Tips and tricks for potty training ASD child

[mamanoish]

Does anyone have anything they'd like to share? I've heard advice from my friends who all have children without special needs, but none of it applies to us. Frankly, it's getting annoying. We're trying to have a third child and would like to potty train our son (on the spectrum) as gentle and easy as possible. So here's what we HAVE done:

We bought two types of potties. A floor potty (frog one that he was interested in) and an Elmo potty seat that sits on the big potty w/ step stool. We have been trying for about 9 months now to spark some sort of potty interest to no avail. I would ask him from time to time and try to make the potty seem fun and interesting, but considering we have serious delays in receptive/expressive communication... things like "big boys go on the potty" and "diapers are for babies" don't work because he lacks the ability to even understand what a big boy is. 

We also bought him a watch called Potty Watch that you can set a timer for as a reminder that they should sit on the potty. Well, all of the sudden he has had interest and thinks the potty is totally cool, however, still has no idea what its for other than "wow putting this lid up and down is AWESOME and watching the water flush is pretty cool too." He also enjoys ripping off toilet paper square by square and ripping it to shreds. I will usually let him play with the toilet paper while he is sitting there otherwise he gets bored and won't stay seated. Books and whatnot don't really capture his attention because he is hyperlexic and will memorize or point out letters and numbers that are his favorite, so he's not really paying attention. The Potty Watch lights up and sings a song every 30 minutes as a reminder, but we haven't had much success. He is still have constant accidents and doesn't really seem to understand the feeling/urge of poop/pee. We put him straight in undies and just go with the flow. I was hoping that the first time he really went that he'd hear it and get excited or realize what had happened but to my surprise he didn't even know what he did. 

I always get really hardcore about PLing then give up and decide that he's not ready and I just need to go at his own pace. He's had a lot more interest lately but just doesn't seem to GET that he's there for toileting, not shredding toilet paper. 

So any tips or advice that worked for your child with ASD/sensory issues/speech delay?

He is verbal, but is lacking in expressive and receptive communication.

[mamanoish]

I figured I should also share that he will be 3 in two weeks, and we cloth diaper since birth so he has more chance of "feeling" wet. 

[beachcomber]

Well, it's really common to be delayed in this area if a child is on the spectrum. My DD is high functioning and we didn't get her successfully using the potty until she was 3 1/2 and for poops we had to hug her while she was doing them for a year. I kid you not. We  didn't have a Dx for her ASD until she was 4 1/2 so had no idea that the delay could be due to a learning difference. We tried EVERYthing. Bought 5 different types of potties, videos, books, dolls that went pee or asked to drink and then asked to be put on the potty, etc. She just didn't make the connection and when she did, there was a huge fear factor. Now at 5 1/2 she's going by herself and almost never has pee accidents. Though she still wears a pull up at night, 90% of the time she stays dry. It's more for her comfort than anything else. The only advice I can give you is to be patient, consistent and take it very very very slow. These kids need 200 times more reinforcement of a concept than a typical kid does. It'll get in there, it just takes more time, more effort and more patience. Don't set a date on when he "should" be trained. Don't pin your hopes on only having 1 kid in dipes. Just take it a day at a time and see what life brings you and your son.

[KimPM]

We tried a lot of things, but our DS just wasn't ready to even START until about 3.5 years old.  We had the floor potty since he was about 18 months.  He was showing interest in it, but not using it.  I tried stuff starting around age 3 (he wasn't showing readiness, but I thought I'd try).  It took about 6 months after that - months of trying this and that - until he started getting the idea.  At 3.5 years we just went naked on the bottom around the house until he got the idea.  Yeah, he peed on the floor a couple times and I had to be near him to catch him in the act and have the little potty ready to show him where to put his pee.  He seemed confused at first actually seeing the pee coming out.  Then he got the idea.  However - it took a good year after that for him to stop having accidents.  Well, he still does occasionally have accidents if he's not paying attention, but I'm talking about stopping the daily 4-5 accidents.  I don't know if his hypotonia plays into that or not.  Oh, and after taking taking about 3 weeks of going naked on the bottom, we went commando (tight pants and no underwear) for awhile, so it would be significantly different from having diapers on.

[KimPM]

I also read the book "Stress Free Potty Training"

[KimPM]

http://www.amazon.com/Stress-Free-Potty-Training-Commonsense-Approach/dp/0814401627/ref=sr_1_1?s=books&ie=UTF8&qid=1303912235&sr=1-1

Stress-Free Potty Training book - I can't get this editor to work anymore, sorry for the multiple posts.

[KimPM]

...I found the stress Free book to be helpful for us, even though it's not specifically written for ASD kids.

[KimPM]

What DIDN'T work for us:- stickers, timers, me just trying to take him to the potty every X minutes or hours, and I seriously doubt  whether those crash courses you may have heard about (Potty Train in 2 days) would have worked with him.  Loading him with water didn't work either - he just put out more fluid whichever way he was already doing it.  Oh, and I think in the middle of the 6 months of trying this and that I took a break and did absolutely nothing on potty training.  It was after that break that we tried again and he started getting the idea.

[KimPM]

Aargh - wish I could get this editor to work.  Just wanted to add that it took another 4-5 months before he was poo trained, and that's another story altogether, but suffice it to say that once I got past his resistance to poo on the potty, it went very quickly.  He was still having pee accidents regularly though. 

[kbins]

I was at my wit's end in the summer of 2008 when DS was 4 and nowhere near trained. I took a class offered by our local Autism Center that was called "Positive Practice" and based on the Foxx and Azrin program. (I have hard copy notes, but I'm sure if you google it you will find more info). It basically uses ABA like behavior modification and timed visits to the potty. We picked over 4th of July weekend and DH and I took turns during 2 hour shifts working with DS. He 'got it' the second day and went to school with an awareness and willingness to use the potty that he NEVER had before.

The program does use timer based behavior but also pairing and positive practice/reinforcement. It apparently works with nonverbal kids with developmental disability, and even institutionalized adults who never had potty learned.

We did have major issues with stool retention for another year but those were due to combined physical issues and psych issues with him.

[PNWmama]

Honestly he just may need more time.  My son with ASD was nearly 4 by the time he was fully using the toilet to pee.  He was a few months past 4 before he finally pooped in the toilet.  Now at 4 1/2 he's using the toilet all the time.  From before the age of two we had little potties all over the house available, toilet seat inserts, would set him on the potty all the time to no avail.  At around age 3 he got really resistant so we backed off.  Then nearing age 4 he started showing interest again.  He started out only wanting to pee outside, so we let him go in the backyard whenever he wanted.  Slowly he moved to peeing in the toilet.   We did offer him rewards to use the toilet.  I didn't really like giving rewards because I felt like I was bribing him, but at that point I was willing to do anything to get him to use the toilet!  We gave him a sticker every time he peed in the toilet.  After he was consistently peeing in the toilet we put him in underwear and just decided to deal with the mess if he pooped in them.  It took a good month of him pooping on the floor or in his underwear (ugh, which was not a fun month) before he was willing to try pooping in his Bjorn little potty.  He felt more comfortable sitting on the floor on his little potty than up high on the big potty.  I think sitting up high on the toilet with his legs dangling made him feel unstable.  After a couple months of doing that he eventually on his own decided to poop in the regular toilet.  I think in the case of my son it just took him a little longer than usual to come around to the idea of using the toilet.  In fact, I know of a few other boys, all neurotypical, who weren't fully using the toilet until they were around 4.  So maybe your little guy just isn't quite developmentally ready yet and giving it a few more months could make all the difference.

[mamanoish]

Thanks for all of the great advice! I think part of my stress with this is that he goes to a typical preschool and is the only kid still in diapers 100% of the time. His teachers are familiar with ASD and are not pushing him or me to PL him, but I guess just part of me feels like I'm not "doing enough". And other parents are constantly asking me (many of which are other parents from his class & don't know N has ASD) how PLing is going. Another thing is he's starting to grow out of all of his cloth diapers and I'm not wanting to drop tons more cash on cloth.  oh well. Every time I start looking at bigger diapers I feel like I'm giving up. But like many of you say... I just don't think he "GETS" it. It's so hard to explain this to a parent of a typically developing child. Which I have one, and he PLed in like a week. 

But we are planning on HSing and I am looking to cut back on my in-office hours and take the kids out of pre-school (which we love, it's in our church so our boys are familiar with everyone and they are family-friends). That way there won't be so much "pressure".

I appreciate the resources! I would definitely like to know more about what worked for you kbins. And I will also look into the book mentioned. Thanks!