Sensory Considerations for Dressing!

Shirt on, pants on, socks on, shoes on, hat on  ... out the door. Dressing should be an easy every day activity but sometimes it is NOT!  Sometimes there are sensory triggers which affect whether a child will or will not get dressed (or undressed)!

Some of these sensory triggers for dressing are found below as well as some behaviours that you may see as a result:

TOUCH

• Sleeves - Some children have a preference for short sleeves, others prefer long sleeves and others prefer no sleeves.
• Seams - Some children are intolerant to certain seams on clothing.  This may be on socks, shirts, pants, singlets, underwear.
• Clothing tags
• Bindings in clothing (eg. elasticized cuffs, waistbands, smocking details)
• Stiff clothing (eg. jeans)
• Texture and type of material (eg. cotton vs wool vs nylon etc) - Some children prefer highly textured clothing and other prefer breathable materials. 
• Length of clothing (eg. length of hems on skirts, length of socks)
• Items of clothing that touch the head (eg. hats, beanies, goggles)
• Shoes (eg. closed in shoes, sections between toes, height of shoe on legs, sandals which expose toes to other sensory experiences, preference for being barefoot)
• New clothes - Some children prefer new clothes to be washed a few times in familiar detergent before being able to wear them.
• Items of clothing that touch hands (eg. gloves, mittens, long sleeves)
• Tight clothing (eg. skivvy, stockings, swimming costumes, singlets, neck ties, waist ties) - Some children enjoy tight clothing and others are intolerant.

Children with touch sensitivities may have difficulty wearing certain clothing.  They may become distressed or constantly pull/tug at their clothing.  Some children will constantly touch or feel their clothing exploring the textures.   They may refuse to wear new clothes or prefer to be naked. These children may have difficulty changing clothing within a day (eg. changing for swimming lessons, getting ready for bed, etc).   Sometimes shopping for new clothes may cause stress as well as letting go of clothing that is too small.

Children who are sensitive to touch may disregard weather and temperature cues when it comes to dressing. They may wear long sleeves in warm weather or shorts and a sleeveless shirt in winter.  Some children will become extremely upset when their clothing is wet. 

PROPRIOCEPTION

• "Weight" of clothing - Some children will be sensitive to how much effort is involved in putting on clothing (eg. denim vs cotton).
• Body awareness -Some children will have difficulty aligning clothing with body position (eg. placing leg in leg hole of pants).
• Pressure - Some children will have difficulty releasing clothing at the appropriate place whilst dressing (eg.  pants released at knees rather than hips). 
• Finishing touches - Some children will have difficulty with tucking in their shirts, pulling up zippers, doing up buttons.
• Clothing position - Some children will have difficulty orienting clothing (front/back) or noticing clothing is twisted.
• Clothing size - Some children will have difficulty noticing clothing is too small or too big.

Children who experience difficulty processing proprioception information may fall over whilst getting dressed and undressed.  They may take a long time to get changed and appear lazy.  These children may look "messy" when they have finished getting dressed.  They may have clothes inside out or back to front.
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VESTIBULAR

• ​Balance - Some children will have difficulty maintaining balance  (eg. standing on one leg, moving head to look down at shoes)
• Movement - Some children have difficulty concentrating and staying still during dressing.

Children who experience difficulty processing vestibular information may appear "restless".  They may move about the room or wonder from one room to another whilst getting changed.  They may make several changes in body position (stand, sit, lie on the ground, jump off furniture, etc). They may also fall over or roll around. Alternatively, these children may prefer to get changed whilst sitting or lying down (eg. on their bed, on the floor, on a chair).

VISUAL 

• ​​Finding clothes - Some children will have difficulty with organisation of clothing (ie. finding and putting away clothing).
• Clothing patterns - Some children will prefer plain clothes or certain colours rather than bold patterns.
• Matching - Some children will have difficulty matching socks and shoes.
• Fastenings - Some children will have difficulty finding fastenings (eg. buttons, button holes, zippers).

Children who experience difficulty processing visual information may take a long time to find clothes and get dressed.  They may make limited clothing choices and have difficulty matching tops with bottoms (eg. understanding what "goes" together).  Some children may have difficulty aligning rows of buttons with buttonholes or they may wear non-matching socks and shoes.

AUDITORY

• Noise of clothing - Some children will be frustrated with clothes that make noise when child is moving (eg. buckles).
• Sound of items in pocket - Some children will seek noise from items in their pockets (eg. coins, keys) and may be distracted by these items.
• Sounds in the environment - Some children will be distracted with dressing because of noises around them (eg. bathroom noises, siblings).
• Verbal prompts - Some children need verbal prompts and others struggle to follow verbal prompts during dressing.

Children who experience difficulty processing auditory information may become distressed easily and make limited clothing choices.  They may try to cover their ears during dressing or scream to block out other noises. They may prefer getting dressed in particular places (eg. bedroom not bathroom). They may take a long time to get dressed as they are easily distracted. 

SMELL/TASTE

• Smell of detergent - Some children will prefer the smell of particular detergents on their clothing.  They may require new clothes to be washed prior to wearing.  Some children may enjoy sniffing there clothes.
• Glue - Some children will be aversive to the smell of glue on some clothing (eg. belts, shoes, motifs).
• Leather - Some children will be aversive to the smell of leather products (eg. belts, shoes, hats).
• Soiled clothing - Some children will become distressed when clothing is wet or soiled. Other children will enjoy noxious smells (eg. sweat stained clothes).
• Some children will chew their clothing (eg. collars, buttons).

Children who seek additional smells in clothing may be seen sniffing their clothes excessively.  They may choose long sleeves or to hold their clothes so that they can bring these to their nose.  Those who are sensitive to smells may become distressed easily and have limited clothing choices. 

Children who seek oral stimulation may chew their clothing or chew the fastenings on their clothing. They may also like to brush clothing across their lips or lick clothing. 

I have compiled this information about sensory triggers and behaviours into a single page printable checklist. Download your copy of this checklist HERE!

​SENSORY STRATEGIES FOR DRESSING
1. Be aware of your child's sensitivities and acknowledge their clothing preferences.  
There will be times where your child is required to conform with social norms (eg. wearing clothes rather than being naked in public, wearing a uniform to school, etc), however their may be times where there are less restrictions on what is worn and how it is worn. 

2. Build a wardrobe of comfortable clothing for your child, avoiding sensitivities which may cause distress or anxiety if possible. This may include: - 

• avoiding certain textures
• using undergarments so that certain textures do not touch your child's skin
• use seam free clothing (eg. Tic Tac Toe Seamless cotton tights from It Makes Sense)
• cut off or tape down clothing tags (eg. Undercover Tape) or purchase clothing which has labels printed on the garment
• allow clothing to worn inside out when appropriate 
• wash new clothing several times prior to wear
• be sensitive to clothing length your child prefers
• warm clothing in a dryer prior to wear in winter
• remove unnecessary clothing choices from your child's wardrobe (eg. keep only seasonal clothes accessible)

3. Contact an occupational therapist who may work with your child on an overall sensory diet to assist with sensory sensitivities.   Your occupational therapist will be looking at your child's arousal and activity levels, attention and impulsivity as well as their ability to regulate themselves.

An occupational therapist may suggest activities such as:

• deep pressure activities prior to dressing to decrease tactile sensitivities (eg. wrapping in a towel and squeezing) 
• massage (eg. scalp to increase tolerance to wearing headgear or overall body massage)
• body position and awareness activities (eg. using a therapy ball to work on balance, sitting to dress to assist with balance)
• a dressing checklist to promote self regulation
• "weighted" activities to promote feedback to muscles and joints (eg. jumping, push ups, crab walks, wheelbarrow games)
• trial of compression garments (eg. JettProof clothing)
• activities to assist with motor planning (eg. using a mirror, using songs, starting an action and getting your child to complete it, modelling)
• organisational strategies (eg. picture clothing labels on drawers to help with finding and packing away clothes, planning what to wear in advance and laying this out for the next day, providing hooks at your child's eye level)
• provide your child with clothing choices (within reason)
• allow extra time for your child to dress independently

Do you have a child who experiences sensory sensitivities during dressing? 


This article is part of “Functional Skills for Kids: 12 month series by Paediatric Occupational and Physical Therapists”.  You can read all of the childhood functions HERE.  Read all Your Kids OT’s monthly posts HERE.

Find more information about “Dressing” and valuable strategies to help with important skill, read what other Occupational and Physical Therapists participating in the “Functional Skills for Kids series” have written: ​

When Do Kids Start to Dress Themselves? | Mama OT
Fine Motor Requirements for Independence with Self-Dressing  | Sugar Aunts
Gross Motor Skills and Independent Dressing | Your Therapy Source
Sensory Considerations for Dressing!  | Your Kids OT
“Get Dressed!” How to Modify Your Child’s Dressing Routine  | MissJaimeOT
Teaching Kids How to Dress Themselves: Activities to extend skills | The Inspired Treehouse
Improving Following Directions with Getting Dressed | Growing Hands-On Kids
Visual Perceptual Skills in Dressing  | Kids Play Space
Work on Dressing Skills Through Play Activities  |  Therapy Fun Zone
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Cindy is a registered Occupational Therapist practising in Sydney Australia.  She has two young children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. Cindy is the author of the Occupational Therapy blog Your Kids OT.

The information on this site is general in nature. The activities are safe for most children; however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions.  

This article does not contain affiliate links and has no association with the companies suggested in this article.  Any items purchased are made at your own risk. 


References:
Yack, E., Aquilla, P. and Sutton, S. (2015) Building Bridges Through Sensory Integration (Third Edition).
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