checklist if they want it and are finding it useful and supportive, then it's supportive. But a checklist that is a demand is control. And, ladies and gentlemen in the audience, if your kid smells, they are of the age where they want you to have less control, not more control. They're starting to pull away. It's normal. It's developmentally appropriate. It's supposed to happen. If you double down on control when they are developmentally moving to have more of their own control and be less controlled by Mom and Dad, it is not a recipe for success. It just isn't.

So, you can advise. You can provide some strategies and skills, but a checklist where they can like earn money or something is not going to work.

Rachel: I was just about to say that like if it is quote successful all of a sudden you need like a shower budget.

Brendan: Right.

Rachel: To get this to happen.

Brendan: And the other side of that too, right? Is if I have a checklist and I get a reward for accomplishing the things on it, and teachers be listening to this ,then if I don't get those things I failed. I met with a school that we were talking about how the kid would come home every day and talk about how he was a failure and he couldn't succeed at anything.

And the school had these checklists and they were like we never tell him he's a failure. We never say that. I was like, "Your checklists say that to him every day."

Rachel: Yeah.

Brendan: That's what all the research says. And it's the same thing for moms and dads and stuff at home. Like, if it's useful, great. If it's not, don't do it.

(23:07) Hygiene late bloomers

Rachel: So, is there such a thing as a hygiene late bloomer? And if so, what would make the awareness or compliance finally kick in?

Brendan: Yeah, there's totally hygiene late bloomers, like the peer pressure is one thing that is going to make that kick in. And most significantly, I am suddenly interested in boys or girls. Like once of that romantic part of the world brain kicks in, once I start wanting to impress people, all of a sudden, then the personal hygiene stuff kind of cascades from there, where "Well, if I want to look good, I should brush my teeth."

Gretchen: So, there's still hope if our kids have not bloomed in that direction. You're saying there's still hope?

Brendan: Yeah.

Rachel: Brendan, this has all been really helpful and made me think about some things in ways that I had not thought of them before. So, thank you.

Gretchen: Yes. Thank you so much.

Brendan: Yeah. Thank you.

Rachel: Now I got to go make my shower playlist.

Thanks so much for listening today. If you have any thoughts about the episode, we'd love to hear from you. You can email us at init@understood.org.

Gretchen: And check out the show notes for this episode where we have more resources and links to anything we mentioned.

Rachel: This show is brought to you by Understood.org. Understood is a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. Learn more at Understood.org.

Gretchen: "In It" is produced and edited by Julie Subrin with additional production support from Cody Nelson and Ilana Millner. Justin D. Wright mixed the show and Mike Errico wrote our theme music. Briana Berry is our production director. Neil Drumming is our editorial director.

Rachel: From Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. Thanks for listening.

Gretchen: And thanks for always being "in it" with us.