Hello everyone, am back after a short break due to illness. I've been thinking of you all and hoping that you are all doing OK as I know some of you are coping with very sad and/or difficult circumstances. You lot are my inspiration!
I am feeling worried because my son's teacher (who has been very nice and supportive as have all the staff in his reception class) wants him to stop using training pants. He has been wearing underwear with pull-ups over the top and has a toilet routine with 1:1 adult support. They want him to learn that he doesn't like being wet or dirty and take the initiative to go to the toilet without adult support. They have been very understanding so far but feel that they need to get him independently using the toilet before YR1.
My worry about this is that I am fairly sure ds has hyposensitivity and not much bowel control. He does not seem to have any bladder control at all or awareness that he is weeing. He only realises he is wet when his clothes are wet and then he finds it upsetting. He is only sometimes aware that he has done a poo.
Ds's bowels are unpredictable as he has constipation and overflow which is being treated with Movicol. He can go from not pooing at all to great sloppy up-the-back-jobs. He did have a problem with withholding (I think, it is hard to communicate with him) and now that has got better but his bowel patterns are still all over the place.
Ds also feels wobbly on the toilet and is happiest on a Bumbo seat with a footstool (which he doesn't have at school). We had a problem with him being scared to go on the loo in case he peed upward and wet himself but now we put a towel on his lap and he is starting to feel safe and relaxed. At school they have child-sized loos but no other accommodations. However with an adult with him he does seem to be OK about it there. He still can't do a wee standing up though although he really wants to try to be like his dad.
Ds has physical co-ordination problems and weak hand grip which make it hard to pull his trousers and pants up and down and wipe himself in more than a token way, or to get on and off the loo, or wash his hands properly.
If any of the toileting steps are done in a different way or different order he gets upset and finds it hard to adapt when given an explanation for the change - usually a sign of anxiety or lack of confidence with him. Usually the next step after that is going completely passive and apparently indifferent.
He also has probable ASD (in process of being diagnosed) with hyperlexia and this means that he finds it hard to understand what is happening in a joined-up way, think about cause-and-effect, and communicate his needs with adults. He is inconsistent with this, at some times seeming to understand much better than at others, and it is much worse when he is stressed. He tends to just answer "yes" or "no" to things because he thinks he is supposed to say that or else come out with a phrase that sounds appropriate but may not be true. He doesn't have much understanding of questions being meant to find out what he uniquely feels - he thinks it is like a quiz, with right and wrong answers so he just guesses.
Ds was completely withdrawn from the whole business of poos and toilets and found it very upsetting but we have seen some progress lately. He is now happy to sit on the loo after he has done a poo or stand and hold his penis in the vague vicinity of the loo if he has done a wee 
. He really feels happier about this now and says he feels proud to be sitting on the loo like a big boy. I think this is real not just echolalia. We praise him for this because we want to encourage the behaviour of going to the loo and get him confident about all the steps involved, gradually getting him to have less adult input with each step. He said yesterday "I feel something funny in my nappy" when he had done a huge sloppy poo - this was massive progress and he got a "high-five" and a "Woo! Good telling!" which is what he gets if he informs us. He was really proud. I think this feeling of dignity and competence is a powerful motivation in itself and by consistently taking him to the loo and praising him for each bit he will want to do more and more as he matures (he is only 4.8 one of the youngest in his class after all).
I am really worried that this fragile progress will be derailed by taking off his training pants. I am scared he will feel totally out of control and stressed by finding his clothes soaked or covered in poo and will start withholding again, getting stomach problems and feeling unwell. I'm worried that if he is stressed he will not think clearly or communicate and might draw the wrong conclusion (I got pee all over me in circle time, I don't want to do circle time in case I get pee on me again). If this is coupled with less adult support with using the loo then I think we are heading for meltdown or school refusal. I also know from experience with ds that when you push him he tends to go backwards.
I also think that if he is feeling worried about continence this is going to have a big impact on his eating, drinking and fatigue levels as he cannot eat properly when stressed and when his blood sugar is low he is impossible to reason with and can become aggressive.
On the other hand I am not any sort of expert and maybe I don't have the clearest picture of my son's problems - I feel easily overawed by professionals and so I'm asking all you experienced people on here - do you think this is a good idea or not? And if not, how should I handle it?