There is a child you might see at the park, or sitting nearby in a classroom.
They smell. Their hair is unbrushed. Their clothes are not quite clean.
It is easy to look at that and know what you are seeing. Easy to settle on a conclusion about the parent who isn’t trying, or doesn’t care.
Often, that conclusion leads somewhere else entirely.
For many neurodivergent children, self-care is not straightforward. Brushing teeth is not a simple task that requires only a toothbrush and two minutes. It is a sensory event. The texture of the paste, the foam, the taste, the feeling of bristles — any of these can make the whole thing genuinely intolerable. For a child with a PDA profile, the demand itself is part of the problem. Not just the external demand — someone telling them to brush their teeth — but the internal one too. The knowledge that their breath smells, that their teeth need attention. That awareness can make it harder, not easier.
The response to this, if you have the resources, is choice and autonomy. You try different toothpastes — different flavours, no flavour, foaming, non-foaming, paste, powder, chews. You try different toothbrushes — electric, manual, soft, firm, rubber ones that fit on a finger, ones designed for children who need to chew rather than brush. You might find an app that turns the two minutes into a game. You might try a timer, a reward, a different time of day, a different order of events.
All of this costs money.
The specialist toothpastes cost more. The sensory toothbrushes cost more. Some children need several options available at once so that there is genuine choice rather than the appearance of it. And some children, even after all of that, still struggle — because none of it removes the demand, and sometimes there is no sensory solution that resolves what is fundamentally a nervous system response.
Then there is bathing. Hair care. Clothing — finding the right fabrics, the right fits, and then buying multiples because a child who struggles to change into clean clothes needs the barrier to be as low as possible. Laundry liquid that doesn’t trigger a sensory response. Deodorant, tried in many forms, many scents, many formats, until something is tolerated.
And on it goes.
I wrote last time about the cost of food — the safe foods, the branded preferences, the experimentation that only works if you can afford waste. This is the same pattern in a different room. The bathroom, like the kitchen, requires money to navigate when your child’s nervous system makes the ordinary difficult.
When families are already stretched — and many families are stretched right now — these choices compete with each other. The specialist toothpaste or the food. The sensory clothing or the heating.
Consider the child sitting a few spaces away. Clean, tidy, hair brushed, no smell. Easy to read as cared for.
But what we see on the surface doesn’t tell us the whole story.
Sometimes the clean, tidy child is simply lucky — lucky that their nervous system doesn’t fight them on these things, that getting dressed is neutral, that toothpaste is just toothpaste. Sometimes they cried all the way through getting ready, were told what to wear regardless, their sensory experience neither acknowledged nor accommodated. Cared for on the outside. Something else underneath.
And sometimes the gap between those two children — the one who smells and the one who doesn’t — has nothing to do with how much they are loved. It has to do with options. Resources. A brain that works differently in a world not yet built to adjust for that.
So when you see that child at the park, the one who smells, the one who looks unkempt — before you reach for a conclusion, consider what you might not be seeing.
A parent who has tried fifteen toothpastes.
A child for whom clean is not a simple instruction.
A family doing everything they can on a playing field that was never level to begin with.