Toilet Training with Autism
from a CEA parent
My son did not toilet train completely until he was in elementary school. Before he was diagnosed with autism, we read the parenting books written for typical kids. I listened to the other parents in Early Childhood Family Education discuss what they were doing for toilet training and learned that the average age to toilet train was four. Ok, I thought, we have time.
Then our son was diagnosed with autism. We still kept up with the toilet training methods that had been recommended. We dutifully sat him on the toilet – first a little portable potty, then the big toilet with a stool under his feet. We sat and looked at picture books and photo albums, waiting for something to happen and for him to make the connection when it did. When there was finally some “movement,” he looked stricken and immediately cried. He didn’t want to do that again anytime soon, no matter how many times we read Everyone Poops.
We went to a behaviorist. Our son was not conversational at that point, but he seemed to “get it” as the man helped him to understand there was nothing to be afraid of when going to the bathroom. His anxiety seemed to lift after a series of appointments.
And although I had read that many kids with autism take longer to toilet train, all the other kids with in his school program seemed to have the process down, and were independently using the toilet by the end of preschool while he still needed assistance. Discouraged by our own son’s difficulties, but determined to help him, we read Maria Wheeler’s book Toilet Training for Individuals With Autism Or Other Developmental Issues, which was helpful to collect information geared to a child with autism. We implemented many of her suggestions, including staying on a schedule and how to use rewards effectively.
We talked to his pediatrician. Since our son tended to constipation, we tried Miralax. When that didn’t help, we tried Milk of Magnesia, which helped a little bit, but not enough to make sitting on the toilet a success.
Eventually, he did start to get the idea of urinating in the toilet, but only if he was sitting down. It took a couple of years before he would try standing. And still no luck with a bowel movement in the toilet.
And then we went to Anne Dudley’s toilet training class. Although the book had been helpful, it was even more helpful to hear information, methods, and encouragement in person from a teacher who “got it.” She was articulate and straightforward, and patiently answered questions from participants, including my own concerns. There was solidarity being in a group of other parents who were working on the same thing with their children. It helped my motivation and helped me persevere.
It gave me the renewed energy to take the next proactive steps. Although true that many kids with autism simply take longer to master going to the bathroom independently (so that much patience with the process is needed), sometimes there are also extra issues. Although we had already been to the doctor to address our concerns, the seminar gave me the push to consult a gastroenterologist for more problem-solving. It led to a hospital test and medical aid to help “clean him out,” and then eventually to probiotics, which is what finally helped his body to function “correctly” so that he could do his business.
Not everyone’s issues in the class were like ours and some had younger children who were quite close to success – their parents were just looking for that last bit of help to get the job done. As always, there is a lot of variety in the autism diagnosis, so each parent’s child was at a different point in the journey of toilet training. Sometimes our kids need a little extra help to learn, and as parents we need a little extra help to know how to teach them, even with a natural body process. Learning information from a trusted expert and with a community of parents helped all of us to take the best next steps for our child.
Join us for our next Toilet Training class on April 18 and access Anne Dudley’s tried and true tips!
Growing a Foodie, Part 4
It’s time to continue with our top eight tips for guiding your child through their Eating Adventures. Refresh yourself on the first four here!
5) Is it a motor planning thing?
Sometimes physical barriers keep your child stuck in a food avoidance pattern. Our son was not wild about meat, partly because he had trouble chewing it. As he got used to using his back teeth to chew (with the help of one of those sensory chews his occupational therapist provided), he was able to chew the meat better and found he liked it. He needs his protein, and meat is his main source. So discover if physical limitations are behind your child’s refusal to eat certain foods.
6) Expected behaviors apply to mealtime too
Trying new foods and appropriate mealtime behavior are part of the expected behaviors we have for our son, and we try to reinforce this through explanations of what those behaviors are. These explanations are like a verbal Social Story in our house. You could always write your own Social Stories for each of the issues your child may be facing at mealtimes, whether is is trying a new food or staying at the table. Parents sometimes think eating should be an intuitive process, but I have found my son needs as much explanation, modeling and reinforcement with eating as he does in other challenging areas of his life.
7) Experts can help
It’s worth considering a multi-vitamin to make sure your child is getting the vitamins and minerals she needs. Consult with your doctor if you are worried about your child’s nutrition. Our doctor was able to reassure us that our son’s growth chart was just fine, even with his limited diet. Try an occupational therapist if you have concerns about your child’s aversion to certain textures and tastes. And there are several centers that offer food clinics, where they specifically focus on addressing issues that interfere with eating. (See comments section for other local feeding clinics.)
8) I’m too tired
There is one more reason why it can take so long to get my son to eat new foods: sometimes I just don’t have the energy to make the effort. Or the energy I have may need to go toward another issue that he is dealing with. I’ve learned that’s okay. If I’m stressing about finding foods for him, it doesn’t help. I love food and family dinners, so ultimately I want to make mealtime enjoyable, for all of us.
Taking it slow and steady helped keep me and my son relaxed during his process of learning to eat. I never thought curried lentils would be a standard meal in our house. But through helping our son try new foods, he has found a surprising favorite, and we did too!
This wasn’t enough, right? Discover the rest of Margaret’s tips and more at Food and Autism on February 28! more info>>
Read Part 1, Part 2 & Part 3 to discover all of Margaret’s great tips!