My Teenage Special Needs Grrl Hit PUBERTY!

Puberty is awkward regardless of the circumstances. Families raising special-needs teenagers have additional challenges.

The Vanderbilt Kennedy Center publishes a guide, Healthy Bodies for Girls, with tips for teaching your daughter (and you!) how to handle puberty as gracefully as possible. Don’t wait, start before the obvious signs are there. Changes can be scary if she doesn’t understand what’s happening.

Use the Right Words

Use the biological terms for body parts:  vagina and breasts, for example — and bodily functions, such as urination and menstruation. This makes it easier to talk about everything from hygiene to reproduction.

Build Up to a BRA

Let your daughter get used to wearing something under her shirt by giving her training bras, camisoles, tank tops with thin straps or sports bras. Find ones that snap in front if she has trouble with dexterity, or ask her occupational therapist about adaptive bras.

Physical Activity: Join In

Ask her doctor or school physical therapist for safe exercises and continue at home together.

Teach Hygiene

Good hygiene habits make us more independent and confident. Create hygiene “kits” for school, “hangs” and sleepovers that are stocked with everything needed for certain tasks and label each kit for that task that you buy together.

Explain Menstruation Early

Bleeding is FRIGHTENING. Her period will probably start a year or two after she develops breast buds. A menstruation kit can be especially helpful in preparing your daughter for her first period. Stock a kit with different sized pads, wet wipes, a change of underwear and pain reliever, if she can take medication on her own. Talk to her teachers, counselor and school nurse that you have started the process.

Show her how the pads adhere to her underwear. If your daughter needs help remembering how to use the pads mark the inside of her underwear so she can see where to place the pad. Provide pictures of the step-by-step process for changing her pad.

Ramp Up Hair Care

Teens need to wash their hair more frequently than younger children. The motor demands of this task might make shampooing challenging = PT HOMEWORK! Create a schedule and consider items that make washing easier: sponges, pumps, bottles or a visor to keep the soap from eyes.

Body Odor, PWEH!

Sweat glands become more active during puberty, so young teens need to learn to use deodorant, wear clean clothes and keep their bodies clean.

Visual checklists can help your Alright Kid take charge of these tasks.

Clean Teeth & Clean Breath

An electric toothbrush might be easier for her to manage than a plain manual one. Timers or songs can help her know how long to brush. (Dentists recommend two minutes.)

Makeup

She’ll want to... start with something subtle and simple to apply, such as tinted lotion, lip gloss or face powder.

Public vs. Private

Explain to your daughter what parts of her body are “private parts.” A simple way to convey this is to describe them as parts that are covered by underwear or a swimsuit.

Kids with developmental delays may need help learning what behavior is acceptable in public and what should remain private. Talk about things that should only be done in private, such as going to the bathroom, changing clothes, touching private parts, passing gas and more.

When she does things such as adjusting her underwear or touching her private parts, redirect her to an appropriate place by telling her, “You can do that in your bedroom/bathroom.”

Teach what’s appropriate to talk about in public and what’s not: her period is private, something that’s OK to talk about only with parents, doctors or the school nurse – not with friends, teachers or strangers.

If your daughter needs help with private tasks, such as getting dressed or using the toilet, teach her how and who to ask for help when she is out in public, such as at a restaurant or at school. With her, think through how to plan ahead, ask discreetly for help, or make picture cards she can use to request help.

All kids touch their private parts sometimes. Shaming or punishing is confusing and might make her less likely to ask you questions, the attention might make her more likely to do it rather than less. Better to teach her to keep this behavior private. Use a visual signal to remind her of the rule (“no hands in pants”) or to shift her to some other action she can’t do at the same time, such as “hands on the table.” Be aware that kids may touch their private parts if they hurt or itch. If your daughter seems to be touching her private parts frequently, she could have an infection, irritated skin or some other problem that needs a doctor’s attention.

Puberty & Moodiness

Puberty creates a lot of emotional ups and downs. Teach your daughter to express her feelings. If she is verbal, help her name her emotions (“It sounds like you’re angry”). If she is not verbal, use visual depictions of emotions she can show you to express her feelings.

Kids with disabilities are at higher risk than their peers for mental-health problems that require intervention.

Signs that your daughter is experiencing anxiety, depression or perhaps even thyroid problems that mimic depression include increases in crying, shouting or laughing for no reason; compulsive behavior; aggression; troubled sleep; confusion; withdrawing from things she used to enjoy; and more. If you notice these changes, talk to her pediatrician about seeing a psychologist, behavioral specialist or psychiatrist for a consultation.

Teaching Strategies

Children with disabilities will need more than just an explanatory chat to learn these skills and rules. Take your daughter’s learning style into account.

Use visual checklists, visual supports and social stories when talking about bodies and puberty. Repetition often helps, so break information into small, simple facts and go over them frequently. Making a picture book will help when you’re teaching her how to take care of herself. Your school can assist you.

Let her help create it. How many images you include and how simple or detailed you make it should vary according to her reading level and memory. Include pictures of supplies she needs: for example, soap, shampoo, deodorant, pads, etc. Create pictures that explain when she needs to perform certain hygiene tasks and what supplies she needs for each step. Laminate an image of a girl’s body to serve as a checklist for hygiene tasks. For example, a shower checklist can be in the form of a picture of a female body. Attach it to the shower with Velcro. List the steps for showering (shampoo, conditioner, etc.), with the steps marked on the right body part on the laminated image.If your daughter needs help understanding the difference between public and private places and behaviors, make a list of public places versus private ones, and what behaviors are appropriate where. Use pictures of places and behaviors instead of words for children who have communication delays. Help her select examples of behaviors that are appropriate for each setting. Create a schedule for how often she needs to do each task – for example, taking a bath or shower daily, brushing her teeth after each meal.

To help her learn how long to stay in the shower or bath, a music playlist of songs that runs for the right amount of time can be a helpful cue. Each new song can signal when to move to the next step on the list.

* Use social stories

* Think about situations and behaviors that are difficult for your daughter

* Create a first-person story that explains the social rules for that situation and helps her understand what other people are thinking and feeling.

Anything and everything KidsAreAlright.org can do for you or your child, we are here for you always and in all ways!

Ellen Hunter, KAA Founder