Adventures in Toilet Training an Autistic Child: Part II

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When Austen was about four and a half, he had finally overcome his fear of the toilet and could intermittently use it to pee. Now I needed to figure out how to get us from "intermittent" to um, mittent? Hm. That is, to a point where he could use the toilet for all his waste release needs.

I started by whisking him into the bathroom first thing every morning, when I knew he was likely to have to go. I'd sit him down on the toilet and stay with him for a few moments until he'd emptied that nice full morning bladder. Now, you'll note, I said "sit down." Yes, he's a boy, but I'm both personally in possession of girl parts and am the one who cleans the bathroom. So, while there are other innovative ways to handle the problem of little boy pee, I did what worked for me.

Now we had to expand upon our one successful toilet use of each day and demonstrate that using the toilet was something not just reserved for the first pee of the day. So I did that thing you're supposed to do when toilet training kids: I put him in some exciting big boy Thomas the Tank Engine underwear! That motivates kids, right? Their favorite licensed characters tucked snuggly in their pants? No. My son was horrified. It was as if I'd asked him to defecate on a statue of the Virgin Mary. Put the sacred image of Thomas the Tank Engine on what was (as far as he was concerned) a diaper? It was an outrage. He'd have none of it. So we moved to dull briefs, which he treated as a new form of diaper, bothered not at all by the supposed discomfort neurotypical children were said to encounter on being wet and dirty.

This was not good. Underwear was harder to clean than diapers and provided no incentive to use the toilet, swiftly defeating the entire purpose of toilet training. So, I ditched the underwear, went to a strict policy of total nudity and stuck to only non-carpeted areas of the house. The floor was much easier to clean up.

Now all we needed to do was create a link between the need to empty bladder or bowels and our new friend the toilet. I'd explained this all, of course, very logically, using that old standby: a sticker chart. "When you need to pee or poop, go in the toilet. Then Mama will give you a sticker and when you get five stickers you get a prize." Austen would nod dutifully, sit on the toilet, get up and go pee in a corner fifteen seconds later.

But I was so not giving up. Not! Do you hear me? I reasoned that if he spent more time on the toilet than off (or close to it), he would have to pee there eventually, if only by accident or boredom. Then we could get a sticker and have a parade and reinforce what an absolutely fantastic and wonderful thing the toilet was. So, I got out the timer and started having him sit on the toilet for at least two minutes every ten minutes. And he still peed on the floor. So we tried every five minutes. And he still peed on the floor. But, I repeat, I was not giving up. So we tried every minute. And he got mercifully tired of being interrupted every minute for an hour to be reminded to pee and eventually... He peed in the toilet! He really did.

So our days went by. During toilet training time (which was limited to a few hours a day for all our sakes) he was naked and had to sit on the toilet every few minutes. (During the rest of the day and night, he was still in a diaper.) As he proved to me that he had things figured out, I gradually lengthened the times: using the toilet every five minutes, every ten minutes, every thirty minutes. And, as promised, every five (or eventually ten) times he peed, he'd get a prize. We also added underwear in, boxers this time, as the snug feel of briefs seemed to remind him of diapers, which led to accidents, while the loose feel of boxers seemed to give him that necessary non-diaper sensory feedback.

While we were making progress with the bladder, we were stalled at the bowels. I could tell when he needed to poop (almost all kids have a tell), but afraid that he'd "fall in" while pushing, he'd hold onto those bowel movements for dear life until the second he was back in a diaper. Still, desperate times call for desperate throwing of money at problems. So, I promised him that if he would poop in the toilet, even a little bit, I would put him right in the car, drive him to the toy store and buy him a brand-spanking new $20 (why are those things so freaking expensive?) Thomas train.

Each time I saw that he needed to go, I'd scoop him onto the toilet, and say, "Come on, baby! Thomas train! Right now! Let's go!" I held onto him and promised he wouldn't fall in. I gave his feet a little stool to rest on. And somehow, after days of trying, in spite of the weird feeling of using the toilet for a bowel movement, he went a little bit. True to my word, I loaded us up into the car and made a grand production of driving to the toy store and buying a train. And I did it every time he had a bowel movement until he was so hooked on the toilet and disgusted with diapers that he gained his own internal motivation and (thankfully) stopped needing to be bribed with trains. Yep, I accrued a lot of trains (and debt) but Austen was out of diapers before he was five.

Now if I could just get him to wipe...

Adventures in Toilet Training an Autistic Child: Part I

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To those of you without children, there are probably few things less interesting or appealing that the subject of toilet training. The fact that we parents engage in such discussions with amazing fervor may even make you wary of having children of your own. (What has happened to parents to make them so weird and boring?) But the truth is, we're enthusiastic about toilet training because we're really, really tired of being so involved in the products of someone else's bowels.

Almost all parents nurture a secret despair that their child may never learn to use a toilet. They picture their children packing up the car to head off to college still wearing diapers (and unable to sleep through the night). Most kids do figure it out eventually, but for some it's a lot more work than others. And it can be especially challenging for autistic children. My son toilet trained at 4, and after having helped him successful navigate that transition, I felt like I should be the reigning toilet training champion of the world. (Really, why aren't there ever Olympic competitions in categories I know I could win?)

The first challenge we faced, like many other parents of autistic children, was overcoming Austen's fear of the loud, cold sensory nightmare known as the toilet, which happens (unfortunately) to be located in the echo chamber that is the bathroom. While Austen was ok with taking baths, it took some work just to get him to venture into the vicinity of the toilet itself. We spent some time trying to get a sense of exactly what it was that was disturbing about the toilet and found that, for him, it was of the sound of flushing and of toilet lid and seat bumping against porcelain as it was raised or lowered.

We put rugs on the floor and covered the seat to help muffle the sounds. We had also found that Austen was less nervous about sounds when he was able to control them, so we had Austen slowly take control of raising and lowering the lid: first by having him direct us so that we would move slowly, carefully and quietly, and then by having him do it himself. We gradually made the flushing more tolerable by having him stand outside the bathroom as we flushed. We moved him closer, bit by bit, allowing him to cover his ears, until he was able to get close enough to flush for himself with our hands over his ears. After several months, Austen was able to touch and flush the toilet comfortably.

Next, we began Project Sit on the Toilet. Austen clearly thought putting naked flesh on the cold seat and hanging over a big watery abyss was nothing short of insanity, so he sat on the toilet clothed at first with the lid closed. From there we moved to having him sit clothed on a training seat that fit over the adult seat; we held him to reassure him he was not going to fall in. (He seemed to be convinced that he would be the first 4-year-old in human history to fall into that tiny training hole.) Eventually he was able to sit on the toilet with his diaper on. I had him practice sitting on the toilet first thing in the morning, when I knew he was most likely to need to pee, and as he grew comfortable with sitting there, he would pee in the diaper while on the toilet. However, at this point we got stuck. We could not get him to take the diaper off, which as you can imagine, really defeats the purpose of toilet training.

Fortunately, I was determined, innovative and totally, totally sick of changing diapers. One morning, I put him in a diaper with a hole cut in it, so that what would have gone into the diaper would fall into the toilet instead. The first time Austen tried it out, he was a little surprised by the tinkling sound of urine on water, but he held it together, and after a few more days of practice, with gradually widening holes and gradually disappearing diapers, we began to approach the point where most other children start the process of toilet training...

Tune in for Part II tomorrrow!

Subscribe to my New Site Feed

I'm in the process of moving my blog to a new server and switching the location of the feed. I noticed that, after I started experimenting with my feed, my subscriber numbers dropped by triple digits in one day. Now either a lot of you started to really, really hate me all of the sudden or I've screwed up my feed or both.

So, for those of you who are still here, and do still want to follow me, please take this opportunity to subscribe to the nice, shiny, new, working feed:

feeds.feedburner.com/aroomofmamasown/lCPA

The current feed seems to be working for me for now, but I am going to shut it down when the new site is ready to go. So, please resubscribe to the new feed and unsubscribe from the old, even if it is currently working for you too.

I'm not really sure what to do about the folks who disappeared. I guess that will teach me to mess with this stuff and all of you not to trust me to mess with stuff.

The Greatest Amend of All

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I was recently working with my online step group on Step 8 of the 12 Steps. This is the one where we make a list of people we've harmed and become willing to make amends with them. One of the exercises we completed asked us to name the person we'd harmed the most and think about how we were going to make amends...

Do I owe you amends for making you click over to read the rest at The Second Road?

The Quest for Humility

Step 7: Humbly asked God to remove our shortcomings

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I've been going through the process of working the 12 Steps around my own personal craziness, and last week, I reached the point where I was supposed to humbly ask God to remove my shortcomings. Whew! That has so many problematic words in it. I mean even if we forget about "shortcomings" (because, let's face it, don't most of us want to keep on keeping on with the ignoring in that department?), we have words like "God" and "ask" and "remove" and (trickiest of all) "humbly."

I do most humbly beseech you to read the rest at The Second Road...

Haiku of Haikus

I said to the kids,
"I'm off to write some haikus."
"What are haikus, Mom?"

"They are poetry."
"Well, what is poetry then?"
"That's a good question."

"Hm. Poetry is:
words arranged in a rhythm.
Poems have a beat."

"Like spoken music
poems can go 'Bum da bum'
and sometimes they rhyme."

"A haiku has beats.
It has five in the first line,
then seven, then five."

Mark said, "I'm impressed.
Now explain it in haiku."
Ha! I just did it.

Guidelines on E-mail Solicitations

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I get a lot of e-mail each day, and adore most of it. I smile and laugh and cry as I read, because most of it is from people who can relate to what I write about and who want to share their experiences and thoughts and hopes and fears.

So, if you are thinking of writing me a personal e-mail, go for it. I'd love to (virtually) meet you or get to know you better. If you have built a relationship with me and want to forward me a cool article on autism or addiction or share something about a cause that's important to you, go for it. (I get some great post ideas for all of you.) I really love to hear from you bloggy friends, even if don't always get back to you in a timely manner. (Ahem. To the 196 people whose messages currently sit in my inbox tonight: I will respond someday. I promise on my codependent perfectionist honor.)

However, some of you -- the ones who most need to read this post and probably never will, because you don't tend to actually read the blog at all -- some of you are a little spammy. So, I thought I'd offer a few guidelines for those who are considering sending me a solicitation:

• I don't do link exchanges. If you would like me to link to you, do one of two things: 1. Be nice, build a good relationship with me, read and comment regularly or 2. Pay for advertising space.
  
  
• I won't write free posts about products or services. While I know you think that your camping gear or organizing software or recipe finder is the coolest thing ever, unless it is an affordable robot manservant that will do my dishes and laundry and clean the litter box, I'm not going to get so excited about it that I will spontaneously spend an hour of my "me time" writing a post to endorse it for free. I will, however, consider doing it for money or a free robot manservant or a really cool on-topic book.
  
  
• I won't write about your charity. As much as I'm sure that your cause of feeding hungry children or ridding the world of landmines or greening our energy is very important, I'm not going to post about it either. There are just too many causes and too many organizations for me to determine which ones deserve my time and energy. And I have trust issues. Read the blog. Somewhere deep inside I suspect you all of being computer savvy heroin addicts posing as charities for drug money, and I don't feel it's an effective use of my time to do the research necessary to build trust for every one of the bazillions of charity solicitations I get. I do have causes I work on in my real life, but I prefer not to link those to the blog for anonymity reasons. Please send me celebrity sex addiction gossip like everyone else does instead.

Oh, and it's ok if you didn't get around to reading all this. You'll get another chance. Gmail has this cool canned response feature, so you'll just be getting an edited version of this post back if you do write.