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Autism and potty training age

post #1 of 18
Thread Starter 
For those who have high functioning autistic kiddos, at what age did they begin to potty train and when did they finish and were able to potty on their own?
post #2 of 18

I'd like to know too, we're at 3.5 with NO signs of interest. crap.gif

post #3 of 18

I don't have children of my own but have supervised or been part of the PT-ing team for quite a few kids on the spectrum, both low and high-functioning. And I think all of them we began between three and four years old.

We didn't wait for interest since only one of the kids actually cared about it. But it was important both for the family, and for the child (socially and physically) so we began and did it pretty intensely.

IME, most kids learned to pee within a week and then with few accidents after a month or so as long as we were very consistent with timing, and making sure they had many opportunities to go throughout the day. Poop took a lot longer for some kids than others, depending on how much time they needed and whether their BMs were soft enough to go in a reasonable amount of time. Benefiber is a wonderful fiber powder that you can add to juice that is tasteless and has no texture. Lots of kids who are having trouble poop-training have a much easier time after taking it regularly. For other kids, something simple like apple juice once a day does it as well. And some kids just need a longer time in the bathroom to feel comfortable pooping, so a portable DVD player can be very helpful.

That's just a few details but my main advice is don't wait - start right away because there are lots of things you can work on even before they are actually going in the potty, and once you start, do it all day long with lots of yummy stuff to drink so that they get lots of chances to go.
post #4 of 18

I'd say he was about 4 when he stated to potty-train. He was 5 before he stopped having frequent (multiple times/ day) daytime accidents. He was just-turned 8, or nearly 8, when he was able to be dry all night.


It was definitely a very stressful issue for all of us.

post #5 of 18
My son started potty training a couple of months after he turned 3. He was already dry at night by that time, so we knew he had bladder control. I took advantage of his summer break from preschool to do potty training. I started with schedule training and he was using the potty reliably by the time school started up again at the end of the summer. He remained schedule trained for many months and then eventually started to initiate when he had to go. DS is now 6.5 and is mostly potty-independent. He still needs help wiping himself. And he has difficulties with snaps and zippers on a lot of pants (fine motor delays) so he wears elastic waist pants to school.
post #6 of 18

DD(5) whom we suspect of having AS, potty trained(pee) just after 4, poop happened about 3-4mo after. She never really showed interest so at 3.5yrs we started requiring her to sit on the potty at certain times a day for certain periods, then we showed her the "Potty Power" dvd and read tons of potty books and those helped a lot. What finally got her trained was me following her around and sticking her on the potty whenever she looked like she had to go.

post #7 of 18

My ds isn't on the autism spectrum, but a cousin who is high functioning autism trained ca. 5 and my nephew who has asperger's trained at 4.5.

post #8 of 18

My ds is nearly 8 and he was dry at night at 3 and had a lot of trouble potty learning---it eventually clicked at 4. He still has a pull up to BM though. He has muscle tone issues and OCD issues around the toilet in this area---it's his preferred place to stim and we have had a LOT of trouble getting him out of those pullups for BM. He has "retained" for over 2 weeks before when we have taken them away---


If anyone has any help for us in that direction it would be wonderful.

post #9 of 18

My spectrum son (pdd-nos/mild) trained a few months before he turned four. I didn't wait for interest for him because there were no signs and I saw none on the horizon. It was a disaster until we went commando and then he was a piece of cake. He trained within the week as long as he was commando. Transitioning to pants and then underwear with pants took longer for him. I think it was an awareness issue. His urine and bowel training were simultaneous. I can't remember if he night trained before or after daytime training. We didn't work on nighttime though. I just quit with diapers when he was consistently waking dry.

post #10 of 18

My son learned at about 4 1/2.  Five months later the poops are still a bit of an issue as far as he tends to withhold, but he doesn't poop in his pants.  He will ocassionally have pee accidents but it doesn't seem like any more than an NT child.  I do still have to remind him to pee though, he seems to not have that awareness 100% yet.  Like sbgrace I didn't even try to nightime train, just stopped putting on diapers when I noticed he was waking up dry every morning.

post #11 of 18

I never even considered this connection, interesting.


My son was quite late to potty-train.  Around 4 I think.  He's now 12, and only this past spring was dx'd with Asperger's.  


Because of our experiences with him, I came around to be a believer in Elimination Communication.  We did that with my daughter from birth.  She was fully potty-independent by age 2.  She's now almost 4.  But, she seems to be completely neuro-typical.  


I still think that if we had done EC with my son, though, he would have been independent much sooner.  Diaper-training can be very difficult for "normal" children to unlearn.  And now that I think about it, I imagine that for ASD kids -- for whom routine is everything and any change can be traumatizing -- getting the idea that peeing and pooping in their pants, like they've been doing their whole lives, is NOT what they're supposed to do, would be an incredibly difficult thing to grasp.  Once they've learned that they're supposed to just let go in their diapers whenever they feel like it, then BAM that's the rule, forever and ever, as far as they're concerned.


So I've become an advocate for not just "waiting until they show interest", for all kids not just ASD kids, because that's not part of natural child development.  Their instincts are not programmed to gradually shift from peeing in their pants to peeing in a potty. Rather, they are born with instincts to eliminate and over the first couple of years they become adapted to whatever elimination 'rules' are foisted upon them -- and in fact their first instinct at birth is to pee when naked, not when covered up.  We first untrain that instinct to make them pee in diapers, then have to re-train it years later.  Some kids manage that transition just fine, others don't -- and I can imagine that ASD kids would have a much harder time with that change.


I'd love to be able to go back and do things all over again with DS.  I truly wonder what difference EC might have made for him.  And it's actually a bit of a relief to realize that his very late training could have had something to do with his Asperger's, and it's not just that "mommy did things wrong" -- mommy guilt gets us all the time, doesn't it?


Hmm, my nephew, currently 4, is still having a hard time toilet-training.  I confess that I've quietly thought to myself (and hubby agrees with me) that it's in large part because his parents were so lackadaisical about diapers... meaning he was just always covered up with diapers, they even started off using cloth but switched to sposies because it was easier and they stopped caring.  Just not thinking about the effects of anything.  Anyway, we're starting to suspect (though his parents refuse to see it) that he's got ADHD or ASD or sensory issues... a lot of his behaviour looks very familiar.  Interesting.  

post #12 of 18

My high functioning spectrum kiddo was daytime potty trained at 3.5 years of age.  Now at nearly 5 years of age, she is night time potty trained as well, but she did that totally on her own.  I don't know how she night trained herself, but she'll wake up now to use the bathroom.  Woo-hoo!

The daytime potty training was done by taking away the diapers and taking her to the toilet every 30 minutes.  We gave her tons of water and made the bathroom a really reinforcing place with all her favorite books and toys. We had the help of an ABA behavior therapist who told us what to do.  It really helped to have her as a resource.  It took about I think 3 weeks for her to get the daytime potty training down pat.  I STILL have to remind her sometimes to wash her hands or to take her time to wash her hands. We've told her to sing the ABC song when she's washing her hands, but she zips through the song and is done in like a few seconds.  So although she doesn't have any accidents now anywhere, the flushing and washing hands still requires reminders.

post #13 of 18

When ds was around 3 years and 7 months old he had never even sat on the toilet. Completely refused anything to do with it. One day while giving him a bath I caught him "teaching" his Percy train to pee. I grabbed that opportunity and ran with it! I told him he was a big boy and that big boys wear underwear (before that he wouldn't even put any on). He got out of the bath and put on underwear! He started peeing in the potty that afternoon! That bedtime I grabbed a diaper and he told me "no mama, that's not the way we do it" (which meant he's a big boy so he won't wear diapers anymore). I let him sleep in his underwear and he stayed dry all night! From that day on he was day and night trained (pee and poop). He had maybe 5 accidents in the next month and that was it. I was so totally shocked that it was *that* easy, just because it was what he wanted at that moment rolleyes.gif


Now at age 7 we just have issues with him not wanting to wipe after a poop. He will sit in the bathroom screaming for me to come wipe him. I don't know where this came from because he used to wipe himself with no problems.

post #14 of 18

We started EC (elimination communication) long before we knew ds was on the spectrum (HFA, now age 5.5 yrs).  I think he might have been around 9-10 mos old, but he looked so much younger sitting on the little potty b/c he was a 29 week preemie! We didn't go full on EC, but we did put him on the potty whenever we took his diaper off if it was convenient (ie at home or at my mother's) and when we knew he needed to poop.  He became fairly predictable w/pees, although he still had wet dipes.  Around 20 mos old or so, he started showing a bit of interest in peeing in the potty on his own, so pretty soon after that he was in pull ups and mostly peeing in the potty.  But poops were a different story--by 2.5 yrs old, he had daily diarrhea and we were off to the GI.  So, he really didn't have a lot of interest in pooping in the potty.  Eventually he started getting constipated, and then we were sunk! LOL He ended up w/encopresis.  The short story version of the road to encopresis is a sensory one, that he couldn't express until very recently.  He does not and did not like the way poop felt coming out--he has sensory issues, plus it had been diarrhea for so long, that it really bothered him.  So, he started holding it.  The secret has now been getting the poop soft enough to not trigger such a strong sensory response AND treating the sensory issues themselves and the resulting anxiety with medication for anxiety (zoloft).   The medicine has helped him gain ground in so many skills in the last six months--it's amazing.  For him, it was the right choice, and I wish we had agreed to try it for him sooner.  He now can poop on the potty himself, rarely holds it and ends up leaking, and doesn't wear Pull Ups at all (last school year, he wore Pull Ups to preschool, which was tough--he was the only kid in the class wearing pull ups).  It's been a long road to total potty training, but the biggest obstacle were his sensory issues.  If the GI had understood that better, we could have had more help much sooner, and saved ds a lot of upset and stress (both from us and from other family).  We weren't really mad at him, just frustrated w/the poop in the undies all the time....but we had to protect him from other family members who felt that they should berate or belittle over it. 





post #15 of 18

I hesitate to put my ds on Zoloft---we've had it suggested to us that it may help with several issues. Could you tell me--PM me if you like---the experience you have had with Zoloft? My ds ( nearly 8) has potty issues, eating issues, and some anxiety that really catches him up in several ADLs and social issues that I see-saw back and forth with trying it. My dh is worried that it would make him "zombie-like" or would potentially cause more problems than it would be worth. I would love to hear your story.

post #16 of 18
Originally Posted by terra-pip View Post

I hesitate to put my ds on Zoloft---we've had it suggested to us that it may help with several issues. Could you tell me--PM me if you like---the experience you have had with Zoloft? My ds ( nearly 8) has potty issues, eating issues, and some anxiety that really catches him up in several ADLs and social issues that I see-saw back and forth with trying it. My dh is worried that it would make him "zombie-like" or would potentially cause more problems than it would be worth. I would love to hear your story.

I have no problem sharing it "out loud". LOL We waited over 6 mos after our son's doc's (behaviorial & developmental ped--she is both) recommendation for Zoloft. I was dx'd w/Bipolar disorder in my late teens, and for me, sometimes an antidepressant alone will trip off a hypomanic episode (even a newer generation ones like Prozac/Zoloft has never caused me any problems itself). So, it made us a bit nervous to try it, just in case his dx was wrong and he has bp. But the doc explained that one of the main difficulties w/spectrum disorders is anxiety. The more anxiety, the more sensory related issues...and the more sensory issues, the more the anxiety level rises.  The higher the level of anxiety, the higher the level of impairment w/sensory issues, learning, daily comfort, etc. His anxiety was impairing his ability to sleep well and/or go to sleep (issues from the daytime would come out and bother him, plus fears of things like a house fire), go out in public for necessities (if anything was too overstimulating, he would freak out-we couldn't even make it through what should have been a 15 minute grocery store trip for eggs & milk!), go to a movie or bowling alley (things he LOVES, due to noise), or even learn new skills or try really hard at them (like writing & drawing--other kids in preschool could do so many things that he couldn't easily do, so he would do other things instead, like pretend to be an animal and refuse to speak--for hours--to avoid painting or drawing). He also had a lot more trouble w/pooping, b/c he didn't like the sensation.  He was also "sad" much of the time--I'm not sure if he was depressed in general or just down b/c of having to struggle so hard every day. He was exhausted.  He wasn't eating well. All of these difficulties have been GREATLY reduced w/a very low dose of Zoloft.  To be honest, I don't think he's experienced a single side effect, and he's reacted to almost every med he's ever had (green dye in meds, Singulair, steroid induced psychosis after just a short course of steroids for croup, etc). He will tell us that he feels better, much better, and that he is "happy" most of the time.  All of our family sees the difference and agrees w/our decision to try Zoloft.  What's funny about that is that my parents didn't and would NOT help me at all as a teen w/severe depression and then manic symptoms.  They were in total denial. LOL


I know that it may not work for every one, but it was (and is, for now at least) so worth it! He caught up in many areas, about a years worth of development, in the first 3 months alone! We figured that if it didn't help, or we saw even a hint of a side effect that was not productive or treatable, we would pull him off of it.  He's been on it since June now, and we will continue for the time being.  Even the doc says that it may not be forever, and it may not help forever, but in her experience it helps MOST of the time w/few side effects.


One thing to consider meds vs no meds (from our doc)...the brain is developing...for my kid, his brain is learning correctly ON MEDS...without them, his brain was learning incorrectly.  What he was learning with all that impairing anxiety was how to be more anxious, how to have terribly high levels of all the wrong brain chemicals and hormones and not enough of the ones he needed.  With the meds, his brain is being set up the right way--the meds are doing for him what his body was NOT doing on it's own.  The longer those patterns are going on, the harder and more resistant they are to break.


(Ah, for comparison purposes, my son is 5.5 yrs old, 37 lbs, almost 43" tall...and was born at 29 weeks weighing 2.5 lbs!)





post #17 of 18

Ah, and he is totally not "zombie like" what so ever.  Zoloft is an antidepressant that happens to work on anxiety.  It's not an anti anxiety drug like Xanax or Valium.  It works differently.  He was a zombie before the medicine! He goes to preschool 3 half days a week and takes a special needs karate class on Saturdays.  He dances and sings, plays video games, tries to do crafts every day, swims.  He's lively--talks to total strangers (usually too much for their comfort, since he doesn't recognize easily when people don't want to be bothered!) LOL Not a zombie in the slightest! (-: In fact, if you didn't know him well, you'd seriously question his dx of autism!

post #18 of 18

Hi our son has high functioning autism and (starting at about 2.5 yrs) potty training in the daytime took about 2 years til he was mostly dry/clean most days,he just didn't seem to mind being covered in muck or wet and often refused to change as well... .

 He still tends to be a little damp/smelly some days but in general is pretty good although he refuses to wipe himself and so if he needs a BM at school (he's now nearly 6) it's a bit of a problem as he won't ask for help unless his brother happens to be in the loos at the same time(lucky brother!).

He is nowhere near being dry at night as his nappies are usually almost falling off due to the weight in the morning......

not sure if that's any help at all though.....guess every child is different :)

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