Self Care Skills and Child Development
by Egle Majute, Student Occupational Therapist
The role of an Occupational Therapist is to support children of any age in participation of their daily occupations. One of those occupations is self-care skills. Self-care skills are everyday tasks such as toileting, bathing, grooming, and dressing, commonly referred to as activities of daily living (ADL’s). In order to participate in self-care, children must have skills within a variety of performance areas. Delays in any of the areas might have an impact on the performance of self-care skills.
Performing self-care skills depends on a child’s strength and endurance, range of motion, fine and gross motor skills, body awareness and the ability to develop the proper motor plan to execute the task. A child also needs to have the ability to remember when and how to perform the task, choose the appropriate items needed, and remember the sequence of the task. In addition, sensory systems may have an effect on the completion of self-care tasks.
During an OT evaluation, it will be determined if a child is delayed in areas that contribute to self-care performance. If the child presents with any deficits in those areas, treatment will involve improving the skills required for self-care.
Below is a table highlighting the average development of age appropriate self-care skills:
| Age | Toileting | Dressing | Bathing, Grooming | Feeding |
| 1 – 2 years | Indicates when wet or soiled, tolerates diaper change | Assists by pushing arms through sleeve
Removes socks, shoes, hats Holds leg out to assist in pulling pants on Helps pull down pants
|
Tolerates bathing, diaper changing, and grooming activities by caretaker | Uses spoon to scoop and feed self, with some spilling
Holds cup with lid well and drinks without difficulty At 2 years may begin to drink from small cup without a lid Tolerates a variety of food textures |
| 2 – 3 years | Needs help to wipe self and manage clothing
Needs reminders and diapers at night. |
Removes clothing and shoes
Puts on front button shirt Can unzip and do large buttons Requires assistance to put on pullover clothing |
Participates in washing self in tub with assistance
Wipes face and washes hands with supervision Assist in brushing teeth and grooming |
(2-5 years)
Becomes proficient in using utensils and a cup without a lid with occasional spilling
|
| 4 – 5 years | Daytime and nighttime control and independence but may need help to wipe self and manage clothing fasteners | Can undress clothing
Puts on pullover clothing, may need help with orientation Puts on pants except fasteners Can button and unbutton large buttons and zip up jacket when zipper is in place Puts on shoes and socks but is unable to tie shoes. |
Requires supervision for grooming, brushing teeth, some assistance with bathing to manage water, wash hair, and safety. | (5 – 10 years)
Learns to open food packages and spread with a knife Cuts meat Follows table manners |
| 5 – 6 years | Fully independent | Independent except with clothing selection
Occasional help with fasteners such as belts and back zippers |
Requires supervision only for grooming and teeth brushing with reminders
Bathes self with to set up water and wash hair |
Reference: Mulligan, S. (2014). Occupational therapy evaluation for children: A pocket guide. Philadelphia, PA: Lippincott Williams & Wilkins
