November 30, 2016

Potty Training with Autism (Part 1)

Let me start off by saying I do not consider Kase potty trained.  We are still right smack in the middle of the training process.  However, he's making some great progress.  I've had a couple people comment on my social media asking how it's going, what we've been doing, etc. so I thought I would share how things are going for us.

I believe in waiting to potty train until the child is ready.  And yes, I think you will know when they are ready.  With Kyla, I actually thought she was ready before we started, but we had two weddings in two weeks.  She was the flower girl for both and there was some traveling/hotels involved.  So we decided to wait until those were over.  The next weekend we started and she was trained pretty much immediately.  She was 2 years and 8 months old.  She had maybe two or three accidents and hasn't had one since.  She was ready and we didn't push it on her.

With Kase, things are obviously different.  I've been wanting to start for awhile now, but his previous therapy provider kept asking us to wait so they had time to build a rapport with him.  Long story short, that never happened.  Soon after we started with the new provider in August, they agreed that it was time and he was ready.  The best part was they were going to help us with every step.  I realize that not everyone has this kind of help.  So if you're a parent with a child on the spectrum and you're wondering how to start the potty training process, you can see here how the professionals helped us.  Even if you only take one thing away from my blog, I'll feel happy about sharing! :)

The first thing we did was take all diaper changes from the living room floor (or wherever else we plopped down and did it) to the bathroom.  All potty business happened in the bathroom.  We'd take his diaper off, put him on the potty for 10 seconds, put his new diaper on (while standing up) and put his pants back on.  He helped with the diaper by holding the back and bringing the straps forward.  He also quickly learned how to pull up his own pants.  A lot of times he'd count down from 10 and say "All done!" and sometimes he'd sit for longer.  We didn't demand he sit longer.  He never actually went potty, but he got used to sitting and being in the bathroom.

Side note - we use this seat that goes on top of the toilet.  It's nice and comfy!
We did that for about a month until his therapists were ready to start the intense training.  We met with his lead therapist on a Monday and then started on Wednesday, November 9th.

Normally, Kase goes to the clinic for therapy 5 days a week.  But they decided to start the intense training at home.  We had a therapist here for three days from about 9:30 am to 3:00 pm (they were both here for a lot of the time).  I am incredibly grateful for their help.  They hung out with him downstairs the whole time for three days.  We have a finished basement with a bathroom, toy room, living room, etc.  So it was really nice that Kenley and I weren't around to district him, but yet they had access to everything they needed.

I wasn't sure how it was going to go.  Actually, I was very nervous.  In those three days though, he didn't cry or fight being down there one time.  I think it helped that it was his two favorite therapists.  We truly are so lucky!

So let's talk about the plan they put together.  The first thing we needed was some reinforcers, some things he would be motivated by.  I knew he'd love this sound machine because he used it with his previous provider and hadn't seen it for awhile.

We also used puppy chow, bubbles (they brought a really fun bubble machine from the clinic), and some other little light up toys that he likes (Target dollar spot for the win!).  We had a visual schedule that showed him potty, wash hands, get reinforcer bin (after he went potty, he got to choose which one he wanted from a bin).

They put him in underwear and pants and set a visual timer for 10 minutes.  They took him to the potty either when the timer went off or if/when he had an accident, whichever came first.  When he had an accident, they did not use any negative language.  Nothing about "that's naughty" or anything like that.  They said, "Kase, you had an accident. Let's go clean up."  Then they took him to the bathroom, made him sit for 10 seconds, and put new underwear on.  Then they went back to playing or doing whatever activity they were doing and set the timer again for 10 minutes.  After about 2-3 minutes (in between the 10 minute intervals), they would do a "dry pants check".  They would ask him, "Kase, are your pants dry?" and they would do a visual check to make sure he was still dry.  If he was, they cheered and said, "Good job keeping your pants dry!"

He started the first day with an accident (which we expected because at this point he had never peed on the toilet), but you could tell he did not like the feeling of having wet pants.  The first day he peed on the toilet a few times and had a few accidents.  I can't remember the exact numbers, but we were all very happy with how it went.  My biggest worry was how his behavior would be during it all, but he did great!  Plus he had some successes on the toilet, which they worried may take several days.

The second day I think they moved it up to 15 minutes in between based on their data from the first day.  For example, after a 10 minute interval, he would sit, but wouldn't go.  Then in between the next interval, he'd have an accident.  So they felt good about 15 minute intervals.  They also really pushed liquids, but documented everything he was drinking.  Day two was similar to the first day, but with a few more successes and less accidents.  AND!  He had a bowel movement on the toilet.  We were all shocked yet so excited!

One thing I forgot to mention.  What if he sat, but didn't go.  They didn't want to make him sit on there forever, but those first few days they did allow him to have an iPad while he sat.  Basically to get him comfortable sitting on there.  But if he didn't go after a couple minutes, they took him off and reset the timer.

The third day was much of the same.  I think he had two minor accidents that day and several successes.  He was very motivated by the bubbles, sound machine and puppy chow.  And he loved cheering for himself when he had success.  I would be upstairs and I'd hear them cheering down there and it was such an awesome feeling.  Not only to know he was doing so well, but knowing he was in such good hands and those two therapists truly care about him.

Another aspect of all this was the language part.  The first few times they asked him if his pants were dry, he would say yes, but I don't know that he really knew what that meant.  So when he had an accident, they'd ask him about his pants (even though they could tell he had an accident), and sometimes he'd say yes.  So they explained that to him that he had an accident and that his pants weren't dry.  Then they'd ask him the question again, "Are your pants dry?" and he would say no.  Also, while he'd be sitting on the toilet, they'd sometimes ask if he went potty and he'd say yes, even if he didn't go.  So they taught him how to answer all of those questions correctly.

I think I'm going to leave off there for today.  This post is already really long!  Thanks for reading if you've made it this far! :)  Tomorrow I will talk about what we did after those three days of having his therapists in our home, how we're doing at home now, how he's doing at the clinic (hint - he's doing really well there) and our plan going forward.

Please leave me a comment if you have any questions or if I left anything out!  Also, let me know if you're a fellow autism parent, even if you're not currently potty training.  I'd love to connect!

See you back here tomorrow!

1 comment:

  1. This is so helpful!! I almost feel like I need to take a week off work and seriously try with Mason. We do encourage him to go but not nearly enough. I think part of it is my fault because I am so used to him in diapers so I don't even think about it. But the other struggle is that I don't think he notices or cares if he goes. Yesterday we got done eating dinner and his actual pants were wet. His diapers was so wet that it wet his pants and he was just walking around like everything was fine. My issue is trying to get him to realize that being wet is a problem and telling us about it. Even if he just told us he peed in his diaper would be a step in the right direction at this point...