I think a lot of autistic people struggle with hygiene. I’ve read autistic people and their parents discuss this. There are many reasons why.
Firstly, there are so many things to remember. When your brain is already overloaded, it’s difficult to remember all of these tiny hygiene steps that everyone else seems to do easily. My morning and evening hygiene routines are identical to reduce the stress of remembering everything. It’s much easier to remember to do one routine than it is to do every individual part. That’s one reason why it can be hard to change the routine, or skip parts. I can remember to do my hygiene routine, but I can’t remember each and every aspect and manipulate the order when I’m already tired out.
My teeth-brushing routine is:
Wash toothbrush.
Add toothpaste.
Brush teeth (first upper layer, then bottom. Left to right usually. Start at the front, then the back, then the pointy parts).
Rinse mouth.
Wash toothbrush.
Dry toothbrush (because I do not want mould to grow if I leave it wet overnight).
Wash hands.
Rinse face.
(And that’s just the teeth-brushing part. There are several other ‘sections’ [EG hand cream] but it would get too long to write).
I’m not sure how anyone would remember all of these steps individually. For me, the easiest way to remember is to do them in this order, because then once I’ve done one step I can remember the next. The simplified version of my whole routine would be: Brush teeth, then put spot cream on, then apply hand cream. But that’s not enough. Because I’ll forget to wash my toothbrush beforehand, so the brush will be dry and uncomfortable. Or I’ll forget to wash and dry the toothbrush, and it will soon end up gross and unusable. Or I’ll forget to put hand cream on after drying my hands, so it will feel gross and slimy. Or I’ll forget the hand cream altogether, and my hands will get too dry and feel like they are burning and itchy.
And that’s just one routine! There’s another routine for showers, clothes, etc. There’s a lot to remember.
Some of the ways I have found to help are as follows:
Explicit clothing rules. I have to be told explicitly about clothing rules. You can’t wear a shirt more than once without washing, but you can wear trousers multiple times. But you are supposed to not wear them two times in a row because then other people will think you don’t wash them. (Side note: who actually notices whether someone is still wearing the same trousers as the day before? Do people really pay that much attention to others clothes? Why do they care?). Socks cannot be worn more than once without washing.
Explicit shower rules: You have to shower every day, or every other day. To be honest, I apply this when I have work or school, but not when I’m just chilling at home. I shower regularly, but it seems unnecessary to shower every day if you don’t have the energy or motivation.
Distractions: When I’m showering, I get distracted very quickly. I’ll easily zoom off into a train of thought, and before you know it the hot water has run out. I need something to keep my attention, and to give me a way to monitor how much time has passed. I play music that I know from my phone to help with this. I can sing along, so my thoughts are occupied, and I can note how many songs have passed to keep track of time (usually I assume songs are 4 mins long, so it’s just 4 multiplied by the number of songs). This has helped reduce shower time from 45+ mins to 15-20 mins, and has probably helped reduce the water bill.
Cut yourself some slack. You could design two routines: one for most days, and one for tired days (or if you’re chronically ill or something, one for energetic days and one for standard days). One routine could have reduced demands. For example, my reduced routine is:
Wash toothbrush.
Apply toothpaste.
Brush teeth (any order, as many as you remember).
Wash brush.
Wash hands and rinse mouth.
The other steps and sections are skipped (which can lead to difficulties later on, such as hand dryness, so I try not to use the ‘reduced’ routine too often). Sometimes when I’m running low on time, I feel pushed to use the reduced routine (‘just skip that part!’), but that leads to increased anxiety, potential itchiness, potential tooth pain, etc.
Music!
Music is great for calming down and getting through a routine you may not like much.
Consider sensory aspects. Does someone refuse to bath? Maybe the shower causes sensory overload (it is incredibly loud when your head is under the spray). Maybe the shower gel is too fragrant. Maybe water feels horrid. There are ways to work around the sensory sensitivities, once you identify them. For example, a bath instead of a shower. No scented items in the bathroom. A soft hand-towel could be used to scrub yourself, instead of standing in a shower or sitting in a bath (if the water is too much).
I’m pretty good with my hygiene nowadays. But I still often miss spots when washing my hair, or forget to brush my teeth in the morning. I was worse when I was younger, as my mum would clean my hair up until I was about 12 or so (which I think is later than most people), and I found it difficult to transition from the routine of ‘wash frequently, and clean your hair once a week’ to ‘wash every day and clean your hair every other day’.
It felt unfair, and it was difficult to understand why, all of a sudden, my routine had to change when it had been working so well before. It may have helped if I were taught about this in school beforehand (maybe during puberty talks), so I could anticipate and understand the changes to come. Simply being told ‘you’re older now, you must shower more often’ makes no sense. Explaining why helped quite a bit (EG: ‘When you reach a certain age, you release more oil and sweat, which can build up and smell more quickly. This oil can also build up in your hair, making it greasy and knotty. So it’s best to get ahead of the build up and clean more often. More dirt/oil = more frequent washing’).