He won't let us cut his nails
Jonathan's parents cut his nails once a month...while he sleeps. Before 5 years of age, many children refuse this simple hygiene-related activity in spite of the fact that, as adults, we very rarely find cutting our nails painful or even uncomfortable.
Why do certain children refuse to get their nails cut?
Here are the most common reasons, although other reasons are possible. Of course, there may sometimes be more than one reason behind a child's refusal. The combination of several apprehensions can result in great distress.
- The need for stability in terms of their body image (they have difficulty accepting cutting small parts of their body; they most likely have difficulty accepting haircuts as well).
- The tactile and auditory sensations involved make them uncomfortable or they may not understand them.
- They don't understand the reason behind this activity (why they must cut their nails).
- They are unfamiliar with the instrument (how the nail clipper cuts).
- Absence of routine for this activity considering it is not done very frequently and it is therefore difficult to plan and anticipate its outcome and duration.
Suggestions and adaptations
- Reinforce the child's body schema and plan activities that will help the child understand where his/her nails are in relation to his/her other body parts.
- Teach the child about nails (what they are used for, why they must be cut, etc.) using a book or pictures from various websites.
- Explore the concept of "cutting" using pictures or illustrations representing items that can be used to cut, items that can be cut, etc.
- Trace the child's hand on a piece of paper and draw nails at the tip of each finger. Cut the paper hand out and encourage the child to use scissors to "cut" the nails (fingertips).
- Help the child get used to the sound of the nail clipper by cutting your nails or someone else's when he/she is present.
- If the child can do so safely, let him/her use the nail clipper to cut your nails.
- If the nail clipper makes the child uncomfortable, use small nail scissors instead. Since the child is most likely already familiar with scissors, nail scissors may seem less scary.
- Make a game out of it and search for tiny nail pieces on each finger together.
- Some children are afraid of getting tiny nail clippings in their eyes. Ask the child if he/she wants to close his/her eyes or wear sunglasses.
- Always pick a time of day when the child is calm and rested.
- Introduce a gross motor skills activity (tag or tickling) prior to cutting the child's nails. Providing the child with the opportunity to run around and laugh before starting to cut his/her nails will increase your chances of the child being quiet and calm when needed.
- Massage the child's hands or rub them with a towel before cutting his/her nails to desensitize his/her skin.
- Play music while you cut the child's nails to play down the sound produced by the nail clipper.
- Count to 10 out loud, cutting one nail at a time, or draw two hands on a piece of paper and encourage the child to draw an "X" on a fingertip every time you finish cutting a nail.
- Keep in mind that nails will be softer right after a child has taken his/her bath. The sound of the nail clipper may therefore seem less intimidating.
- Set up a monthly nail clipping schedule and indicate the next nail clipping day on a calendar. This will help the child anticipate this moment.
- Plan a nail clipping routine that will remain the same every time. For example, your routine could look like this: dinner, special dessert, bath time, nail clipping (always done in the same spot), popcorn and a movie.
Josiane Caron Santha
Occupational therapist