occupational therapy

Put a Sock on It! Occupational Therapy Tips for Donning/Doffing Socks

For many kids, learning to independently put on their socks and shoes is an important early childhood skill and major milestone. It’s an important indicator of emerging independence and self-care, and it also lays the foundation for planning and sequencing of more complex skills. But our occupational therapy team knows it can also be difficult to learn.

Several skills are required for one to be able to put on/take off their shoes and socks, including:

  • Crossing midline
  • Bilateral coordination
  • Intrinsic and extrinsic muscle strength in hands
  • Pincer grasp
  • Hand-eye coordination
  • Biomechanical postural control
  • Forearm pronation and supination

All of this to say: It’s something that takes some baseline skills and practice! Children with delays, disabilities, injuries and other challenges may find it even more difficult to master if they struggle with:

  • Poor finger strength (needed to manipulate items).
  • Difficulty planning/sequencing (Step 1, Step 2, Step 3, etc.).
  • Trouble with self-regulation (critical to persisting with a tough task).
  • Limited interest in self care or independence.

Speaking from an occupational therapy standpoint, kids are probably going to acquire the developmental skills to take off clothing items before they learn to put them on. With socks, kids can usually cooperate at around 1-year-old by sticking out their foot. About six months later, they can take off their own socks (if they are loose). Around age 3, kids can usually put on socks with some help. Most 4-year-olds can put on their socks on their own. If this is something with which your child struggles, we can help.

Research published in the American Journal of Occupational Therapy indicates that for parents of children on the autism spectrum in particular, improving independence in dressing, feeding and personal hygiene is a top priority. This is true for many of our FOCUS Therapy families because they are critical to improving one’s ability to live independently and lowering the need for one-on-one assistance (at home, at school and throughout their lives). Mastering sock management is just one piece of the larger jigsaw puzzle of independence.

Practice First With Easier Materials

To prepare for the more difficult task of putting on socks, tying shoelaces, etc., we start with materials that are a bit easier and build up from there. Some ideas for where to start:

  • Big socks. If you use socks that are more stretchy and larger than necessary, your child will have an easier time mastering the skill. Then you can work your way up to socks that fit.
  • Colored heels. Socks that have different-colored heels help serve as a visual reminder of where the heel should be (usually the toughest part to get right!).
  • Velcro. We don’t want to rely too much on Velcro as kids get older, but it’s a good place to start. Avoid shoes that require laces or buckling when you’re first starting out teaching them how to fasten and unfasten their shoes.
  • Support their posture. One trick we use in occupational therapy when this skill is emerging is to put the child in the corner of a room, with their back wedged up against the two walls. This allows both hands to be free to work on manipulating their socks and/or shoes, rather than needing  to use one hand to keep themselves sitting upright. It also allows the child to have their foot in front of them, rather than twisted or lying on the ground.

Occupational Therapy Can Help

The child should start with learning to pull their shoes off first (depending on the type of shoe). Then they’ll learn how to pull their socks off (sometimes, if pulling it off at the toes is tough, we’ll teach them first how to tuck their thumbs into the sock and pull down toward the heel).

Once they have this mastered, we’ll work on putting their socks on. We’ll help them with positioning of their body as well as the sock (making sure it’s turned the right way and having them observe which way it goes; this is where those colored heels and toes can really help!).

If this is an area of concern or if you have any questions, please feel free to ask your occupational therapy team!

FOCUS offers pediatric occupational therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

Effectiveness of Work, Activities of Daily Living, Education, and Sleep Interventions for People With Autism Spectrum Disorder: A Systematic Review, April 30, 2020, American Journal of Occupational Therapy

More Blog Entries:

Why Our FOCUS Speech and Occupational Therapists LOVE Puppets, April 2, 2018, Fort Myers Occupational Therapists’ Blog

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