the level of independence, physical and intellectual
capabilities, knowledge of the significance of hygiene,
and emotional state (Koutoukidis et al, 2012). Poor
hygiene may also occur as a result of an underlying
health condition causing repeated infections or the side
effects of medication, which may make it harder for an
individual with a disability to attend to and maintain his/
her personal hygiene needs (Box 2). Neglect of personal
hygiene can have a detrimental effect on physical and
psychological health and the comfort of an individual
with a learning disability, such as being in pain from
dental or skin infections or leading to early signs of a
mental illness such as depression, which may result in
anxiety, fear and social isolation (Ireland, 2011).