ASD-refusing to poo in the toilet-help...

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DS2 is HFA, aged 4.8 and in reception at mainstream primary with a full statement. I have previously posted about his toilet training issues. He is in pull ups at school. We have been trying to encourage toilet training for 12 months now. He has made fantastic progress with having a wee. He knows he needs to go and he has the odd dribble accident but he has also had some wees independently,so all good. But the poo-argh i am at my wits end and ready to give up. He soils 3/4 times a day, often very runny and he is covered. He absolutely completely refuses to even consider pooing on the loo. He doesnt really know how to push a poo out, he has had 4 successful poos on the loo and it really was down to luck and timing. He will push for a few seconds and then gets really flappy and stressed refusing to even try. I know it is my issue but i am so conscious he is in mainstream school and in sept will be yr1. He shows no signs he needs to go, does not have a regular pattern of bowel movements and just does not want to do it. Says it is too tricky, the problem is he pushes for a few seconds nothing happens and its a failure so he wont try again. He really is happy just sitting in his own soiled pants / pullups and would not say if we didnt change him. I have books for him, reward charts, over the top rewards etc but nothing is working. Please help. I am at my wits end and want him to move forward. We have a referral to a soiling clinic, but wont be seen till july. Have spoken to paed, school nurseand GP. He is definately not scared of the loo or bathroom. This is just not an issue for him but it is making going anywhere, even the park a.nightmare as he will probably poo while we are there and if there are no facilities we come home and he is too big for baby changing tables. If you have read this far thanks. Please help, i am desperate!!!!!

Do you know why he refuses to go?

We had a problem with this with my ds (HFA) which lasted until he was 4 too. In his case I think (though never totally sure) he was scared of the sensation/sound of the poo falling into the loo (he is still rather anxious/phobic about toilets generally despite being fully toilet trained). We tried for a while with putting a nappy on him when he wanted to go, but only if he was sitting on the loo. Then when he was comfortable doing that, then progressed to taking the nappy off but putting it in the loo almost like a net. Then removed the nappy, and used loads of loo paper. Then final step was removing the loo paper. At each step we used huge rewards every time he did it successfully (we do ABA), and also spent loads of time in the loo with him, playing with his favourite toys etc to make the loo a nicer place (sounds a bit weird but it was so that he stopped seeing it as a fearful place).

I don't know if this kind of thing would work with your ds if fear is not the problem though. But I suspect that even if he is not scared of the loo/bathroom itself, there might be something he is scared of about the process - the sound or sensation. Just wonder if he is panicking a bit about this and that's why he's holding it back?

We also had the problem of being out and about during this phase - but if you can even get him to ask for a pull-up/nappy when he wants a poo that would make it easier.

Don't know if this will be of any help as it's not quite the same problem we had, but good luck anyway - and you do have my sympathy.

Thanks Bialy, I really am at my wits end with this situation. DS seems to have very poor awareness of any need to do a poo, until it is actually coming out of his bottom. I will perservere with asking him what the problem is, he struggles to find the words to tell me, he has had a huge speech delay but is now chatty, if not always appropriate chat, and he doesn's always get the right phrases and words. The only thing he can tell me is 'its too tricky', ot 'it's too hard I can't try' and I can only think of all the times we have taken him, he has tried to push a poo out for about 5 seconds and then nothing comes out and he gets frustrated and gives up. he will not try for longer, a complete flappy distraught refusal and I can't carry on making him try when he is distressed as we are getting nowhere, and he just keeps crying and getting off the loo. We have a big-ish potty so we have reintroduced this, I have promised him any toy at all for success and he has had a few toys and treats for the successes he has, but he just does not want to do it. When he does poo it does not bother him at all, and if I didn't change him I'm sure he would stay sitting in it for hours. If I leave him for a bit to see if he tells me he does not. He is getting a sore winky from wearing pull ups at school, and has a sore bum if he poos a lot during the day. I have said to him that he wont have a sore bum anymore etc if he does it in the loo and his response is 'i want to have a sore bum'. He can only tell me it is too hard to do, and he can't do it. Argh!! I am desperate, especially as he is in mainstream and I don't want other kids being mean to him as he gets only, not that it would bother him but I want to protect him from being the subject of ridicule, and make life easier for us all.

Has anyone toilet trained a complete stubborn refuser??

My dd is nearly 5 and doesn't have autism but does have a huge issue with pooing in the toilet. We were recently referred to a continence nurse who said this isn't unusual even up to the age of 8 which surprised me. We can't work out what dd's problem is but she will only poo in a nappy and can't explain what it is she is worried about. All the advice we were given we have already tried - nappies getting too small, Poo goes to Pooland etc but she did promise to send some further info through the post. I'll have a look when I get it and let you know if any more ideas that might help. I'm also worried about school and bullying issues but so far, she holds on until she gets home which can't be too comfortable for her