Advice for potty training SPD child? **UPDATED**

[KatherineNaomi]

Hi, I have a 4, almost 5 year old (in March) son with SPD. He has low muscle tone, is sensory seeking mostly, gross and fine motor delays and a severe articulation delay. We've been struggling with potty training and am hoping to get some support/advice about what to do. For a long time he'd been unable to tell if he was wet or dry but he's made some progress with that recently so over the holiday break we decided to make the switch to underwear and see how he did.

We've had almost as many accidents as successes over the last 2 weeks but he's actually peeing in the potty occasionally which he'd never done before. No poop yet though. He doesn't seem to have any control over over his bowels/bladder yet or he doesn't recognize the signals of needing to go. We've been sending him every hour or so and just seem to get lucky if he actually goes. The strange part is he usually doesn't wet at night and wakes up with a dry diaper 90% of the time. I think we'll stick to underwear at home (and do lots of laundry) for the time being. Is anyone else in a similar situation or has your hard to train SPD child finally mastered the potty? IS there something else we should be doing to help him progress? I'm going to talk to his OT tomorrow and get her input but I thought there surely must be another Mom here that's been through this too. Thanks for reading!


***UPDATE 5/13***

I just wanted to share our happy update in case anybody else is dealing with potty issues with their SPD/under responsive child. After I posted in January we decided to back off a bit and wait and try again later. Well, a couple weeks ago we decided to try again and the waiting paid off. He was just ready this time. Something must have clicked for him because he's finally able to recognize when he has to go. He had some accidents in the beginning but he's peeing and pooping in the potty all the time now and can tell us when he needs to go! He's doing so well we can even bring him out in public in underwear without issues. The best part is seeing how proud he is of himself!

[KimPM]

My DS has SPD and low tone in his trunk area. I tried numerous methods, but nothing got through to him until he went naked (on the lower half). Then he could actually SEE when he was peeing. Still, it took a few weeks in this half-naked mode for him to get the idea and make it to a potty somewhat reliably. I got this idea from the book Stress Free Potty Training. After the weeks of half-naked mode, when I switched back to underwear...oops accidents again. I guess it reminded him of his diaper/trainer days. So I put on him the tightest pair of pants he had...without underwear. That was sufficiently different to him that he figured out that he needed to hold it until he got to a potty. Once that was working (a few weeks?), then I added back in the underwear and regular pants...and we were pretty much there. That was around age 3.5. He's 4 now, and he's been getting to the potty when he has to go...but usually he's already wet his underwear a little bit. So we still go through at least 5 or 6 pairs or underwear a day. I think that maybe he's not quite feeling when he has to pee...until he's already starting to go. I'm not sure if it's related to the hypotonia or what. My mom thinks it's fairly normal for boys to be like this.

As far as poo training...that happened later. He was pretty resistant to sit on the potty for that. But as luck would have it, during this time he had some serious constipation. So, I gave him some glycerine suppository, and suggested he sit right down on the potty after that. Somehow, this one time got him over the fear of going poo on the potty. I would never suggest someone use the glycerine just for potty training, but I just got lucky with the timing of his constipation episode.

[sbgrace]

My sensory seeking low tone kid wasn't successful until we did it naked on the bottom half. After going on like that for a couple of weeks (successfully pretty quickly) we went back to wearing pants and he had accidents as if we never started. Naked again. Success. I was confused. Then I decided to try commando (no underwear) and he was successful. We went like that for a while and then added underwear without a hitch.
I don't know why it worked but I think the underwear felt like diapers to his body/mind.
He actually did poop at the same time as the pee training (again, accidents with underwear/got it naked/without).

My other son was resistant to pooping in the potty. He would refuse to go without a diaper. I tried everything I could think of with him. My dad babysat one day and he went on the potty. My dad said he didn't do anything just suggested he try the potty when Caleb asked for a diaper. I think he was just nervous about something new perhaps or sensed pressure from me.

edited to add: interesting that KimPM had a similar experience with her son.

[KatherineNaomi]

Thank you so much for sharing your experiences! He really hates to be naked but we did try going without under wear while wearing pants. Not a lot of progress with that yet.

Over the last few days we've had issues with him withholding both urine and BM's. I'm wondering if he's feeling too stressed out and we need to take a step back? It was so bad tonight that he was wiggling with discomfort on the potty for a long time but just would not or could not pee. He kept asking for us to help him but there's not much we can do except sit with him and comfort him. He was so uncomfortable that we had him get off the potty and we put a pull up on him. He peed about 10 minutes later, the first time he'd peed since this morning. Ugh.

[KimPM]

Originally Posted by KatherineNaomi

Over the last few days we've had issues with him withholding both urine and BM's. I'm wondering if he's feeling too stressed out and we need to take a step back? It was so bad tonight that he was wiggling with discomfort on the potty for a long time but just would not or could not pee. He kept asking for us to help him but there's not much we can do except sit with him and comfort him. He was so uncomfortable that we had him get off the potty and we put a pull up on him. He peed about 10 minutes later, the first time he'd peed since this morning. Ugh.

Yes, it sounds like he is too stressed out over it. I would take a break from it for now. Maybe there's another way to approach it (after a short break), like trying to get him to sit on the potty with his pull-up on. I did stuff like play cards with my DS while he was sitting on the potty. I also let him play with a toy that I would only give him when he was sitting on the potty. Maybe keep the stress level down by not asking that he actually pee on the potty. Just get him to sit on it for some (short) length of time. And have an activity that will be ... fun?, pleasing?, at least not boring to him....to make potty time more interesting. There are some good books that I read, like the "Stress Free Potty Training" and "Toilet Training for Individuals with Autism and other Developmental Issues". Those might give you some ideas. The Autism book talks a little bit about withholding problems.

A final thought...do you think he's having any pain while peeing? Or any itchiness? That could trigger withholding.

[InMediasRes]

This is really interesting. DS was partially ECd, so he pee trained at 2, but we're going on a year now of him withholding BMs until he has a diaper. Even suggesting the potty will induce panic. He has a very set routine for pooping and will hold it until he can do the routine, even if we're out.

We also did the final move from diapers naked on the bottom. When he could see that the pee was coming out, he could link that with sensation and we just kept a potty in the living room so that he could get to it really quickly. I'm not sure how this translates to an older child. We also had the same experience of undoing all the progress when we moved to pants until about 6 mo after we started, and then we just reminding him more frequently, and he's got it down now, almost a year later.

[KatherineNaomi]

Update in first post

[KimPM]

Originally Posted by KatherineNaomi

***UPDATE 5/13***

I just wanted to share our happy update in case anybody else is dealing with potty issues with their SPD/under responsive child. After I posted in January we decided to back off a bit and wait and try again later. Well, a couple weeks ago we decided to try again and the waiting paid off. He was just ready this time. Something must have clicked for him because he's finally able to recognize when he has to go. He had some accidents in the beginning but he's peeing and pooping in the potty all the time now and can tell us when he needs to go! He's doing so well we can even bring him out in public in underwear without issues. The best part is seeing how proud he is of himself!

I love to hear success stories!

[LMI Mom]

Congrats on your son's accomplishment! It's great to hear what's worked for others as well.

We've tried a number of different methods with DD and nothing works. I'm about to attempt the naked from the waist down method when our weather gets a bit warmer, but at this point I realize it's her decision and we may have to forfeit her preschool slot for Fall.

How does your son cope with public restrooms? My DD is terrified by flushing toilets and hand dryers to the extent that she won't even step in to a bathroom with me, much less pee there.

[KimPM]

Originally Posted by LMI Mom

How does your son cope with public restrooms? My DD is terrified by flushing toilets and hand dryers to the extent that she won't even step in to a bathroom with me, much less pee there.

You can get a travel potty and hand wipes. We have one and I usually take it with us. He's gone potty in the travel potty in the back of my wagon many times. I've also set it up in a semi-private area as well.

[KatherineNaomi]

He's doing ok in public restrooms but definitely prefers to go at home. He's sensitive about loud noises so I always warn him when we need to flush, etc. Also, I try to use the family bathrooms wherever possible.