Saturday, November 11, 2006

Potty training

This post is mostly going to be one long whine. I need to complain here. I promise that the complaining will lead to a positive ending, but I have to tell this story of struggle. I try not to complain or allow despair to set in too often...and I'm really good at it about 95% of the time. T is an angel child whom I love with every ounce of my being. But I really need to whine about this subject, and darn it, I think I've earned it.

Several posts back, I said that I would talk about T's potty training saga. This has been an ongoing source of stress, confusion, and until quite recently, despair for me. T has been able to "tinkle" (I know, only mommies use that word) in the toilet for at least a year now - almost always prompted - he rarely requests to go - but he can do it and that is a relief and a major milestone.

Potty training is a major issue for many kids with autism. T's challenge is exascerbated by his almost complete inability to imitate. Echoing language - no problem. But he does not learn a new task by simply watching another person do something. It doesn't occur to him. This is why I was so excited about The Itsy Bitsy Spider several posts back. (This is THE major skill area we are tackling with his Verbal Behavior program.) Another thing: kids with autism don't receive messages the body sends the brain in the same way as you or I. So they may not realize that they have to go, or even realize that they've already gone. Layer on top of that his struggles with understanding language (although he is making MAJOR, major progress because of the VB program), and we've got a challenge to say the least.

Okay, so let's say you have a child who doesn't understand language too well, that doesn't imitate the actions of others and whose brain doesn't always get the message that "I have to poop." Where on earth do you begin?

Start a potty schedule. Okay. Track bowel movements for three weeks, then find the pattern and time he usually goes and take him to the toilet and sit him there until he goes. Check.

Mission NOT accomplished. About 60% of the time, he'll go between 4:00 & 5:30. Right when I'm making dinner and can't watch him like a hawk. I try, but little luck. What about the other 40% of the time? 2:30 p.m. one day. 11:00 a.m. another. 3:15 p.m. (while on the bus) THEN again at 7:30 p.m. 4:00 p.m. Pattern? Hmm.

But wait, it gets better. Add to this his panic over sitting on the toilet with or without the potty seat. Yep, even on the days I did catch him about to go, he'd scream when I'd approach him and resist & pull my hair on the way to the bathroom. Force him to sit? All you parents out there: remember the "banana" position your kid would go into when he/she didn't want to sit in their car seat? Yep - that was T. Needless to say, we haven't pooped in the toilet yet. And the stress over all this was making him averse to even going into the bathroom at all! No, no - we can't regress, please.

I asked our Occupational Therapist. Nothing helpful beyond what I already had been trying. I called our children's therapy clinic to see if ANYONE had any help to offer, any different ideas. Nope. Is there anyone who knows how to potty train autistic children?

Books. Okay. Still pretty basic. Websites & blogs...ah, there are some interesting ideas (have your child sit on the toilet with a full diaper then cut their diaper open so the poop falls in - interesting, but with a writhing child? Maybe not.)

THEN...our Verbal Behavior consultant came for her weekly visit. She asks, in passing at the end of a session, how my week has been. I sigh, try to keep a good face on, but she sees through it. I'm at my wit's end and am in despair. We try to take T to the bathroom, and she sees what no one else has - and no one else seems to believe - that he now freaks out about going to the bathroom. Then she suggests what will be a miracle: how about putting something in the bathroom that he absolutely cannot resist? How about giving it to him ONLY when he's sitting on the toilet?

Out comes the portable DVD player. Out comes a Baby Einstein DVD. And in a few minutes, T is not only in the bathroom but happily sitting on the toilet. "I have families who have set up an entire entertainment system in their bathrooms for just this reason," she says with a smile.

So here's the plan: several times a day, T gets to watch a few minutes of Baby Einstein while he sits. We slowly increase the amount of time so he's completely comfortable. We try to find a pattern again, a usual time of day, and try again. She said that one kid took a year to finally poop in the toilet, but he did, and so will T - eventually.

Relieved sigh. So now I have a plan. T will happily go to the bathroom and tinkle and sit on the toilet. Now I just have to be patient and positive. It will happen. I look forward to the day we don't have to be washing poopy underpants anymore. It's been 5 years and 3 months. I'm ready. Now I just need to wait for him to be ready! Any time, T, any time.


EA said...

Sorry lovie, I didn't hear any whining here. Just a mom who really knows her boy and is trying her best to help him live a quality life.

I have to say, I grew to hate ABA techniques in the MSU clinic, mostly because they had been used on me growing up. Oh, she's having a 'temper tantrum', don't reinforce her behavior, ignore her, etc. I feel like they killed my emotional, every time I used ABA in the clinic (which was every session I did there), I felt like I was killing the emotional life of each kid I worked with. Oi! It was such a huge projection. The kids I worked with needed so many other things that their emotional life was the least of the worries.

SO, to get to the real point here, I hear you now and see how ABA techniques are REALLY helping you to maneuver around or through T's obstacles, and they seem like a true gift. Wow! I'm so glad to be seeing this all through your eyes.

Also, I'm so GLAD you have a plan. I hope this helps mediate some of your moments of despair.

I love you and I'm proud of you. You are doing such GOOD mommy work.

Anonymous said...

I was very frustrated as well with potty training. When I was researching potty training a common theme seemed to be praise and positive reinforcement. I came across a website called We hung it in the kitchen and named the little boy on the front of the package, “Bobby”. My son could not wait to go to the potty so he could push the button, hear the praising message, and get his chocolate reward from, “Bobby”. It really got my son excited about using the potty himself and it was fun for him. Because he became so involved, potty training was easy. So give it a try.

Anonymous said...

Pam from Portland here:

Oh - wow! is about all i can say. I am thinking of you and sending good "poop on the toilet" thoughts to you and T;-)

I must say, you did make me laugh with the "banana" comment.

Keep the faith, sister.


lemming said...

Cheers, cheers and cheers.

You're not whining. You describe a struggle, your love for Moose and your fervent hope that you can help him, i.e. you're a great mom. Hang in there.

EA said...

Hi again,
I've been reading around other mother's-with-autistic-children blogs.
I am near to tears with the beauty of how you are all loving and working with your children.
I'm also continuing to be thrilled and excited to discover how shallow my undergraduate understanding of ABA is and how different moms are using these techniques to work WITH their children's emotions.
I can say nothing but BRAVA and watch on with serious respect!!