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Toilet training -ASD

(35 Posts)
WireCatWhore Wed 13-Feb-13 18:12:57

Toddler will be 4 in April.
I have tried unsuccessfully to toilet train HM. In the last few months it has become apparent to me that he has ASD traits. I have an appt on 2nd April.

He is refusing to toilet train. Part of his problems is that if you do something a certain way, well that's how it's always done! A even though he does understand going to the toilet & he understands the books we've got, he will not do it himself.

As its half term next week, I am thinking of going cold turkey in the hope he will get it. Will have 9 days, including the weekends.

Did ay of you have trouble with toilet training your ASD children? I expect so, as it's a common thing.

I have lots of questions but will not ask everything at once.

Reading this forum, I am so shocked at how shit SN kids are treated.

I have already been warned to fight for everything I need & now I see why.

Thank you all.

WireCatWhore Wed 13-Feb-13 18:13:20

Him not HM.

MummytoMog Wed 13-Feb-13 18:19:53

DD has some traits, and a severe speech delay. She is also quite particular about things being done the way she knows them. We've had success recently (if you consider reliably peeing in the potty and no accidents so long as we remind her every hour success and we do) by just going cold turkey and using stickers and high fives as a reward. Also the weewee dance. Madam is a praise junkie, so going nuts over potty wees helped a lot. For ages she just wouldn't see on the potty, but once we finally had one and could start the crazy positive reinforcement it all flowed from there. She is three and a half.

ouryve Wed 13-Feb-13 19:43:55

DS1 was 8 before he was clean and dry, day and night - almost 8 for daytime.

DS2 is 7 in May and will have nothing to do with the toilet. Unlike DS1 at the same age, he doesn't save poos for when he gets home, either. We think he's a long way off.

Crawling Wed 13-Feb-13 20:16:43

I have put a lid on dd age 3.7 toilet training as we were both finding it to hard and stressful. We will re try when shes a bit older.

EllenJaneisstillnotmyname Wed 13-Feb-13 20:40:48

DS2 was very late being clean. Pooed in his pants most days until he was 5 or 6, then saved pooing until he was at home, usually while on the computer. He got better at about 8 or 9 and now we just get skidmarks, for want of a better word. Tried everything, rewards, sticker charts, sat on loo with iPod, you name it, we tried it. I just think his sensory issues, he's hypo sensitive, under sensitive, mean he can't properly control it. sad 13 now, and still getting skidmarks. Always worse if he's at all poorly. So be prepared, he may just click, but he might not.

On a happier note, he's been dry since 2 1/2.

dietstartstmoz Wed 13-Feb-13 20:56:57

I have started threads on this on the SN board, this really was a huge issue for us. I went on a course with NAS and read everything I could find. We finally had success with DS last yr, he was just a few weeks short of his 5th birthday and we had been taking him for wees for a very long time, and it took 6 months of work every day to get him to understand about poo. I also bought him about 6 books from amazon about everyone pooing, etc. The wees he understood earlier on, although he had awful runny poo 4 times a day so we had to keep him in nappies. There are some great products called 'dry like me' which are like a panty liner for kids, and these really helped us to put DS into pants and helped with both catching wee and poo. I had to literally follow him around for months, but this didnt work. In the end he started wearing pants for an hr a day and then this was increased. He understood the stickers, rewards etc but in the end we had to resort to big blackmail. We went back to a potty (Wilkinsons do a biggish one that is good for boys for a quid) and we sat in the bathroom on the potty when I thought he needed to go. I had to spend hours watching his bum to see if he was pushing, as he couldnt understand he had to push for longer than 2 seconds to make a poo come out. Eventually, at my wits end I told him he could have anything he wanted for doing a poo in the potty. We sat (on the potty!) with an argos catalogue, he chose an item-a nintendo DS game. I cut it out, stuck it to the toilet sticker chart. After a few more days of bathroom hell he finally did the smallest amount of poo and he got his DS game. He chose another item, and then the next day did a bigger poo. Then we started to scale down the items, and he did a big poo-result, and thankfully we have not looked back. It cost us a few quid but it was the best money we ever sent.
DS did not have any fear of falling in the loo, smell, noise, flush etc he just refused to do it and it was only by spending time every day encouraging this for 6 long months that we were successful. And now my mom and MIL say to me, "isnt it amazing how he just got it"-grrr, they didnt see the 6 months of hell, tantrums, me having to be mean and forcing him to sit and try and tears from both of us. Sorry-huge post

DS1 (ASD) was around 4.6 when he was dry during the day. We had Camhs support as he was non-verbal until 4. In fact his language really took off around this time as well. Anyway they helped with token on a key ring for him to use to ask for the loo which I thought was a great idea even though he wasn't impressed!

Other things that helped were planning the count down and thinking about how to handle it and actually doing about a 10 day countdown to "no more nappies". We also noticed he did wee in the bath so we tried that (into the potty) which seemed to break his duck so to speak. He also never weed sitting - only standing.

Follow his lead is the best advice I'd say. For a good six month or more after that he was still in a nappy to sleep which went after he said "no more night time nappy" one night. And he has just started pooing in the loo without a nappy in the last week. He is now 6.3.

Sorry - an essay and just our experience! But for a long time we thought it (and speech) was never going to happen... And then it did. smile

AgnesDiPesto Wed 13-Feb-13 22:34:05

I think DS was 4.5
we tried and failed before
We tried doing it to a schedule - so we kept a note the week before of when he went and worked out the usual interval and then tried to take him 20 mins before that but he just held it and refused to go (then he went as soon as he got off the loo!)

Then we left it a few months and (with professional help & advice) did it intensively over a few days. If you google "ABA intensive toilet training / scheduled toilet training" advice should come up how to do it

We withheld his favourite things eg ipad for several weeks before to use as reward
We made sure he was happy to drink alot and got him his favourite drinks
We made sure he was happy to sit on the loo for a good while eg reading a book, playing games etc and was comfortable just being there

Then we started in the morning and sat him on the loo and gave him lots of drinks and read books etc. He did not get to get off the loo until he had gone - just kept saying wee in the toilet (use visuals if helps) then ipad
He did eventually go and then he got to get off for 10-15 mins and then sat him back on - loads more drinks - until he went again - had no pants on throughout
So lots of successful wees in the toilet in a few hours (he drank loads bless him)
Each time he went massive reward (ipad) and cheering etc and got off the toilet for 10-15 mins only
If he had an accident he had a bit of loo roll and had to dab the wet bit and put it in the loo (he didn't really clean it just gave him the idea he had to clean it and put it in the loo) to reinforce the idea that wee goes in the toilet
Then after several successful wees we moved a bit further away from the toilet
We did this for about 2-3 days - so we would sit and play 1 metre away, 2 metres away, on the same floor, downstairs etc gradually moving further away from the loo etc
Really important you do not prompt but wait and see if go themselves - if don't then go back a step. You need them to recognise they need to go.

Once going himself regularly we faded out the treats
Within 3 days DS was taking himself, no prompting and not looking for treats
Within the first week he was clean and dry all day and within a few weeks dry at night.
He's quite rule driven so once he gets a rule he sticks to it.
He is the only one of my children who has never wet the bed.

If you are going to try and do it intensively you really need help eg several adults to cover the whole day and at least 2 of you together the first day. We did it as part of his therapy (ABA) programme and were lucky enough to have 1-2 staff with us the first 3 days. Do not try this if your child is not happy to sit on the loo for a long time or happy to drink a lot.

Your post just brought back strong memories - it's half-term, we have nine days to get started....

Our half-term was the October one and I remember looking bitterly at the calendar and realising the process had been on-going for over a year (it was the second November to come and go) sad

He used to sit to wee, now he's moved on to standing wees, but also standing poos hmm. Hopefully in time he'll adjust. He's 5.7 btw, in Dry-Nites at night but they're getting lighter so I may be seeing a tiny wink of light at the end of the tunnel.

bialystockandbloom Wed 13-Feb-13 22:44:36

We did a similar route to Agnes (also do ABA). We spent an unbelievable amount of time in the loo playing with toys, making it a 'fun' place to be, etc. Ds was dry by 3.6, but didn't have a poo in the toilet until he was over 4. For this, we did a gradual thing of putting a nappy on but sitting on the toilet, then when he was completely comfortable with this, taking the nappy off but putting it over the loo like a 'net' (he was scared of the poo going straight into the toilet), then removing it completely. At each stage, massive rewards for mastering each step, with a ginormous reward at the end of it all.

One other thing to note is to take off pants so he's naked from the waist down (if you can do this, being at home). We found with ds that if he wore pants he treated them more or less like a nappy. When he had the sensation of having nothing against his skin he was much more reluctant just to wee on the floor, so basically no other choice than using the loo.

PolterGoose Wed 13-Feb-13 23:14:38

Ds was nearly 4. At the time we had a handmade year-planner so we designated a day as Pants Day, and stuck a picture of pants on first day of Easter holiday. We did this several months in advance.

A difficulty with older children is that potties are too small, use a decent toilet seat, we actually bought an all in one adult and flip down child's
loo seat which was really stable, as well as a solid stool, comfort is crucial.

We had a big plastic tub of "potty presents" on the cistern for every success. These were those cheap little plastic bugs you buy in tubes, each was wrapped in tissue paper.

We were advised by our lovely HV not to have ds either sit for periods on the toilet or to tell him when to go except for about every 2 hours. Her advice was to give big drinks about every 2 hours with a snack or meal, to include lots of salty snacks to encourage drinking for a couple of days. Before every snack/meal he was to be instructed to try for a wee on loo and wash hands, which is a good habit anyway! The thinking behind not telling child to go is that it is actually really hard to expel a small amount of wee if your bladder isn't full, and that it isn't a good habit to strain to wee.

I covered the sofa in towels and bought lots of big loose pants. Ds wore joggers with socks, these stopped the wee going everywhere! Arrangement was if he had an accident he had to go next to the washing machine to be stripped off and wiped down before putting on clean clothes. It was all very matter of fact, no judgement.

First day around 10 accidents and nothing in loo. Second day we went to town shopping and he didn't wee when out shock and slowly improved. It took a year for days to be 100% reliably dry, but after the first week accidents were occasional, not every day. Poos took about 18 months, luckily he held them in while at school (mostly). Interestingly, he had a wet nappy after the first night, then completely dry at nights and he's another who has never wet the bed.

We have though for the past few years had huge problems with him holding in his wees which makes him stressy and angry (unsurprisingly) and I assume it is a sensory thing, but I've yet to find a professional who takes this seriously hmm

MerryCouthyMows Thu 14-Feb-13 08:58:00

3/4 of my DC's are on the Spectrum. Awaiting genetic test results, possibly later this morning.

DD was dry during the day at 7, at night at 12y7mo. She wasn't clean until 7yo (after medication for encoparesis).

DS1 is relatively NT but school are mooting Aspergers and given family history and certain 'traits', I'm inclined to agree. He was clean and dry day and night at 18mo.

DS2 was dry day and night by 2y7mo - he couldn't walk or talk but I used a form of elimination communication as he had nappy rash issues. He still isn't clean at 9yo, and is on medication for encoparesis.

DS3 is just over 2yo, and he knows when he has BEEN for a poo, but not when he is doing it, and definitely not before he has done it. He has no clue about wees, and when he wees on the floor when he has his nappy off, becomes very distressed. He REALLY isn't ready to potty train. His speech isn't anywhere near good enough either, and neither is his Makaton yet.

ApplePippa Thu 14-Feb-13 11:26:54

I toilet trained DS at 3.5yrs. He was very resistant to the whole idea, and is another one for who if you do something one way, then that's how its always done smile. Preparing him for the change was key for us, that and heavy doses of rewards (aka giving him a motivation!).

A week before I pinned up on the wall a calender for the week ahead, with pictures of what we were doing each day culminating in "pants day". We crossed off each day at bedtime and talked about pants day and no more nappies. I also did a series of pictures showing the toileting process (go to bathroom, pull down pants and trousers, sit on potty etc) I really believe it helped DS to know what was coming.

On the big day, he was very, very unhappy at the idea of putting pants on, so I showed him a new toy car he could have if he put them on. Instant success grin. It was then a case of taking him to the toilet at regular intervals - he was rewarded with a chocolate button initially for just sitting on the potty, and then for doing a wee. Loads of accidents, but it got him used to the process.

It took about three weeks before he started to actually indicate when he needed to go (he was still non-verbal, so we used a PECS card).He had to work a bit harder for his chocolate button after that, and only got one if he "asked" to go. He was dry quite soon after that, and then I gradually phased the chocolate buttons out.

Poos were much harder because he just didn't get it. Eventually, after a lot of tears and frustration on my part, I managed to catch him in the act one day and dumped him on the potty. He was promised another new car when he did his next poo in the potty, which he managed a couple of days later. He "got it" very quickly after that. He's been clean and dry during the day for six months now. Have yet to tackle the nights...

HecateWhoopass Thu 14-Feb-13 11:39:03

Oh, it was a nightmare. I tried at the normal age but it was very quickly clear it wasn't happening, and tbh, I didn't see the point in making it a battle when it really wasn't within their control.

So they stayed in nappies and eventually got the nhs ones - that you're entitled to if your child is in nappies after a certain age due to disability.

I decided to wait for them to be ready, however long it took.

One day, when my youngest was over 5 years old, he got up and I took off his nappy, cleaned him up and put on a fresh nappy. He took it straight back off, flung it across the room and never wore another one. He didn't really have many accidents - mainly when he was so busy doing something that he wasn't aware of the need to go - or decided to not go to the loo but do it in his pants!

My eldest was still in nappies at that point (he's 15 months older) but my youngest doing that triggered something in him and he started to refuse to wear them. He had serious problems with soiling for many years after that though. Despite his paed saying it was his choice hmm I have never accepted that. He's 13 now and still has some problems, but for the most part everything is ok.

We were fortunate in that the school had no problem. They understood their needs and were ok to change nappies (they were both statemented and had 1:1 and all manner of funding).

I know that most people don't agree with me on this, and it's only as a result of my personal - limited - experience with ASD, and so clearly it's just one person's opinion - but I always say to just leave it until they're ready. Achieving control over their bowels and bladder is not a battle you can win. It's a battle THEY win. Just continue to create opportunities for him to use a potty/the loo. Carry on with of stories/comic strips about it. etc. and see how he goes. (plus them refusing can be about control too!)

in my limited experience (just my two boys with autism. I don't claim to be an expert) getting into a battle of wills with someone who is rigid is a bloody nightmare! grin

Mine did it when they were ready, when they wanted to and, as with all things, their general attitude was screw you wink I could have sat them on potties every 15 minutes for years and it wouldn't have made a difference.

WireCatWhore Thu 14-Feb-13 12:08:57

Thanks all. I've been a bit busy today so will come on & read properly & reply later.
Am about to take toddler to nursery. As its my last free time for over a week I am going to Costa for a large caffeine hit & cake!
Once again. Thanks for replying x

MummytoMog Thu 14-Feb-13 12:17:13

DD still poos in her pants. Thankfully they are nice neat poos and at roughly the same time everyday, so we pop her in a pull up, remind her it's for pooping in and she generally pops one out within half an hour. I think that's pretty common in all children though, to be a bit more bashful/uncomfortable with pooing in potties. DD will not use a toilet, even with the world's most amazing loo seat on it. Sigh.

Even though we have to remind her every hour or so, this is SO much easier than being in nappies all the time. And it really helps me feel more positive about her other developmental delays. I completely agree with the in their own time thing, this was our third or fourth attempt and we gave up on the others when it became obvious they were going nowhere and upsetting everyone. But this feels good for us. And DS is really starting to get the idea too, maybe I'll have them BOTH out of nappies soon smile Would be lovely to have no more nappy washes smile

largerleon Thu 14-Feb-13 16:59:24

DS1 was dry during the day just before his 4th birthday. Still wears pull-ups at night, he's 8 now but regularly leaks out of the 8-15 yr ones sad even though we restrict his drinking after 4pm. He's ?Aspergers & has sensory processing issues. Occasionally he will still poo in his pull-ups during the night, presumably he relaxes in his sleep. Certainly his most regular (every 2-3 days) poo time is about 4.30-5am.
DS2 is now nearly 6, he was 4.5 before I got him out of nappies during the day, it was the August before he started school in the Sept. He was much much harder to poo-train, I remember hours spent shaking his legs trying to get him to relax enough to poo anywhere, toilet or potty. His whole body would tighten up & go rigid, he would hold it for days, eat less and get progressively grumpier. He's ?dyspraxic & has sensory processing issues and still holds it for days but now at least goes when it starts to "turtle" (sorry, TMI! wink)

Both my DD's are fine grin maybe it's just boys... no, that's what my mum says hmm

I am starting to feel a bit stressed about this. DS is 3.8 and no sign at all of indicating when he needs to wee or poo, or even when he has done so (he is non-verbal but perfectly capable of using signs and making sounds to indicate other needs). His poos are very loose indeed (he is currently under investigation by a gastroenterologist for this) so we can't even do the fluching them down the loo thing. I am getting him used to sitting on the toddler loo seat every time we change a nappy and he loves flushing, but has no concept of the actual function of the loo!

MummytoMog Fri 15-Feb-13 16:01:50

DD was completely like this up until Christmas, right down to the loose stools. Luckily, it seemed to clear up around the time she had a course of antibiotics for something else, so maybe she had a low level infection that cleared up. Anyway, hope you get some advice on the loose stools, it's pretty grim (we cloth nappy too, YURK). Do you get DS to watch you/his dad on the loo? DD is very interested in what I'm up to, and I think that helped. We also used the Avakid potty app, which she loves. DD doesn't tell us when she needs to go very often at all, we just plonk her on the potty regularly, but it does feel like we are getting somewhere now.

That's interesting to hear MummytoMog. We sent stool samples off for all kinds of analysis this week, and he is to have some abdominal x-rays soon (getting him to stay still for that should be fun, hmm!). Hoping to find out if it is a bug, or an absorption problem, or an allergy of some kind.

He does watch me on the loo and finds it hilarious. Also watching his dad pee standing up, perhaps that's a bit confusing! Our ABA consultant has said he will be devising a toilet training programme for him, so we will see what he says on his next workshop, which is in 2 weeks!

PS what is the world's most amazing loo seat, MummytoMog?

WireCatWhore Sat 16-Feb-13 10:59:38

Complete melt down. Just tried to put pants on him.

Thanks for all your replies.
Not ignoring, just been busy, need to get house on the market x

WireCatWhore Sat 16-Feb-13 11:07:18

Right. He's happily got his pyjama bottoms on. No pants. That'll do!

MummytoMog Sat 16-Feb-13 17:25:12

We got this spangly one with a built in ladder, handles and a padded seat. She insists on using the five pound potty from Mothercare. No one else is allowed to use the stupidly expensive potties we bought for DD that play music, so had to buy DS his own dinosaur potty this week to start potty training him. DD feels very strongly that dinosaur things and blue things belong to DS. Thank heavens for blue dinosaur potties.

MummytoMog Sat 16-Feb-13 17:27:25

I used to think it was normal to never have a solid poo btw, so the change to well formed stools was amazing and very noticeable. I have IBS so maybe madam inherited my sensitive gut.

have you got the make of the seat? We have one with handles and ladder but not a padded seat.

PS I also began to think this was the norm (and have not had any other children so didn't really know!). I hope we can get to the point of formed stools (amazing what one can feel excited about isn't it!)

MummytoMog Sun 17-Feb-13 00:20:10

It says roger Armstrong on it, but it was second hand from eBay...

WireCatWhore Sun 17-Feb-13 11:40:18

He managed a wee on the potty before bed.
Nappy was dry when he got up! He is always dry overnight anyway, but put a nappy on as don't have mattress protector yet.

He is currently holding his wee. He is contender for strongest pelvic floor in history. He is desperate to go. And last night he enjoyed his chocolate lolly after he had his wee. He knows there is a chocolate lolly when he wees on the potty.

Today he will need a poo as well (he went before I removed his nappy yesterday). That will be fun. I have new cars for pooing.

That seems to be an Australian make. Well, the one we have seems Ok in terms of his being happy to sit on it 9although not do anything else!).

I wanted to ask a related question if anyone can advise me. What is the deal with changing from regular nappies to pullups? My nanny tells me her friend (who has two small kids, one with ASD) thinks things would be better with pullups now. I (having no experience of any of this) would just like to know what the purpose of the change would be, is any?

WireCatWhore Sun 17-Feb-13 13:17:14

thedudesmummy
My toddler got confused with pull ups. He just we'd in them all the same. And if I put pants on him, he would ask for his "elephant pants" (aldi pull ups!) when he needed a wee.

I didn't use them with my older 2, they are quite a bit older though.

They could be useful for longer journeys one LO has just become potty trained.

sickofsocalledexperts Sun 17-Feb-13 13:19:17

The theory i s I think that pull-ups are a halfway house between nappies and pants, and are less absorbent - so the kid starts to feel the wetness and therefore more uncomfortable. It is supposed to lead them to want to use loo.

MummytoMog Sun 17-Feb-13 14:06:17

Ah, sorry, not much help. We got it because madam gets horrid red marks on her bum from the potty, and we thought it would encourage her to sit, but it doesn't seem to have worked...

We use pull ups at night rather than cloth now because she got very upset at putting a 'nappy' back on, whereas she can call these special monkey pants (tesco).

I might try the pullups I think. But whether it will make him make any connection between wetness and loo I don't know (he is non-verbal, but can sign and indicate things).

PS wish I could re-toilet train our (very old) cat who has just pooed on the floor. Yuk. Gve me DS's ones any day!

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