Toilet training autistic 8 year old

[Mumofsend]

My DS is 8 and still in nappies.

There is 100% a sensory element but there is also a significant psychological element. He has zero concerns about sitting in his own wee/poo. He won't communicate having had an accident when wearing pants. If he poos in his nappy he won't tell me he needs changing. He absolutely does know when both of those things have happened. I'm also trying to get him out of his mindset that if he wees/poos somewhere that that is the easier option than just going to a toilet.

I dont think he can properly feel/interpret the body signals that he needs to go in the first place, however, the behavioural element is significant and he won't ever learn those signals if he isn't put in the position that he has to try.

I have three weeks left of this summer to tackle it, I can't cope with it much longer when I know much of it is him choosing not to use a toilet and not to tell me he needs changing and not to tell me he's had an accident.

I'm hoping for some views on what I have set up for any other tips or ideas.

• Drinks in higher quantities in one sitting rather than sipping throughout the day. Then sitting on the toilet 60 minutes later. If he does not pee on the first sitting then he is to keep trying every 30 minutes.

• heavily incensitivising using the toilet with rewards that are very meaningful to him

• he has to clean himself up, get his blankets and clothes in the wash, change his pants and give the accident patch a clean over.

• if he does not tell me he has had an accident then he gets a consequence - loss of screen privileges.

I have a teen who is not toilet trained (and it is now accepted by all involved, he probably never will) and personally I wouldn’t remove screen privileges as a consequence. I would go with natural consequences like DS has to stop what he was doing (including screen time when it falls that way) to clean and change, etc.

If you think psychological issues are at play, what support is there for that?

Is DS receiving sensory OT support?

When my DS (who is ND but potty trained at a typical age) was training we discovered he's a camel and got him to sit on the potty about half an hour after a drink while watching TV but it turned out it took over an hour.
However sitting there waiting for a wee did mean it came eventually and it meant he got the sensation of doing it in the potty.
I am not sure this would work as well for a poo as it's easier to withhold. I know some people try a pull up opened out over the potty or loo.
We also used a Family Toilet Seat which helped with the feeling of the seat being too big for a smaller child.

I am always amazed that there are not more posts like this on toileting. I think when we say about our children ‘they have zero concerns about x’ and yet x is something that is socially unacceptable or something that is causing huge issues (for us and them in terms of development) I’m always at a total loss as to what to do. Because you can’t make someone care about doing or not doing something when they don’t, can you?

I think the options are limited and really revolve around rewards and creating inconvenience (they have to stop and clean up.) ‘Telling off’ and so on are poor options and don’t work!

PP talks about how to get a child to use the toilet but the problem seems to be where they will.., but equally are happy to wee and poo in pants. How do you convey to them that the toilet is the best/ only option?

is he verbal OP?

Im hoping someone can offer a suggestion better than what I’ve been able to. Watching with huge interest if so! OP do school have input, are they working on this? Do they have any suggestions?

Rather than "consequences= loss of screen time for accidents in pants" we find it much more helpful to do "sit on toilet for 10 mins after breakfast = screen time reward".

@drspouse … ok, what happens after that though when he’s left to his own devices, presumably still allowed screen time which isn’t reserved just for the toilet? What prompts him in general life to think that he needs (when he needs to go to the loo) to actually stop, and head to the toilet rather than just going in his pants?

without the social understanding/ motivation I just don’t know how it’s cracked!

The idea is you build up from that.
So then either a longer or more frequent sitting on the toilet, associating it with fun or pleasure during or after.
If the OP DS can respond to questions about whether he needs to go, or even if the OP can just check if he's used his pull up and can start to predict when it will happen, responding to that question can be associated with something he wants.
It's going to be very slow with small steps.

With my pre-verbal DC aged 7, I went cold turkey on nappies towards the end of last summer, as DC was ready and if I didn’t do it then, once back at school DC would have had to continue in nappies for potentially another year (at special school, taken there and back by school transport).

We stayed home from activities for a week, the first day was the worst as DC was weeing everywhere. We have wooden floors so it was the case of me getting the mop out 4 or 5 times in a day. DC did not like the sensation of wee and no nappy, so with the help of toiletting flash cards, DC got there pretty quickly. I had Dry-Nites sheets on the bed for nighttime’s, which DC must have used up to about 10-12 times over the last year as I only bought a couple of packs.

Poo is still being worked on; although DC knows when they need to go, instead of taking themselves off to the toilet, they crouch in a corner and start doing it in their pants. Whichever adult is in the room usually recognises the early signs and takes them to the loo, which DC doesn’t object to.

I did/do lots of praise and encouragement, no punishment, although I have felt the frustration when handwashing a third pair of poo pants in a day!

Absolutely keep going, even if it doesn’t feel like progress is being made, it is. Before cold turkey I’d tried toilet training DC on and off for a year or so, but this time I knew they were ready. Small steps will lead to the larger steps eventually.