Louden on Autism Q & A: Volume #4

Autism Q&A
560 315 Paul Louden

Welcome to the Louden on Autism Q & A: Volume 4. Over the course of the next few months, I’m going to be using questions submitted by my website visitors, readers, autism advocates, parents and others to shed light on some of the most important questions about autism. I receive questions every day, and I want to make sure that the answers to these important questions are being shared with all of you.


Please know that these are my opinions and my answers come from my research and my own personal experiences. Of course, each situation is different. All of us as people are different. And no two people with or without autism should be treated the same exact way.


This week, I received a question about struggles with autism and hygiene — specifically brushing your teeth.




How can I get my son to brush his teeth? He’s 21 and has suffered from depression. I’ve bought every type of dental accessory and paste, but he won’t use anything. He had 9 cavities and early gingivitis. He just does not care.




Honestly, this is a case-by-case basis for most people. For me personally, repetition of activities creates a lot of anxiety, so I found myself unable to consistently brush my teeth when I started living on my own. Because of this, I had severe decay and some significant problems. For me, it was the internalized anxiety of the nature of the activity. For many autistic people, the consistent routine is important, but because of my toothbrushing routine as a child, the lesson I’d learned had been “brush your teeth before bed,” and because I had severe sleep difficulties, it didn’t work well.


Once I became relaxed and tired enough to sleep, I had to embrace it fairly quickly. Getting up to brush my teeth before would’ve made it much harder for me to sleep. As well, I didn’t eat breakfast, though morning brushes were at least somewhat of an occurrence. If someone had just told me “brush your teeth at 8 pm every night” it would’ve helped.


While your son’s challenges with tooth brushing may be different, part of it is a simple fact that the anxiety spike is a “now” thing, while rotten teeth is a “future” thing. It can be really hard for those of us on the spectrum to be motivated by things we can’t necessarily make a firm emotional attachment to. Also, presenting the task as “extremely important” can then make the task feel more high-pressure, and increase the anxiety over doing it. Then, the sense of “I’ve already failed” kicks in if your teeth are already in rough shape.


My recommendation is to take your time, and try to work through what the obstacles are to getting it done — is it schedule, taste, the texture, the time needed, or something else? It’s so important to figure this out. We need to know the “why.”


Then, once they’ve been better identified, work on plans to overcome these obstacles. Try to identify places where he may get stuck — assumptions he’s made about how things “have to” be done. And at the same time, try to let him lead in making the plan as much as possible. If it’s his plan, it can help grow his confidence and sense of control along the way.


Thanks for reading. Check back next week for another Q&A.

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