Nail Clipping for Children with Autism

Children with autism may be more sensitive to the nail clippers than the others. To help them overcome this fear, they need a plan that is more thoroughly broken down. We can’t rely on sneaking into their room and clipping their nails only after they fall asleep.


Here is a guide of a long-term solution to build your child’s tolerance to nail clipping!


  • Basic cooperation & compliance with First Then instructions
  • Understanding the Visual Schedule
  • Some level of functional communication


  1. “Nail Cutting” Social Story
  2. Nail Clipper
  3. Video Model
  4. First-Then board
  5. Visual Schedule
  6. Rewards


Item List for Nail Clipping


1. Communicate expectations: gradually expose your child to the expectations of nail-clipping visually, through reading the social story, showing the video model and presenting the First-Then visual.



2. Probe: assess and identify your child’s main challenge. Adapt the desensitization plan according to your child’s exact needs. For example:

a. Place nail clipper at the edge of the table

b. Gradually bring it closer to your child

c. Demonstrate clipping your nails

d. Get your child to touch the nail clipper



3. Practice:

a. Read the “Nail Clipping” social story.

b. Show your child the First Then chart, the reward he/she is working towards, then show he/she the video model

c. Begin practice (desensitization plan):

  • Let your child tap the nail clipper with one finger one time. Gradually build it up from there, until your child has touched it with all his fingers.
  • Tolerate blades of clipper touching the tip of their fingers: start 1cm or 2cm away, build your child’s tolerance to 3 times snipping movements per finger, without actually clipping any yet. Repeat this a few times until your child is able to tolerate it well, then clip one nail once before immediately giving the reinforcement to your child.
  • Gradually build the number of nails to be clipped: start by giving reward after 1 clip, then move on to 2 clips before reward, and then 3 clips, etc.



4. The BIG DAY: it’s time to cut your child’s nails! By this time, your child would already be able to tolerate his nails being clipped.

  • Target: tolerate nail clipping for ALL your child’s nails
  • Remember: if your child shows anxiety (e.g. pulling their hands), take it slow and consider going back to step 2, if necessary
  • Reward: your child deserves an EXCLUSIVE REWARD for completing BIG DAY!



5. Review: Generalization or Troubleshoot?

a. Other carers: caretaker at daycare center, babysitter

  • Gradual: begin practices according to step 1, then 2 and 3, until the attempts are successful

b. Toe nail clipping

  • Follow the same progression from step 1-4

Your Turn

Prepare the materials for a nail-cutting practice with your child.


Identify the best exclusive reward(s) for your child.


Begin teaching!