A guide to potty training kids with autism.
On Thursday I visited a friend’s blog and the post was about potty training. She was asking for tips or advice for potty training a child with special needs. Her ADORABLE son has epilepsy, but epilepsy or not we all know potty training is dreaded by any and all parents. First let me say, I am NO expert in potty training. In fact I dreaded it like a horrible plague!! Cali was a difficult one. Ava made me think…wow, is it really that easy!! Every kid is absolutely different so every potty training tip, book, video, or article will prove faulty in some area or another. One vital bit of information I have learned through potty training the girls, is to expect the unexpected. Be ready for things to not turn out the way you planned. For instance, Cali went two rounds with potty training. First round did not work, so we readdressed it four to five months later. Second round was still no walk in the park. Ava also went through two rounds. I initially thought she would get it down the first time. First time was torture, and round two was a breeze. After trying and then going back to diapers, I was positive diapers and wipes would continue to be on my grocery list for at least another four to five months. Well, only a short month later and she decided to wake up one morning and tell me she didn’t want to wear diapers anymore and that was that! I was singing praises that whole week!!
I remember Cali’s first round and feeling fully prepared and ready to go. It’s one thing for the mom to be completely prepared and ready, but if the child is not, there is no way it’s going to work. I tricked myself into thinking both Cali and Ava were ready and prepared to rid themselves of diapers. I guess my next advice is to REALLY know whether or not your child is ready to take the plunge. I guess that’s the magic question, huh. How do you really know when they are ready? Especially a child with special needs. Madi, Cali’s therapist, did me a huge favor by providing me with a number of different tips and advice to help answer this question and more.
The information I am about to give comes from The Best Practices Newsletter Of The Interdisciplinary Council on Developmental & Learning Disorders, (Vol. 7 No. 2).
Here are a few questions posed from a parent in Chicago:
1. How will I know that my son is ready to train?
When your child is related to you and wants to please you, as well as himself. When he alerts, orients to and listens to his own individual cues and communicates them nonverbally or verbally.
2. Given his sensory issues, how will I know if he is reading the internal signs that he needs to use the bathroom?
He will let you know in many ways, that he has developed the capacity to communicate his wants, needs, and ideas. You will find yourself in situations with him where he says, “mama, I’m thirsty” or takes your hand when he wants you to play with him. When he knows what he wants in other situations, and he can communicate that to you, he will be ready to begin gaining control of his toileting habits. Again, this is a function of him being developmentally ready for mutual communication, having an ongoing awareness of his own individual cues as well as his own motivation to experience this growth within his relationship with you.
3. Given his challenges in staying focused and difficulties sitting still, how can I help him stay seated long enough to allow his body to work?
Make sure that it is enjoyable and consistent, and be persistent. Build up slowly to sitting for a reasonable period of time, taking his individual differences into account. Pair your knowledge of his tolerance of quiet sitting with your capacity to enjoy being with him, so that he doesn’t think of it as sitting, but he thinks of it as relating with mommy or daddy, and finally make sure that he is eager for the developmental step of becoming a ‘bid boy’ in your eyes.
4. What should I do to help with the process without creating a “pressure to perform” issue for him?
Pressure becomes destructive only when the child is not developmentally ready to be a ‘big kid’, when your son or daughter has individual differences that slow their learning to orient to their own internal tension. Finally, and maybe most difficult of all, learn to cope with your own anxiety around toilet training without allowing it to spill into your relationship with your child, so that your relationship with your son supports your son’s attempts whether they are successful or not.
5. What words and actions are appropriate praise for his successes?
Just like you would for any other activity that your son is participating in, observe how he is engaged in the process, not the outcome. Use your relationship with him to let him know that you see how hard he is trying to learn this skill. Encourage him to find his own individually meaningful sources of self-esteem, rather than simply praising him. For one child it may be that he did ‘what pap wants me to do’. For another child it may be that his individual differences make it extra hard for him to feel the good feelings of accomplishment in his body. For that child you might want to find many many moments of accomplishment in-the-moment, so that he builds an internal memory of ‘I can do this’.
6. What words and actions are appropriate for times when he has “accidents”, so that we don’t compromise his self-confidence?
Follow your child’s individual differences and let him know that your understand his bodily needs and everybody has accidents, all their lives. Rather than avoiding the disappointment of not being ‘master’ of his body, use this opportunity to deepen your relationship with him so that he can learn to repair his self-esteem.
7. Is an award system appropriate for a child with sensory challenges- such as a gift of stickers for each success on the way to learning to use the potty (from sitting on the potty to actually using the potty)?
External reward systems can be useful, but most children figure them out within a week of being implemented. They are a sort of script that does not support the on-goingness of intentional toileting capacity that your are encouraging with the relationship with your child. It rather helps develop the initial developmentally supported intention to “try sitting” on the potty, and then using it to explore a new way of ‘letting go’.
8. Should he watch videos and should we read him books on the subject?
If this activity is one that you and your child already share, yes, by all means use whatever activities you and he find mutually engaging and statisfying to help you help him develop the capacity to persist at an activity in relationship with you. Often rigid consistency in our actions leads to a lack of developmentally appropriate exploration and we do not want to go down that road.
9. Should we encourage him to use the potty at various routine points during the day, for example, upon waking from nap, before a bath, before bedtime, after a meal…?
Yes- consistency but not rigidly. When we adhere to a ‘rigid schedule’, we rob our child of learning about what happens if he doesn’t listen to himself when he has to go. We assume the responsibility for his success. rather than using our relationship to help him grow into that responsibility. Helping our children develop the capacity to be consistent in their orienting to their own individual ‘I gotta go’ cues can be supported by our noticing that they need to eliminate around the same time every day. But, helping them develop this awareness has to be paired with enticing them, or wooing them into making it their own responsibility is the developmental step we want them to navigate.
These questions are from one mom for her own individual son. You may have many more questions and some of these may not even apply. I hope they can be of service to some of you. I know they helped me when I was going down this road for the second time with Cali.
Tuesday’s and Wednesday’s post will also be dedicated to potty training.
Tuesday: Considerations For Toilet Training, Lisa De Faria, MSW, LCSW
Wednesday: Toilet Training- Suggestions for the Child with Challenges, Beth Osten, OTR/L
Let me know of any questions you may have or tips and tricks you have used during your own trip through potty training. Yes, a trip. With twist and turns, tears and joyful praise, and everything in between. Oh potty training, why can’t we just make you simple and easy.