7 year old girl unable to independently tie hair up in ponytail

This girl was unable to independently tie her hair up in a ponytail. This was problematic as when the client’s mother did her daughter’s hair, it would result in meltdowns.

7-year-old girl with Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), anxiety, and traits of pathological demand avoidance.

The main cause behind the client’s meltdowns was that she felt incompetent as her peers were able to tie their own hair. Although there were some sensory challenges (i.e., sensitivity to others touching her head), the anxiety around not being able to tie her own hair was the main cause of the meltdowns.

The therapist provided very explicit instructions around how to tie hair into a ponytail. The therapist created a visual which had each step within the hair tying process. The therapist and client created a song/phrase to use when tying hair (“crab grab, pull, twist, crab grab…”) to help remember the steps. The client and therapist created “movies” (i.e., the therapist and client took turns filming each other doing this task and discussed where it was breaking down).  Parent education around how to facilitate success at home.

After approximately 5 weekly sessions the client was able to independently tie her hair up in a ponytail. There were no more meltdowns in the mornings due to hair tying.