Toileting

[poppetandmog]

Not strictly adoption related but I know I won't be judged on this board! Our AS is 5 - about to go in to year 1. He has had problems with his bowels his whole life - constipation and constant poo smearing in his nappies. He came to us at 2 and a half. We've tried various medications and nothing has really worked. For this reason, we've never been able to toilet train him. He also has global developmental delay (likely genetic disorder but they've never been able to diagnose anything.) He is making good progress but is operating at around a year behind his peers in most areas.

On Tuesday, he had a colonoscopy and had a massive foetal impaction, which was cleared. The surgeon said we now have a small window of opportunity to toilet train him. I have taken a week off work and we have started trying today. He is just not getting it at all. We're on our 5th pair of pants this morning already as he just keeps peeing on the floor and seems to have zero awareness. He says if I need a pee I'll run to the toilet so gets the concept. We are offering the potty and toilet and getting him to sit on both regularly but haven't had any successes yet. We've had no poo at all since coming home from the hospital and we're starting to get poo smears again so I suspect he is withholding. I know it's really early days but I suppose I am just feeling the pressure because he's 5. Is it possible he's still not ready? Just looking for any advice and support please as I feel like I'm failing him.

That's hard. Was he left in wet soiled nappies as it may be a comfort thing for him familiar smell,feelings etc.
I had one son who was like your with additional needs and it was just perseverance and not getting her up about it. Easier said then done. I did in the summer and let him run around the garden so not too much to clear up unless a poo .every time he weed I would show potty then worked toward sitting on it then somehow it just clicked. But was a long process.
There are now children books about potty use maybe get some of them.
Sticker / rewards did not work for mine but might for you.

Is he on a maintenance dose of constipation meds? Something like a sachet or half a sachet of movicol paediatric before breakfast in the morning (whatever dose it takes to ensure he does a poo most days), and then sit on the toilet half an hour after breakfast when he should naturally want to go. If he's not having a maintenance dose or it isn't high enough, I suspect he has gone straight back to withholding poos. I would get the doctor to prescribe this if you don't already have it. Why did the surgeon say that you only have a small window? What happens after the window?

Are you a member of the Facebook group movicol mummies? They offer really good advice. His bowel will be extremely distended from all that poo so he physically can't poo like the rest of us. He could also need a stimulant as well as a softener to help train his muscles.

If you are in the group, someone shared an article on the signs and symptoms of withholding and it was clear that some of things my child does that I thought meant she was trying to go were actually the opposite.

I know it's really early days but I suppose I am just feeling the pressure because he's 5. Is it possible he's still not ready?

Try not to put yourself, or him, under pressure. My DD was 7 before she was reliably toilet trained - she also has GDD and suspected ASD. In her case she had constipation, and couldn’t feel the usual urge to go because her bowel had been distended. In all honesty it just takes time and perseverance - I remember having 14 changes of clothes in one day between a 6 year old and 4 year old child. Twas a stressful time but she’s been completely clean and dry now for 4 years.

Id like to also do a shout out to the faceboom group "movicol mummies" - terrible name but exceptional group! One of our LOs had terrible bowel issues as a result of early years experiences and this group is the only reason we are now on the road to recovery. Also the ERIC website and helpline are a fantastic resource. x

www.eric.org.uk/