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Aspergers and toileting

11 replies

sarah99 · 15/03/2010 11:22

Hi, this is the first time I've posted and I'm hoping to get some advice on the toilet problems my 4yo dd with Aspergers has. Altho ' she's dry during the day she very rarely goes for a pee without prompting. So unless I take her to the toilet she would go all day without doing a pee. I'm concerned about how we'll manage this when she starts school in Sep. Also she frequently soils during the night. The best thing we've tried is encouraging her to do a poo before bedtime - long sit on toilet witha book. Unfortunately this doesn't always work. Any suggestions?

OP posts:
Clarissimo · 15/03/2010 11:29

Hiya

There's a good book about ASD and toilet training called toilet training for individuals with autism and related disorders- a comprehensive guide for parents and teachers by maria Wheeler. I used it with ds3 (Autism) and wished I had been aware with ds1 (Aspergers)

HelensMelons · 15/03/2010 15:54

Yes we have problems too. Atm we are trying to do things that encourage ds2 (9,hfa/adhd)to stay in the toilet longer, as he gets up when he isn't always finished/doesn't have time, etc and we end up very messy.

So, we are trying out a couple of things, first of which is a picture (something that ds2 is into,specialist subjects are dinosaurs and cars - the picture(s) are bluetacked to the wall opposite the loo at his eye level when sitting down.

Secondly I have blue tacked to the sides of the walls on each side of our toilet, sandpaper, one is very rough to feel and the other not so rough. These are sensory things and he can feel them when sitting down. YOu could also try sandpaper on the floor, so that dd can rub her feet on them. It doesn't have to be sandpaper just things with interesting surfaces x

coppertop · 15/03/2010 21:47

My 7yr-old with AS has toileting problems.

The Paed advises giving regular reminders that it's time to go. At school it can be made a part of the normal routine to go at break time and lunch time (or whichever time is convenient for your dd). A good way to do this is to give your dd a visual timetable with the toilet breaks included on it.

For soiling the Paed suggests giving something like lactulose. It might be that your dd is holding it in, getting a blockage, and the poo is then leaking out at night. The lactulose softens the poo so that it's easier to go and therefore reduces the chance of blockages developing.

JillMLD · 16/03/2010 00:14

Hi
My DS is 6 1/2 and has just been diagnosed with Aspergers. He had trouble for years with toileting and has only been reliably dry at school this year (he is in Year 2).
In Reception he frequently came home wet, it drove me mad. If wetness is the main problem then the first thing to remember is that worst case scenario is she will come home wet. Whilst its annoying its not the end of the world, the other children wont notice, they really wont I promise you, and hopefully she wont care either (you didnt mention if wetting herlelf upsets her ? My DS couldnt have cared less ... half the problem .....). You can always send in a carrier bag of spare pants/tights/skirt stuffed in her bookbag so then you arent having to keep track of rapidly turning around school spares if she comes home in a change of clothes.
Obvious, but buy tons of bottom halfs of uniform (tights/skirts/trousers) so you arent stresing about getting them washed in time for the next day.

So thats all worst case. I promise promise promise you she will not be the only child who isnt reliably dry. School wont think you are over fussing if you mention it to them. You will probably be asked to fill in a detialed questionnaire about her likes/dislikes/strengths/areas of concern (if any) before she starts. When she has a visit, if its the same teacher that she's going to have, introduce yourself and mention it then. Mention it again on day 1. Assess how she got on and ask them to make sure she is reminded frequently (even if you think she'll ignore them or say she doesnt need to go). Also remember school toilets can be minging and smell rank so who would blame them for not wanting to go in them ? When she starts, if she does come home wet a lot ask to see the teacher and ask them what they normally do in this situation. They may suggest a timer than beeps every half hour as a reminder, or something like that. Ask them how the children are supposed to tell them they need to go - do they shout out, raise their hand, just take themselves off, or what. This way you can remind her at home what to do.

I've no idea about the poo thing though my son did go through a stage of pooing first thing every morning in his pullup. We did have a potty in his room at some stage but I cant remember if that worked. I think his body routine just changed or something.

To give you some hope - my DS is now (touch wood) dry in the day at school and doesnt come home wet at all. He still has accidents at home (I guess home if more interesting so he doesnt want to leave the xbox/ds/telly to go!) and he is still in pullups at night.

I remember before he started school I was worried about the forthcoming September and how he would be in school and people used to say "ITS A LONG WAY OFF" and I would think "yes yes but he's been wetting himself for years, no way will he sort it out before September" and he didnt, we had some periods where I would get so stressed and angry, but as I say he is loads better now, its just taken time and gargantuan amounts of patience and tolerance.

HTH and sorry for waffling
Jill

ps havent spell checked, out of time!

sarah99 · 16/03/2010 10:48

Hi many thanks for sharing some very useful tips. The pooing at night problem is perplexing because she will actually ask to go to the toilet if she needs to do a poo during the day, altho hardly ever to do a pee. She never goes more than 48 hrs without a poo and - sorry if this is tmi - her poo is always reasonably soft but not really runny. I think a big part of the problem is something to do with lack of sensation. She never wakes up at night when she's had a poo and on the rare occassions she asks to go to the toilet its alway very last minute.

oh yeah i forgot to mention she hates going to toilets outside home and will not go in one if there's a hand dryer - even if its not on.

OP posts:
Clarissimo · 16/03/2010 11:25

Children with AS are more prone to intolerancews- for ds1 its gluten and dairy at the minimum- so it might be worth seeing if that causes the short notice / soft poo thing?

But with ds3 it ws becuase he had hyposensory issues and that's a harder battle to overcome I think, as he genuinely does not realise until short notice regardless of management (we've luked out that he now has a toilet adoration so has to cisit them all regardless LOL, helps loads!)

Another problem with some AS kids is that they simply cannot ask for help / rell someone - that's quite common in fact, the local NAS include inability to ask for help in their list of pretty-much guaranteed issues when providing support ideas.

You might find symbols work with that: a way she can ask and a reminder prompt. We have laminated signs on what we are focussing on with step by step actions to take and we don't just keep them in the specific room: if theya re everywhere they are prompts, similar to a vis timetable with a toilet symbol regularly (I know itc an seem these measures are for more severe kids, they are not- I fell into that gap when we just had ds1, it is only as he ages that we realise how important things like TEACCH are and how well they work).

Also some AS kids can be really funny about private things like the loo: so rather than a picture of a toilet your child might benefit more from just a colour card she can flash if needed.

Finally tehy were talking about visual cues last night and kids who are struggling to build routines around things such as toilet training and suggested that videoing a routine (eg come home, hang up coat, use loo) can work well, the trick is to reward child to watch daily and usually takes about 3 weeks.

sarah99 · 16/03/2010 11:49

Hi Clarissimo, thanks for sharing that. I think my little'uns probs in this area are some sort of hyposensory thing.

She's only just been diagnosed and she's only 4 and tbh we are still coming ot terms with it and on a very steep learning curve. Your point about not using visual prompts etc cos we think they are for more severely affected kids is very interesting. I'm definitely going to look into using visual prompts now.

OP posts:
Clarissimo · 16/03/2010 12:09

If you want to borrow the book I linked to below do email me ([email protected]), it's really good with lots of ideas and I am not using atm its just part of my resource ibrary IYKWIM, happy to loan

Squiz · 16/03/2010 20:39

My son (8)sounds similar with the weeing! He would rather not go, never wets himself though. I have literally trapped him in the bathroom in the morning to make him have a wee before school because he won't use the toilets there. We have a morning routine pinned up in the bathroom so he knows he needs to go.

He still goes for a wee only twice a day - 3 maximum! Doesn't like to go to any public toilets, and always does a toilet inspection when we go away.

He was very easy to toilet train and I guess this is because he either doesn't need to go often or that he doesn't feel the sensation to wee until he is bursting. As long as he goes before school and in the evening I'm happy!

sarah99 · 17/03/2010 11:27

Hi Clarissimo - thanks for the offer of the loan but I've already ordered the book from Amazon.

OP posts:
Clarissimo · 17/03/2010 11:39

Excellent, it really is quite good and actually the way it deals with things gives ideas for other issues IYSWIM

Good luck. Most of all though don't let anyone else make you feel that your child needs to achieve complete training before theya re ready.

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