Measure 44 — SH 1

Personal Care Routines: Toileting and Hygiene

Child responds to and initiates toileting and hygiene routines that support healthy growth and help prevent the spread of infection

Developing personal care behaviors and routines, including toileting and personal cleanliness (hygiene), is important to supporting healthy growth and preventing the transmission of illness and infection. Young children begin to develop these behaviors by passively participating in or reacting to personal care routines initiated by their caregivers. In time, these routines become familiar to young children, and they begin to anticipate the steps in the routine and participate with increasing independence. They also begin to communicate to others that they understand the reasons for personal cleanliness behaviors and routines.

At birth, infants require complete caregiver assistance for toileting and hygiene. They respond to these routines with undifferentiated actions, such as turning away or reaching out. As they gain experience and knowledge of routines, infants anticipate steps in simple care-giving routines and can begin to participate, for example, by lifting their legs when their diaper is being changed.

As they develop the cognitive and motor skills necessary to complete some steps in simple care routines, toddlers will begin to take a more active role. For example, when an adult turns on the water and says “Time to wash hands,” the child might put her hands under the water. A young toddler may blow his nose when an adult puts a tissue to his nose and says, “Blow.” Toddlers begin to show a desire for more independence (saying “I’ll do it” when beginning a task) with washing hands, brushing teeth, and performing other personal care routines; but they require adult assistance to complete most routines. For example, an older toddler may be able wipe her own nose and mouth when an adult provides the tissue.

Young preschoolers begin to remember the sequence of steps in personal care and hygiene routines. They can complete some simple personal care routines but need verbal or physical assistance from an adult. For example, a young preschooler may be able to follow a hand-washing routine if the teacher recites the steps as the child is completing them. The child may follow the steps for washing her hands, but need the adult to turn the faucet off completely.

Older preschoolers complete personal care routines more independently. They can wash their hands, brush their teeth, and toilet with little adult assistance or prompting. Learning and performing all of the steps in personal care and hygiene routines leads the child to internalize these routines. Older preschoolers can perform the routines in new places. They also show that they know the rationale for a personal care routine by communicating to others about the routine. For example, a child may remind another child to cover his mouth while coughing. Or a child may explain that washing hands before eating is important because it helps remove germs.