My daughter recently turned 4.
In December, she was diagnosed with autism. She is on the mild (verbal) end of the spectrum. She has communication and social issues, as well as some self care and behaviour issues (tantrums).
Toilet training attempt #1
Shortly before she turned 3, we tried to toilet train her for the first time. We did this for a few weeks and it became much too stressful. She never told us when she needed to go, and we constantly needed to prompt her. The end result was constant weeing on the floor, a couple of frustrated parents, and being put back in nappies shortly after.
For most of 2014 we had a few major events (including the birth of another child) which put toilet-training well on the back burner. She was pretty much in nappies the entire year.
Although, she would often express an interest in going to the toilet (or potty) to make a wee. We would take her nappy off in these situations and let her make a wee like a "big girl". We would always praise her and do a big song and dance whenever she had a successful wee on the toilet, and she seemed to delight in this.
Toilet training attempt #2
In January this year we decided to give it another go, and with this 2nd attempt we were much more determined to be successful. So off came the nappies. "You're a big girl now, and you don't have to wear nappies anymore. Big girls go on the toilet". She seemed to enjoy this concept. The only time she goes in nappies now is when she goes to sleep (because we don't want to have to clean her sheets every day).
The accidents still happen fairly regularly. We keep on telling her "please tell mummy or daddy when you want to go to the toilet". She seemed to understand this, but very rarely tells us she wants to go.
Fast forward 5 months to June...We don't seem to be making a lot of progress, and we're going a bit nuts.
Summary of issues
- She very rarely tells us when she wants to go.
- We will usually start to see signs of her wanting to go (pushing legs together, walking funny) but by that stage it's often too late and she's already wet herself.
- If it's been quite a few hours since she last went, we'll try to take her but she will refuse. I have discovered recently that bribery (allowing her to watch a cartoon on the toilet) helps though. And if I managed to convince her to go to the toilet, she'll make a wee (she clearly needed to go).
- If she has a tantrum (for whatever reason) she will usually wet herself if she hasn't gone for a while.
- She oddly seems to be better at kindergarten and has less (wee) accidents - they have smaller toilets there which are more accessible than our home one, which might encourage her to go. She also mimics other children who are going.
- We offer both the toilet and potty at home to encourage her to not go in her pants.
- Dirty public toilets are a no-go zone (understandable, I don't really like them either).
- Often when we are out (e.g. at a restaurant) she'll say "I need to go the toilet". We get very excited that she wants to go, but then we take her and she doesn't want to sit down. Apparently she just wanted to go the toilet room, but not actually make anything.
- She always tells us after she had made something in her pants, just not before she has made it.
- If she makes a wee on the toilet (quite regularly, when we are able to convince her to go), we always make a big song and dance of it, rewarding her with stickers, stars and rewards. She enjoys this attention. Positive reinforcement to the max.
- She seems to also realise (maybe) that drinking water leads to wees, and doesn't seem to like drinking water as much as she did when she was in nappies.
What about number twos?
That's even more stressful. In all this time toilet training, she's only made a poo on the toilet maybe once (and that's when she was caught about to make one in her pants).
Otherwise, it's either in her underpants or her nappy (when she's in bed).
She has mostly dropped her daytime nap now, but often she'll tell us that she wants to go to sleep during the day. She knows we will put a nappy on her for this, and after she goes to bed she'll often call out 5 minutes later "I made a poo". We then change her, and she wants to be awake again. All apparently very premeditated on her part...
Getting her to makes poos on the toilet is close to impossible. We have even let her sit on the toilet or potty with a nappy on just so she can get used to the concept of making a poo in that position. But she still won't do it.
Sorry for being graphic, but when she does make a poo they can often be quite messy ones (not diarrhea but not solid either).
Advice we have received
We have seen a psychologist and occupational therapist who advised the following:
- Social stories (provided to us) about toileting, in both book and DVD form. The book even has pictures of my daughter in it to try to encourage her to do the right thing.
- Making the environment at home peaceful and non stressful.
We always try to remain calm when there is an accident, but we all have our moments and sometimes it gets a bit much.
Where to now?
They say that insanity is doing the same thing over again and expecting different results, and that's definitely where we're at now.
Anyone have any ideas about how to tackle this seemingly insurmountable problem?