Adaptive clothing can make a great difference to families with a child or relative with special needs. The right type of clothing or underwear can make the day to day care of someone with special needs easier and less stressful for carers. It can also improve the comfort and well-being of the user. The right type of clothing can make coping with incontinence less challenging while clothing designed with those with sensitive skin or sensory issues in mind can really help improve their physical comfort. Some people may need clothing adapted for wheelchair users or those with limited movement, while other may need garments which allow access for a feeding tube. There are different clothing solutions for a range of specific needs.

Clothing to help with incontinence (underwear)

For families and carers who have a child or relative with special needs, coping with incontinence can be a major part of their daily routine. There are many clothing solutions which can make these daily tasks more manageable.

Bodysuits/vests with poppers - most of these under garments are styled to fit over the body and fasten with poppers between the legs. You can find versions with a vest top, short or long sleeves – in various stretch or jersey type fabrics. Some styles incorporate an opening to accommodate a feeding tube, while others have poppers across the body to allow for easy dressing. They can range in size from small child up into adult sizes. The advantage of having bodysuits with a popper opening are;

        • Bodysuits with poppers between the legs, at the gusset, allow easy access when pad/nappy changing is required.
        • Versions which have back, side or cross body openings are helpful for those who need help dressing as well as those who are tube fed. The garments are easier for carers to change, keeping unnecessary movement to a minimum.
        • They can keep the nappy or pad in place, both during the day and at night time.
        • The vests can help conceal the nappy and avoid embarrassment or unwanted attention, can be worn under regular clothing.
        • Can prevent a person undressing at inappropriate times and places.
        • The vests are comfortable and help to keep the person warm.
        • Provide a comfortable and practical solution if a child or adult has a feeding tube.
        • As it takes longer and is harder for the wearer to access their nappy, the vests can help with incidents of ‘smearing’.

It is worth thinking about the style which is most suited to the person who is going to wear the garment. If they have a sensory condition associated with autism for example, what kind of fabric would be most comfortable? Some children and adults may prefer the closer fitting feel of bodysuits with lycra in the fabric while others may feel more comfortable in a softer, looser jersey. In addition, there are bodysuit versions which incorporate a little short leg with poppers between the legs which may be practical for others.

When thinking about purchasing a bodysuit vest it may be worth while trying out one or two different styles to start with before committing to buying a larger quantity. This way the underwear can be tested to see which suits the wearer best. It will also allow you to see which size you need. We always advise that you take good measurements before ordering, it will help you and the supplier decide what would be the best size for you. Again it might be a good idea to buy one first to check the sizing before ordering more.

Unitards - The unitard is an all in one garment which does not have a poppers between the legs. Ideal if the wearer has worked out how to undo poppers. The wearer would step in through the neck opening and pull the garment up over their body. Some styles have short legs and no sleeves while others come with a long leg. Usually made of a stretch fabric containing lycra, they are designed to be close fitting. For those on the Autistic spectrum or with sensory issues the closer fitting garments provide compression across the body which can help with proprioception (a person’s sense of body awareness) As these undergarments do not have a popper opening they are harder for hands to get at the nappy or pad underneath: the long leg versions are particularly effective and can help minimise incidents of smearing. As the unitards are harder to remove they can also help with those who might undress at the wrong time or in public. They can be worn under normal clothes as under wear or at night time to help prevent the wearer accessing their pad or nappy.

Stretch shorts - these shorts tend to have a longer leg and are usually made in a stretchy lycra fabric. They can help keep a pad or nappy in place, discourage the wearer from putting their hands in nappy and as help prevent the wearer undressing. The shorts can be worn under trousers or a skirt.

All-in-one pyjamas - these all in one pyjamas come in zip back or zip front versions. The pyjamas can be found in jersey or fleece fabrics. Some styles have integral feet attached, while others have zips at the front which allow the suit to be opened from the front and down the legs to allow for the easy changing of pads and nappies. Back zip pyjamas can help stop the wearer undressing at night or taking off their nappy. These all in one sleep suits can keep the wearer warm at night, especially if they are inclined to kick off their bed clothes.

Made to measure underwear and sleepwear - For many families made to measure garments can provide a more tailored fit. This can include back fastening garments which prevent undressing and accessing nappies or pads or underwear that full opens up to allow changing. The advantage of made to measure garments is that allowances can be made for the wearers unique shape and amendments made to include changes such as an opening for a feeding tube. Made to measure garments are available in a range of styles and can be made either in cotton jersey or micro fleece, white and various colours are available. With made to measure garments you would need to co-ordinate closely with the seamstress team working on your order, they will need accurate measurements and details of your specific requirements. Be aware that made to measure garments are bespoke and returns may not be accepted unless the garment is faulty. They may also cost more than ready made products and it is likely that you would need to allow more time for your item to made up and sent. If you are considering made to measure, it may be an idea to have one made first to check the fit and to see if the garment works for you before ordering more.

Therapeutic, Sensory and Seamless Clothing

Many people with special needs and other conditions can experience sensitivity and sensory issues that make wearing normal clothing uncomfortable and distressing. This can include those with a Sensory Processing Disorder, Autism, ADHD as well as those with skin conditions such as Eczema and Psoriasis. For these people, soft natural fabrics and seamless clothing can be very helpful.

There are suppliers of underwear and garments that can help people with skin sensitivity. They tend to use soft breathable natural fibres such as organic cotton, bamboo, silk or viscose. The fabrics tend to be knitted jersey which will conform well to the body shape – often they come in seamless styles. The fabrics may also be medical quality or anti – bacterial which are designed to be used with salves and skin creams to protect and treat the skin. Some of the clothing is designed to help night time scratching, such as nightwear that incorporates mittens.

There are a wide range of undergarment styles and items available, including vests, leggings, shorts, socks, caps and gloves. You can find clothing suitable for adults and children, including small babies.

Skinnies – supply soft, seamless skin wear such as vests, leggings, shorts, socks, caps, gloves etc. Ideal for use with salves and creams and to protect sensitive skin. Socks suitable for diabetics. Available in Adult, Children’s and Baby sizes. May be available on prescription.
https://www.skinniesuk.com

DermaSilk - DermaSilk Therapeutic Clothing is made of a special, knitted medical grade silk, capable of absorbing moisture without causing irritation to the skin. Special knitted construction allows the free movement of air through the fabric; this allows the skin to breathe more easily. Designed to help a range of skin conditions, suitable for sensitive skin. Range of underwear garments for children, men and women.
http://www.dermasilk.co.uk

Eczemaclothing.com – range of garments for adults and children in soft natural cottons, especially organic cotton. Range includes gloves, nightwear with integrated mitts to prevent night time scratching, vests and fleeces. Also a range of children’s school uniform.
http://www.eczemaclothing.com

Clothing – Outerwear, Wheelchair adapted, Back Opening

Some families and carers need adapted outerwear clothing for their child or relative. This can include clothing designed for ease of dressing, including fastenings at the back or sides and garments designed for those in wheelchairs or with severe physical disabilities. There are suppliers who provide ready to wear items while others offer a bespoke or alteration service. The advantage of a bespoke service is that the clothing can be made to fit any size, shape or proportion and the openings/fastenings tailor made for the wearers needs - however the made to measure option may be more expensive and you would have to wait longer for the garments to be made up. There are ranges of ready-made products which may suit however.

Wheelchair Covers – Outerwear - You can find different sorts of covers designed for wheelchairs which can be brought ready-made. These are available in child and adult sizes. Think about what sort of cover you may need;

• Does it need to be waterproof? 
  
• Do you want it to be lined for extra warmth? 
  
• Do you want one that is easily folded, can be popped on and off quickly, stored in a bag for when you need it? 
  
• What sort of opening do you need for easy access? 
  
• How mobile is the user? Some users may have more mobility and want to get out of their wheelchair on occasion, they may need a cover that can be taken on and off with ease. 
  

Capes - These garment have no sleeves and can come with or without a hood. They are designed to be easy to pull over the head and drape over the body and wheelchair They are usually waterproof but unlined. The advantage is that they will fold away in a bag until needed, ideal for rainy days. If the weather is cold the wearer would need warm clothes underneath, however as they do not have sleeves the wearer may feel a bit restricted and it could be harder for them to self- propel in their wheelchair. Some capes are longer than others, so check the length to see if the cape is designed to cover the knees or the whole leg.

Wheelchair covers with sleeves - Similar to the capes in that they are intended to cover the body in rainy weather but they incorporate sleeves - ideal if the user needs their hands free and wants to propel their own chair. Again check the style for length to see if it suits your needs.

Waist high wheelchair covers - There are a range of covers which are designed to come up to the waist and cover the legs while the user is in their wheelchair. These can be lined or unlined and are usually waterproof. Some fit over the user’s legs, pop under the footplate and attach to the wheel chair at the waist. Others are made to fit into the wheelchair so that the user can be lowered into or sit into the cover, which is then zipped up around them: these sorts of cover are usually fleece lined so that the user’s body is encased and protected all round from the elements. This style is great in bad weather and for those whose lack of mobility or have a condition which makes them feel the cold. You would need to check if the opening allows the user to get in and out of the chair easily, some have a central zip, while others may have a zip at each side.

Clothing adapted for use in a wheelchair - Clothing adapted for use in a wheelchair include, trousers, tops fleeces, ponchos, capes and jackets. Many items can be brought ready-made, although there are manufacturers who make and adapt clothing for those with a disability.

Trousers - Trousers which have been cut and styled for sitting in a wheelchair – usually higher at the back and lower at the front, may have elasticated waistband, a drop front for easy access and a longer leg to cover the ankles while the wearer is seated.

Ponchos/capes - Usually made in a warm fleece fabric these items of clothing are often designed to be dropped easily on over the head and to drape over the body while seated. Others may have front or back openings. Some are sleeveless while other incorporate sleeves. These loose fitting garments keep the wearer warm and drop on over the user’s other clothes easily. Can be worn under a waterproof cape for added protection. Capes and ponchos are good garments for those who experience stiffness in the limbs or difficulty raising their arms to dress.

Jackets - These have different adjustments to accommodate sitting in a wheelchair such as a raised back and longer front to cover the knees, others may have a higher front so that the jacket does not bunch up at the waist when the user is seated. Can include a back opening so that the jacket can be put on from the front without the user having to be raised.

Able2Wear – supply adapted clothing for wheelchair and non wheelchair users.
http://www.able2wear.co.uk

Clothing Solutions – Make bespoke garments and undertake alterations. Clothing Solutions is a registered charity no. 1120118, and offers information, advice and a garment production/alteration service. They can offer solutions to most clothing and dressing issues whether concerning, shape, size, proportion, access and fastenings, fabric technology and care. Contact them for advice and how to order.
http://www.clothingsolutions.org.uk  

School Uniform

Often as a child grows it can be difficult to find school uniform to fit. For example, trousers with a fully elasticated waist are often much easier for a child with special needs to manage but often these become unavailable in larger sizes. Similarly, a child at school may be expected to be able to dress themselves but find normal fastenings such as buttons difficult and time consuming. If a child has sensory issues or sensitive skin, the fabrics of clothing found in many shops can be uncomfortable and hard for them to wear.