Taking the stress out of cutting children’s fingernails

Yvonne Newbold, author of The Special Parent's Handbook and mum of three children who have disabilities, shares her tips on how you can make cutting a child's fingernails easier.

Yvonne and Toby
A task that every parent has to do regularly but which can hold extra challenges following brain injury. Physical problems such as increased tone and pain can make nails more difficult to access while cognitive and emotional difficulties may make a child more sensitive to touch and less able to tolerate what can be a time consuming task. What do you do if your child can’t tolerate their finger or toenails being cut? It’s a very common problem in families where there are children with Sensory Processing Disorders or who are on the Autistic Spectrum. Parents try every strategy and tactic they can think of until they run out of ideas. Something that is a relatively simple task in most households can send families like ours to the very edge of despair.  It’s a question that I’m regularly asked, and it came up again on The Special Parent’s Handbook Facebook Page. When you are a special needs parent, you soon learn that the best information and advice often comes from other parents who have been there, so I threw it open to other parents, and I asked for them to help by pooling their ideas and suggestions.   So here’s what they said – real solutions from real families!  

Do it carefully once your child is in a deep sleep.

Sleeping boy
This was suggested by several parents, and for many it seems to work well, even if they have to climb in under the duvet with a torch. However one parent said that for her child the best time to do it was exactly 15 minutes after she had dropped off to sleep.
Another parent pointed out that, although it works most of the time, you do run the risk of waking the child up, and they’ll be furious and you’ll never be able to get them back to sleep easily! I’ve done the sleep time nail cutting too, but I’ve always been wary of waking them up so I only cut one or two nails each night, which takes about 3 weeks to work your way around all their fingers and toes, by which time you have to start the whole process again!  

Do it in the bath

Soaking in a bath makes fingernails and toenails become softer, so they are easier to cut. One mother always cuts her son’s nails in the bath under the water, because it muffles the sound. Another parent said that the bath was great because their child couldn’t run away! Other parents find that the best time to cut nails is straight after a bath, when their child’s nails are still soft, and they are still feeling the relaxing benefits of having been in a nice warm bath. If you are going to try cutting nails in the bath or when the child is still wet, take into account that they might be slippery, so make sure you are able to hold each finger and toe firmly enough to be able to do it effectively. Try using different types of equipment.  Every child is different, but by experimenting with different things, you may find one method that is easier for your child to cope with. One mother uses baby nail-clippers, other parents find their children prefer nail scissors, with the curved bladed nail scissors being successful in some families. Other parents have had to give up cutting nails altogether, but have found that their child can tolerate nail files much better, so nails are filed instead of being cut.  Some children get on best with battery-operated nail files – that could be worth a try too.  

De-sensitising your child

Dad and daughter
Try and find out which aspect of nail cutting your child can’t cope with – for some it is the sensation, for others it’s the sound of clippers or scissors, and sometimes it’s the fear of it hurting. Some parents have used foot massagers to help their children learn to tolerate different sensations on their feet. Introduce tickling games, then move up to using nail files. Get them used to hearing the noise of nail clippers. Let them watch you when you cut your own nails, or even let them cut yours for you. Touch their nail with the nail-clippers or nail file, without doing anything else. You can turn it into a game – either counting fingers and toes or playing “This little Piggy”. Some children find it easier during nail-cutting time if there is music playing – not only does it make them feel more relaxed but it can also cut out some of the noise that the clippers make. Many parents said that they found massaging their child’s fingers and toes, or in some cases their hands and feet, helped to make their child less sensitive. One child eventually told his mum that the reason he doesn’t like his nails short is that he can’t feel his knife and fork in the same way!  Once you know something like that, you’re more than halfway towards solving the problem with a compromise along the lines of agreeing not to cut them quite so short. One parent had been on an autism-specific course about sensory issues where she learnt a technique to “polish” the nails as a de-sensitising exercise.  She highly recommended other parents finding out about and taking part in similar courses.

 

Ask for help

As parents, we are often too close and too emotionally involved, and our children are more relaxed with us and therefore more likely to react adversely towards our nail-cutting attempts. It’s also really hard for parents to be the “bad guy” and forcibly restrain a distressed and struggling child. Is there a close friend or a family member who might have more success with cutting your child’s nails? Can you talk to your child’s school? Some parents have been very well supported by teachers who have helped to devise de-sensitising programmes or who have introduced Sensory Stories dealing with this issue.  

Finger holding techniques

Several parents reported that if they hold their child’s finger or toe in a particular firm but gentle way, their child is able to tolerate it much more easily. Some parents found that by gripping a toe or finger tightly, the actual cutting sensation was greatly reduced. The mum who had done the Autism-related sensory course had also learnt a technique whereby she squeezes the tip of the child’s finger or toe just before cutting it, and by doing so, the sensation is greatly reduced. She has her child squeezing her fingers too, taking it in turns to squeeze each other’s fingers and turning it into a little game.  

Distraction

Music has already been mentioned, but one parent found that when her child stroked a pet rabbit during nail cutting time, the child’s anxiety levels significantly reduced. Favourite toys, or having access to an ipad throughout works well for some children. Parents also reported that singing songs helps, as do a whole variety of tickling games. One parent uses a timer, so her child knows that when the buzzer goes off nail cutting time will finish, and that makes it much more bearable, and gives the child a sense of control.

 
Yvonne's Family
Yvonne's children Francesca, Toby and Adam

Motivating with rewards

One family has made huge progress over several months by breaking the whole process down into “baby-steps” and introducing rewards such as sweets. Initially the child won a reward simply by allowing a nail file to touch a finger  or toe. This progressed to tolerating the “snipping” noise of the clippers close to their hand or foot. Then they made a reward board out of a tracing of their child’s own feet and hands, and using a velcro token at the end of each finger or toe on the board which can be removed and exchanged for a reward as each nail is cut. Over time, the rewards were reduced so that a whole hand or a whole foot’s worth of nails had to be cut to gain a treat, and eventually a treat was only given when all 20 nails had been cut in one setting. Another parent exchanges a cut nail for a chocolate button.  

Let them do it themselves

Some children, even as young as 6 or 7, are able to cut their own nails under supervision, and find it much easier to tolerate than having a parent do it for them.  

A few last thoughts

One parent has given up even trying to cut nails altogether, but now her small son will come to her with a slightly torn fingernail and allow her to gently tear it off. You don’t have to attempt to cut all the nails in one marathon sitting – a nail or two a night might be far less stressful for everyone, regardless of the method you’re using. Every child is different, and they experience touch sensations differently. What works for one child may be the last thing another child can tolerate. Keep trying different things, and eventually something will work. For many of our children, control is a huge element – only by having some control over a situation can they feel safe. Think about ways you  can help them be in charge to some degree – maybe an agreement that you will stop the second they ask you to might help. Try and take the stress and conflict out of it – that’s a recipe to make it all much harder for both you and your child. Never make a battle out of something you’re going to have to do again. If it all goes pear shaped, forget about cutting their nails until another day, and use the time for a precious cuddle instead. Yvonne is mum to Francesca, Toby and Adam all of whom have disabilities.  She is also the author of The Special Parent’s Handbook, book for parents of children with any diagnosis of additional needs, disabilities or serious illness.  It is packed full of tips, tricks and strategies for coping with family life. To find out more about Yvonne and her book visit her website here.
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