Sunday, November 15, 2009

Autism and Potty Training: Calling all suggestions

I know that I'm the one usually giving support and advice, offering a suggestion or climbing a soapbox or two. But this time I come to you, my loyal friends, for your advice and suggestions.

Nolan is four-and-a-half and big for his age; he's also heading into the home stretch for Kindergarten. He's currently attending an early Early Essential Education (EEE, or Triple E) program here in Vermont, which is funded by Medicaid and is not quite considered "real" school. It is a half-day classroom full of students not all that dissimilar from Nolan, so the teachers are understanding where his "special needs" are concerned.

But next year is "real" school, a full day long with 'normal' kids and less understanding educators. The problem is, he is not yet potty trained. At four-and-a-half, he still wears disposable underpants which must be changed when he soils them. And oh how he can soil them! This big boy has many nicknames, of which one is 'Poop Machine'. No joke. Just playing on the computer will relax him enough to fill it to the brim.

We hate changing those ourselves, and dread having to leave that in the hands (so to speak) of someone less familiar with the Machine. During a half day, the teacher encounters a butt wash every once in a while. But for the full-day class, it's gonna happen.

Though I know he will learn what he can when he's ready, we feel almost compelled to make this one happen. But he doesn't even get the concept of pooping, when it's going to happen or why. We tried potty training last summer, with little result. He would go to the potty in the morning and sit there 'til he peed, but never got the essence of why he was there. And try as we would, we could never get him to go during the day in order to stave off a surprise.

We're going to try again during the Christmas break. And while there are great books out there with lots of suggestions and offerings, we thought we'd put it to our friends ---especially those with older kids who have experienced this stage in life.

Please, any and all recommendations will be heard, tried and welcomed. Nothing is too radical and there's no need for embarrassment. If you can think of it, we'll try it. Because, by Kindergarten, 2010, Nolan will be using the toilet. If not, it's your fault!

OK, not really. But we'd still like to hear from you.



Corrie Howe said...

Wow! This is a hard one. Jonathan was using the toilet during the school day, but still having wetting accidents and regressed into soiling accidents last year. He's almost ten now.

All I can suggest is a good behavior modification clinic near you. We ended up with Kennedy-Krieger in Baltimore. We'v had Dr. Jim Ball, I believe an ABA from you area, in our school systems. I really respect his work.

Jon G said...

Corrie, thanks for the suggestions!

Keep 'em coming, everyone!

Jan said...

I have made a treasure chest out of a cardboard box, covered with gold foil paper and "jewels". I go to the dollar store and buy about $50.00 worth of really cool toys. I fill this chest and when the child does what they are supposed to do, they get to pick.

We had a 9 year old with autism and this was a HUGE contributor to his potty training. Just make it simple.

"When you poop on the potty, you get to pick."

Show him what's in the chest, but don't let him pick for anything else.

Show him you and your wife and any other kids picking after they use the potty.

Let me know how fast it works, I will be crossing fingers for you. Just remember, lots of praise and some bribery is not wrong, we all do what we do for the positive strokes that we get.

Jan said...

By the way, I take the toys out of the wrappers and just have the box full of unwrapped toys. That way a set of six cars is six individual picks. More cost effective.

Anonymous said...

My suggestion might be completely off the wall...but you said nothing is too radical.

I'm thinking from a physiological perspective - but think this is not mutually exclusive to a behavioral approach (two excellent suggestions already).

Some patients' gi tracts are 'trained' for bm at a certain time each day. That is, a bm is stimulated by suppository and whatever else it takes to 'relax'. Everyday at the same time.

Diet adjustments are effective but I cannot advise on that.

Came here from Corrie's post on your book. I will look for a way share about your book on my blog, too. Barbara

Deanna said...

I feel for you Jon. Jimmy having accidents in Kindergarten was one of the big straws that broke the camel's back, (for lack of a better phrase), finally leading us to a diagnosis. You may remember that he wasn't diagnosed until much later than most autistic children. This brings back horrible memories. The principal actually made him sit in her office all day long after he'd wet himself early in the morning before she even called us. That was a terrible day.
But, I don't want to reflect on that. I just wanted to say that Jan's idea works. Giving a specific reward only for going to the potty will work wonders. The hard part is going to be getting the teachers at the regular school to accept that. Give a 5-year-old a reward for using the bathroom?! I'm sure you'll get the righteous "wells" out of it, but I know you're strong and you can handle it. It will take a while, as everything does, but he'll get there.
Good luck!

Trish said...

Hi there - just found you through an article on autism sucks - looking forward to reading more but wanted to respond to this post right away!

I had written an article about potty training for another site which is no longer online, so I just republished it on my own blog. I'll give you the link rather than write a way-too-long comment here:

I found that our son's special ed preschool was unhelpful in potty training because they were TOO accepting of his delays, so nothing really happened until we took the initiative. Good luck and I'm happy to chat about it more if you want.

Lexi said...

I must say, with my son we tried it all: stickers, candy, sheer bribery ("If you poop in the potty every day, you can get a cat for Christmas!"). None of it worked.

Until the "star chart". Same thing he uses at school...basically a picture schedule w/blank squares beside it, which get filled in with stars as each item is completed. I had to actually draw an illustration of what was expected (a pile of poo with a red arrow into the toilet-such a literal child!), and it's one of the stars he has to earn.

Another thing to consider: he would not go in the toilet if one of us was sitting beside him. He needs absolute privacy, door closed, or it won't happen. I add this because it didn't occur to me for a long time, for some reason.

Jon G said...

Jan, wonderful ideas...we are willing to try anything!

Jon G said...

therextras, as I had said, we are willing to try anything. for instance, one thing we noticed is that EVERY time Nolan plays on the computer, he has a BM.
If there was some way to incorporate that into the regimen, we would love to (tho the computer is NOT moving into the bathroom!!!)

Jon G said...

Deanna, thanks for the comments...we're trying it all!

Jon G said...

Your suggestions are something we can incorportae into the plan! Thanks for the suggestions!

Jon G said...

Lexi --- this mirrors a few of the comments and links we've gotten. We will efinitely need to work on some sort of reward and I am curious about the "physical modification" suggested by "therextras" as well.

Thanks for all your suggestions and keep 'em coming --- we'll take all you can give us!

jennifer elaine said...

Make sure that your child is not constipated. This is the most important in getting started. Children’s are afraid of the toilet and the whole process of getting in a cold wet small room. If you are not an expert in knowing about the constipation, get them to a doctor when you see signs of them not eating well or change of mood. Increase the amount of fluid and fiber in their daily diet. Water plays an import role in helping your child staying healthy and helping to digest easily. Give lots of water and encourage with praise when they drink. Fiber enriched food for kids include; Barley, Navy Beans, Baked Beans, Split Peas, Oat Bran, Raspberries, Green Peas, Prunes, Spinach, Broccoli, Raisins, Mixed Vegetables, Strawberries, Carrots, Potatoes, Corn, Rice, Apples, Oranges, Celery.

Read children's story books about potty training to your child. There are lots of books available for you get online on potty training. Reading and imagination helps the child to relate to the interesting characters and behaviors within the story and helps them follow accordingly. Offer lots of praise when your child does make some progress. It is not an easy practice but this will help you see results amazingly when you really put in the effort to make your child proud of their achievement. Avoid physical punishment for not using the potty. Stop all reminders about using the toilet. Replace the reminders with the potty training stories you’ve read to your child. This helps as their mind recalls the story and how will keep it in mind when its time.


Tammy said...

My son is ten and we just potty trained him this past summe. Up until then, he just wasn't ready. no matter what we did. Finally, he was ready and we found a method that got him fully potty trained in less than a month. We started taking away his favorite things whenever he went in his pull up. He had to go to the bathroom without being told in order to get something back. That was the hard part. He wanted us to tell him and he wanted us to take him to the bathroom. He finally started to cooperate and we were able to take him out of pull ups. Now, his accidents are few and far between. Usually they occur when he doesn't know where the bathroom is or something is really bothering him.

Jon G said...

Tammy, thanks for the encouragement and reality. I guess when he's ready, he's ready.