Achoooo! ‘Tis the season for cold, runny, and stuffy noses. If you’ve ever struggled to help your child to understand how blow their nose, I have a few fun strategies and pieces of information for you.---

Caution: It may be best to practice this skill when your child has a clear nose.  You’ve been warned!

First, it will be important to think about what part of nose blowing is causing your child difficulty. There are a few factors that could be impacting their performance with nose blowing including challenges with the physical, cognitive, sensory, or interoception aspects. If your child doesn’t recognize his/her nose running or the need to blow their nose, it could due to challenges with interoception (i.e., the ability to feel sensations from an individual’s skin and internal organs). If they are having challenges with the act of wiping on their face or the feel of a tissue, it could be due to differences in their response to sensory input (i.e., over responsivity to tactile input). If your child insists on picking their nose, they may benefit from exploring cognitive-behavioral strategies (e.g., a social story, books), to help them understand the alternative options (e.g., fidget, blow nose, go somewhere private), the impact of picking their nose (e.g., germs) and importance of washing their hands.

Second, nose blowing can be a difficult or abstract concept to teach. It takes coordination and understanding that air can flow through both your mouth and nose. Therefore, first it will be important for the child to be able to show confidence with exhaling through their mouth. You can do this by blowing onto hot food (e.g., pizza/cookies), dandelion puff, pinwheel, bubbles, party horns/kazoos, candles, or into a straw to make liquid bubbles. Focus on their breath coming from their belly (diaphragm) for a deeper and longer breath. Try placing their favorite stuffed animal on their stomach while they are lying down to watch it rise and fall or having a silly competition to see who can breathe out longer. This type of breathing has added benefits for strength required for effective nose blowing and overall calming effect for improved self-regulation skills.

Finally, help them notice how they take in their breath through their nose. Once they have mastered blowing out of their mouth, level up! Ask them if they are up for a challenge and try breathing in through their mouth and out through your nose! There are a few fun ways to practice this. One way is by placing their finger or a small mirror underneath their nose to feel/see the air come out. See the picture below for drawings made from tracing our different nose blows! You can have contests with blowing lightweight items (e.g., a cotton ball, feather, pom pom ball, single layer of Kleenex) using your noses. If it is still too tempting to exhale through their mouth, you can try having them close their lips with their hand/fingers or lay scotch tape over their lips (with supervision, modeling and their permission, of course). Want another mind-blowing challenge? Try blowing bubbles with your nose! “How do you make a tissue dance,” you ask? Try closing one nostril and nose-blowing into a single layer and watch it boogie on down!

Learning new skills can be difficult and can trigger large emotions, so remember to support your child’s self-efficacy and self-determination skills. Praise their efforts, and problem solving observed during the process! If your child isn’t taking to these strategies or you suspect your child has other challenges related to nose blowing, talk to your child’s occupational therapist. Nose blowing is part of the child’s self-care skills that can be addressed in treatment as a part of their goals.

Best of luck, have fun and stay well.

Written by: Christy Jo Edgerle, MS, OTR/L