Difficulty with Daily Living Activities

What Are Activities of Daily Living?

The activities of daily living, or ADLs, are basic self-care tasks that healthy people and children of the right age can do by themselves. ADLs include:

• Bathing. Being able to get into the shower, clean yourself, and get out.
• Dressing. Putting your clothes on by yourself.
• Toileting. Using the bathroom, including sitting on the toilet, cleaning yourself, and getting back up after you’re done.
• Transferring. Being able to move around, including walking, getting in and out of bed, and sitting on a chair.
• Eating. Being able to use your hands, fork, spoon, and knife to feed yourself during meals.

There are many other activities that children and adults do every day that aren’t included in this list, since ADLs are meant to describe a minimum level of ability that someone needs to survive on their own. The number of ADLs someone needs help with is one way of measuring how severe their disability is.

Studies have found that disabled people are more likely to need help with some of these activities than with others. People most often need help with bathing and dressing, while more people are able to eat and move around on their own. 

What Is Difficulty with Daily Living Activities?

Your child might have difficulty with daily living activities if they are unable to do one or more of the ADLs listed above. It is normal for infants and young children to need an adult’s help with some or all of these activities, so this list only applies to children who would normally be expected to do these tasks on their own.

Depending on your child’s condition, some of these activities might be hard or impossible for them to do without help.

If your child has difficulty with daily living activities, they will not be able to do one more of the ADLs listed in the section above. They might not be able to do these tasks at all, or they might need the help of a parent or caregiver. Problems can include:

• Bathing. Your child might not be able to get in or out of the bath or shower themselves, and they might not be able to clean themselves once they are there.
• Dressing. Your child might not be able to get dressed, or they might have trouble putting on certain clothes, like socks or shoes.
• Toileting. Your child may not be able to sit down on the toilet or get up from it without your help, and they might not be able to clean themselves after using the bathroom.
• Transferring. Your child might have trouble getting out of bed, or getting up from a chair. They might not be able to walk around on their own.
• Eating. Your child might need help eating because they can’t bring the food  to their mouth or use a fork and knife.

If your child has difficulty with ADLs, it is probably because of an injury, disease, disability, or other condition. These conditions can cause many symptoms that can lead to difficulty with daily living activities. For instance, if your child has a chronic pain condition, it might hurt too much for them to get out of bed in the morning. A child with delays in fine motor skills might have a hard time using a spoon to feed themselves or fasten zippers and buttons.

You should see a doctor if your child starts to need assistance with any of the activities of daily living listed above, especially as they get older and should be able to do things for themselves. If your child has a permanent disability or a chronic condition that causes difficulty with an ADL, you might have already talked to your doctor about this problem. However, your child might start to have new difficulties with daily living activities later. For instance, they might not be able to feed themselves even if they could before.

New difficulties with ADLs can be a sign of your child’s condition getting worse or changing, and you should see a doctor right away if this happens.

Many injuries, illnesses, diseases, and other conditions can cause difficulty with daily living activities. Almost any condition, if it’s serious enough, can stop your child from doing one or more of the activities of everyday life. Sometimes this is temporary, as in the case of a bone fracture that stops your child from being able to get dressed on their own until the bone has healed. Other times, the difficulty is part of a permanent disability like cerebral palsy.

Doctors and medical researchers tend to talk about ADLs in the context of older people, because this is the largest group of people who have difficulty with daily living activities. Conditions that mostly affect older people, like Alzheimer’s, heart disease, and stroke, often cause problems with ADLs.

However, many diseases that affect children can also cause difficulty with ADLs. Congenital illnesses, which are present from the time your child is born, are an especially common cause. Examples of these conditions include:

• Cerebral palsy
• Cystic fibrosis
• Usher syndrome
• Spina bifida
• Muscular dystrophy

As a parent, guardian, or caregiver, you will probably be the first person to notice that your child has difficulty with daily living activities. Usually, your doctor will ask you questions about each of the five major ADLs (bathing, dressing, toileting, transferring, and eating) to make a diagnosis.

Many times, difficulty with daily living activities is the expected result of an illness, injury, disease, disability, or other condition. In these cases, your doctor will probably be able to tell you ahead of time if your child will have problems doing some or all these ADLs. For instance, children with muscular dystrophy can eventually need a wheelchair to get around, and won’t be able to do some of the ADLs.

There are two areas of treatment for children who have difficulty with daily living activities. One approach is to treat the condition that is causing the difficulty with ADLs. For instance, if your child has a temporary illness that is making it hard for them to move around the house, treating that disease can fix the problem.

Much of the time, however, difficulty with daily living activities results from a permanent or progressive disability (one that gets worse over time). In these cases, treatment is focused on improving your child’s quality of life. Your doctor may give you instructions on how to care for your child and help them complete these ADLs. For children with severe disabilities, you might need to hire a caregiver or home health aide who can help you some or all the time.

Children with developmental or intellectual disabilities like Down’s syndrome or autism can have problems with ADLs for different reasons than children with physical disabilities, so the treatment for them is also different. Occupational therapy helps people learn to do ADLs by training their bodies to do those tasks. Behavior therapy can help children learn tasks that are hard for them by using rewards and redirection.

Sometimes, difficulty with daily living activities can be caused by preventable accidents that lead to injuries like broken bones. Keeping a safe home and making sure your child stays safe when outside or playing sports can help prevent these injuries.

Many times, however, difficulty with daily living activities is caused by illnesses, diseases, and other conditions that can’t be prevented. This is especially true with children, who most often have trouble with ADLs because of congenital disorders that are present from the time they are born.

The activities of daily living are basic tasks that healthy people and children of the right age can do by themselves, including bathing, dressing, toileting, transferring (moving), and eating. Children can have difficulty with these activities as a result of injuries, illnesses, disabilities, and other conditions.