How Do You Get An Autistic Child To Keep Their Shoes On?
For many parents and caregivers of children with autism spectrum disorder (ASD), everyday activities that seem simple can present unique challenges. One particularly common struggle is getting an autistic child to keep their shoes on. According to the Centers for Disease Control and Prevention (CDC), approximately 1 in 36 children in the United States is diagnosed with autism spectrum disorder, meaning this challenge affects millions of families nationwide.
Sensory sensitivities, which affect up to 90% of individuals with autism according to research published in the Journal of Autism and Developmental Disorders, often make wearing shoes uncomfortable or even painful for children with ASD. What might seem like a behavioral issue is frequently rooted in sensory processing differences that require understanding and specialized approaches.
In this comprehensive guide, we’ll explore why many autistic children struggle with wearing shoes, practical strategies that actually work, product recommendations, and expert insights to help make this daily challenge more manageable for both you and your child.
Understanding the Sensory Challenges
Why Many Autistic Children Resist Wearing Shoes
Before addressing solutions, it’s essential to understand why this challenge exists in the first place. Children with autism often experience sensory processing differences—the way their brains interpret information from their senses differs from neurotypical processing.
Common sensory-related reasons why an autistic child might resist wearing shoes include:
Tactile sensitivity: Many children with autism have heightened sensitivity to touch sensations, particularly on the feet. Seams, tags, tight elastic, or certain fabric textures can feel intensely uncomfortable or even painful.
Proprioceptive differences: Proprioception refers to the sense of body position and movement. Some autistic children struggle with proprioceptive input, making them extra aware of anything on their feet, which can feel restrictive or disorienting.
Temperature regulation: Research published in the Journal of Neurophysiology suggests that some individuals with autism may have differences in how they perceive temperature. Shoes that feel comfortable to most children might feel uncomfortably hot to a child with ASD.
Vestibular processing: The vestibular system helps with balance and spatial orientation. Footwear that changes how a child perceives ground contact can trigger vestibular discomfort for some children with autism.
Need for sensory seeking: Some children with autism are “sensory seekers” who crave certain sensory inputs. They may prefer the tactile feeling of bare feet because it provides more sensory information than shoes allow.
A study published in the American Journal of Occupational Therapy found that over 80% of children with autism demonstrate some form of sensory processing difference, with foot sensitivities being particularly common.
Practical Strategies That Work
1. Sensory-Friendly Shoe Selection
Finding the right shoes is often the first and most important step. Features to look for include:
Seamless interiors: Look for shoes specifically designed with minimal or no internal seams to reduce friction against sensitive skin.
Flexible, lightweight materials: Heavy, rigid shoes can increase proprioceptive discomfort. Opt for lightweight, flexible options that allow for natural foot movement.
Adjustable closures: Shoes with hook-and-loop (Velcro) closures, toggle systems, or elastic laces allow for customized tightness levels, accommodating sensory needs.
Breathable fabrics: For children sensitive to temperature, breathable materials can prevent overheating and sweating, which often exacerbate discomfort.
Pressure distribution: Some children benefit from shoes that provide even pressure distribution rather than concentrated pressure points.
Correct sizing: Shoes that are too small or too large can intensify sensory issues. Consider going up a half-size if your child seems particularly sensitive to toe compression.
2. Gradual Desensitization Techniques
Research in behavioral therapy supports gradual exposure as an effective method for building tolerance. Try these approaches:
Start with short periods: Begin by having your child wear shoes for just 2-3 minutes, then gradually increase the time as tolerance builds.
Create a visual timer: Use a visual countdown app or timer to help your child understand exactly how long they need to keep their shoes on.
Practice at home first: Allow your child to practice wearing shoes in the comfort and safety of home before expecting them to wear shoes in more stimulating environments.
Pair with preferred activities: Introduce shoes during highly motivating activities that might distract from the sensory discomfort.
Sensory integration exercises: Work with an occupational therapist to develop foot-specific sensory integration exercises that can help desensitize your child’s feet before introducing shoes.
3. Preparation and Transition Strategies
Visual schedules: Create a visual schedule that includes putting on shoes, helping your child anticipate and prepare for this step in their routine.
Social stories: Develop a simple social story about wearing shoes, explaining when, why, and for how long shoes need to be worn. Include pictures of your child’s actual shoes.
Choice and control: Whenever possible, offer choices between two acceptable shoe options to give your child a sense of agency and control.
Sensory warm-up: Before putting on shoes, try a foot massage, brushing protocol (under professional guidance), or proprioceptive activities to prepare the sensory system.
Transition warnings: Give clear warnings before it’s time to put shoes on, like “Five more minutes of bare feet, then shoes.”
4. Modification Approaches
Sometimes, the most effective strategy is to adapt either the shoes or your expectations:
Cut out irritating parts: Some parents find success by carefully removing tags, cutting out uncomfortable seams, or modifying shoes to eliminate specific trigger points.
Consider alternatives: In some situations, sock-shoes, soft moccasins, or other minimal footwear might be acceptable alternatives to traditional shoes.
Seamless socks: High-quality seamless socks underneath shoes can significantly reduce friction and discomfort.
Barefoot-friendly environments: When possible, choose activities and destinations where shoes are optional or where alternatives like slippers are acceptable.
Product Recommendations
While every child’s needs are unique, these sensory-friendly shoe options have proven helpful for many families:
Stride Rite Made2Play: These shoes feature seamless construction designed specifically for sensory-sensitive children. Their adjustable closures allow for customization of fit and pressure.
PLAE shoes: Known for their interchangeable tabs that allow for width adjustments, PLAE shoes combine durability with sensory-friendly features.
Tsukihoshi Children’s Shoes: These Japanese-designed shoes feature machine-washable materials, wide toe boxes, and flexible construction that many autistic children find comfortable.
Native Shoes: Lightweight, easy to clean, and made from soft, flexible materials, many parents report success with these slip-on options.
KEEN Newport H2 Sandals: For warmer weather, these provide protection while still offering ventilation and minimal contact points.
Professional Support Approaches
Occupational Therapy Interventions
Occupational therapists specialize in helping children overcome sensory challenges. They can provide:
Sensory Integration Therapy: Structured activities designed to gradually help your child’s nervous system process sensory information more typically.
Desensitization Programs: Customized step-by-step programs to build tolerance specifically for footwear.
Sensory Diet Planning: A personalized schedule of sensory activities that can help regulate your child’s sensory system throughout the day, potentially making shoe-wearing less challenging.
Environmental Modifications: Suggestions for adapting environments to reduce overall sensory load, which can increase tolerance for challenging sensory inputs like shoes.
A study published in the American Journal of Occupational Therapy found that children who received sensory integration therapy showed significant improvements in sensory processing, including tolerance for clothing and footwear, compared to control groups.
Behavioral Approaches
In some cases, behavioral strategies can complement sensory approaches:
Positive Reinforcement: Consistently reward shoe-wearing with praise, tokens, or small rewards to build positive associations.
Token Economy Systems: For older children, create a token system where earning a certain number of “shoe-wearing tokens” leads to a desired reward.
Differential Reinforcement: Gradually shape behavior by rewarding successively longer periods of shoe-wearing.
Cognitive Behavioral Therapy (CBT): For older children with verbal abilities, CBT techniques can help address anxieties or rigid thinking patterns related to wearing shoes.
Real-Life Success Stories
Case Study: Jamie’s Journey
Seven-year-old Jamie would have meltdowns whenever his parents tried to put shoes on him. After working with an occupational therapist, his parents discovered that compression was the specific trigger for his discomfort. They switched to extra-wide shoes with elastic laces and implemented a gradual desensitization program. Jamie started by wearing the shoes for just one minute while engaging in his favorite iPad game, with the time gradually increasing. After six weeks, Jamie could wear his shoes for up to two hours without distress.
Parent Perspective: Maria’s Approach
“We tried everything with our daughter Sophia, but what finally worked was finding shoes with absolutely no internal seams and using a visual timer. We started with just 30 seconds of shoe-wearing and gradually built up. We also created a special ‘shoe box’ with sensory toys that she only gets to play with while wearing shoes. Now, she actually asks to put her shoes on so she can play with those special toys.”
When to Seek Additional Help
While shoe aversion is common among children with autism, certain situations warrant professional consultation:
Pain responses: If your child shows signs of actual pain (not just discomfort) when wearing any type of shoes.
Self-injurious behavior: If shoe-wearing triggers self-harm or aggressive behaviors.
Significant life limitations: If shoe aversion is preventing participation in important activities or education.
Regression: If a child who previously tolerated shoes suddenly develops an intense aversion.
In these cases, consultation with developmental pediatricians, pediatric neurologists, or specialized occupational therapists may be beneficial.
Planning for Different Environments and Seasons
School Settings
Many schools require shoes, creating additional challenges. Consider these approaches:
IEP or 504 Plan accommodations: Work with your child’s educational team to include sensory accommodations related to footwear in their formal education plan.
Teacher communication: Ensure teachers understand the sensory basis of shoe resistance rather than viewing it as defiance.
Indoor shoes: Some schools allow children to change into more comfortable “indoor shoes” once at school.
Gradual school-specific desensitization: Practice wearing “school shoes” during home activities that mimic school settings.
Seasonal Considerations
Different weather conditions present unique challenges:
Winter strategies: For cold weather, thermal sock-shoes or lined boots with minimal internal seams might be more tolerable than multiple layers.
Summer approaches: Heat often exacerbates sensory discomfort. Consider ultra-breathable options or water shoes that can get wet and still provide protection.
Rain solutions: Waterproof socks inside roomier shoes sometimes work better than traditional rain boots for sensory-sensitive children.
Looking at the Bigger Picture
Balancing Needs and Expectations
While working toward increased shoe tolerance is important, it’s equally essential to consider:
Picking your battles: Decide which situations absolutely require shoes and which can be flexible.
Respecting sensory needs: Acknowledge that sensory discomfort is real, not behavioral stubbornness.
Celebrating progress: Recognize and celebrate small steps toward increased tolerance.
Self-advocacy skills: As appropriate, help your child develop language to express their specific shoe discomforts and advocate for their needs.
The Importance of Emotional Support
The shoe struggle can be emotionally taxing for both children and caregivers. Remember:
Validation matters: Acknowledging your child’s discomfort rather than dismissing it builds trust.
Caregiver self-care: The daily challenges of supporting a child with autism require sustainable self-care practices.
Peer support: Connect with other parents facing similar challenges through support groups or online communities.
Perspective maintenance: Remind yourself that sensory challenges are not willful disobedience but neurological differences requiring patience and accommodation.
Conclusion
Getting an autistic child to keep their shoes on represents more than just a daily parenting challenge—it’s a window into the unique sensory experiences that many children with autism navigate. By approaching this issue with understanding, patience, and evidence-based strategies, families can find solutions that respect their child’s sensory needs while gradually building tolerance.
Remember that progress may be slow and nonlinear. What works today might not work tomorrow, and strategies that fail initially might succeed later as your child develops. The key is persistent, compassionate problem-solving that balances your child’s sensory needs with practical requirements.
With thoughtful shoe selection, gradual desensitization, environmental adaptations, and professional support when needed, most families eventually find workable solutions to the shoe challenge. Along the way, the problem-solving process itself builds valuable skills in communication, sensory awareness, and collaborative solution-finding that benefit both caregivers and children.