Self-Care Skills

Provision and/or strategies: approaches, adjustments and specific interventions expected to be made by settings according to the ages and stages of the CYP

Universal

• Work collaboratively with CYP, families and professionals to understand the child's self-care challenges (e.g. toileting, dressing, eating/drinking, personal care) and develop an intimate care or toileting plan that promotes independence, respects the CYP's preferences, and reflects their abilities and potential. Further guidance on intimate care can be found here.
• Work collaboratively with CYP, families and professionals to establish effective and sensitive communication methods, enabling the CYP to express their self-care needs (e.g. verbal, visual or symbolic communication), while being mindful of cultural and family practices when supporting self-care and intimate care routines.
• Ensure staff have a basic understanding of interoception [HH1] and how difficulties in recognising internal body signals (e.g. hunger, thirst, toileting) may impact self-care and may present as physical discomfort or emotional dysregulation.
• Ensure a consistent approach across staff in supporting self-care routines, promoting familiarity and reducing anxiety for the CYP.
• Ensure self-care facilities (e.g. toilets, changing areas, handwashing) are accessible, safe, and appropriate to the CYP's needs.[HH2] 
• Provide predictable routines and, where appropriate, prepare the CYP in advance for self-care activities to reduce anxiety and support independence.
• Provide co-regulation and emotional support during self-care routines, recognising that these tasks may be stressful or overwhelming for some CYP.
• Make reasonable adjustments to ensure CYP with self-care challenges are fully included; CYP should not be excluded from activities due to self-care needs.
• Ensure that CYP with continence needs are fully included, and are not:
  • Excluded from activities
  • Sent home to change
  • Dependent on family attending the setting to manage toileting
• Consider carefully how and when medical or personal care procedures take place, to avoid CYP feeling different and to promote inclusion within everyday routines.
• Ensure consent is sought at an age- and developmentally appropriate level before providing any personal or intimate care.
• Communicate clearly and sensitively with the CYP before and during any intimate care, respecting their preferences and promoting dignity.
• Ensure staff providing intimate care are appropriately trained, including moving and handling, [HH3] and follow safeguarding procedures (e.g. working in pairs where required), while maintaining dignity and privacy.
• Provide support with personal care sensitively, ensuring maximum access to the curriculum and wider opportunities, and maintaining dignity in front of peers.
• Adapt provision for eating and drinking, including:
  • Access to a range of appropriate utensils to support independence
  • Adjusted diets where required
  • Allowing additional time to eat safely
• Maintain realistic expectations around timing for self-care tasks (e.g. changing for PE), allowing sufficient time and support.
• Support CYP to develop independence in managing their personal care, including (where appropriate) the administration of medication.
• Access specialist advice where appropriate, including:
  • Just One Norfolk (continence support)
  • ERIC - The Children's Bowel and Bladder Charity (training and resources, including awareness of constipation and toilet training for CYP with SEND)

Targeted

• Work collaboratively with families and professionals to ensure consistent approaches to self-care skill development across settings.
• Work with families to seek specialist continence assessment and advice where appropriate, to inform planning and provision.
• Deliver targeted interventions to develop underlying skills required for self-care (e.g. fine motor skills, sequencing, sensory processing, and postural control).
• Implement structured teaching of self-care routines using task analysis and step-by-step approaches to break tasks (e.g. dressing, toileting, eating) into manageable components.
• Provide targeted small group or individual interventions to explicitly teach and rehearse self-care skills within meaningful daily routines.
• Implement structured toileting programmes, such as scheduled sits, using evidence-based, routine-based approaches tailored to individual needs.
• Provide targeted support for establishing and maintaining personal hygiene routines (e.g. handwashing, oral hygiene), using explicit teaching and repetition.
• Use consistent prompting, modelling and graduated support, alongside opportunities for choice and control within routines, systematically reducing adult input to promote independence, autonomy and dignity.
• Use motivating activities and meaningful outcomes, alongside positive reinforcement and feedback, to encourage engagement, persistence and independence in self-care tasks.
• Provide visual supports, sequencing tools and structured routines to support understanding and independence in self-care tasks.
• Adapt equipment, resources and the environment to enable participation (e.g. adapted clothing, step supports, accessible hygiene facilities).
• Embed regular, planned opportunities to practise self-care skills in real-life situations throughout the day, so they transfer beyond structured teaching sessions.
• Provide targeted support to develop self-monitoring and awareness of personal needs (e.g. recognising hunger, toileting needs, and hygiene requirements)