In depth toilet training advice?

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Just for info sake my son is almost non-verbal and four years old, and I'm not in a country with any professional help for autism so I'm doing this on my own for the time being.

He has regressed on the toilet training front, we had relative's male toddlers pee in the toilet in front of him and I also demonstrated for him(I'm his dad) and he was formerly using the toilet for urination for more than six months. We never did get him to defecate in the toilet. But now he refuses to urinate in it, if he is not diapered he will just urinate wherever he is, he has even started just urinating if he is sitting down which he never did before

Basically if he is not wearing a diaper he goes number 1 or 2 randomly in the house if he doesn't have underwear and pants on, he doesn't seem to have an area he just goes wherever. He usually will take off any underwear or pants he has on right before going, but sometimes he pees in his pants. We have to clean up the random spots and it is getting tiring. The problem is there is only one brand of diaper that still fits him, the others are all too small unless we investigate adult diapers.

If we see him about to urinate I take him to the toilet and ask him to pee in it, but he just refuses. We have also tried placing him on it if it seems like he has to defecate, but again he just refuses and struggles.. He often will get a fresh diaper and demand it be put on before defecating, I think he thinks the proper place to go is in a diaper but I'd like that to switch to the toilet.

Whenever he defecates in his diaper he immediately comes one of us and takes us by the hand to the shower to be cleaned off, he isn't satisfied with wet wipes he wants to be cleaned with water and soap. I can tell he doesn't like the sensation of feces on him but I just can't seem to make the connection in his mind to use the toilet(he is tall enough that he can now easily sit on it).

If anyone could suggest a book or video or resource I'd be grateful, I think he would be more comfortable and we would too.

Thanks!

We never had much luck with videos. My son did like this book:

http://www.amazon.com/The-Potty-Book-Fo ... 0764152327

I think he liked it b/c the boy kind of looks like him.

Have there been any changes in routine or anything that could have caused the reversal? We had that issue, and we had to stabilize things before we could try again.

I think a lot of parents here can relate to hard time with bathroom training.

My son is 5 but 2 years ago every time I put my son on the potty I read him that book linked above from ASDMommy, also as a night time book a couple of times a week. It's a good reference and for my son helped I think reiterate what we need to do and mistakes happen and that's ok. I never had the reversal issue though so I'm not sure the best way to approach that.

He didn't get potty trained so to speak until he was about 4 years old though. My son was obsessed with superheros and we knew Walmart had a superhero potty seat, so we took him to the store and let him pick what potty seat he wanted (we knew he'd pick that superhero one). That got him excited and wanted to try sitting on it just because it was his style. That changed the game for us.

He's very structured though and he only went to the bathroom on a schedule from us and not when his body told him to go (he still does this today). He has some super powers where he will hold it in all day, literally 12 hours at a time is not unusual unless someone tells him it's time to go to the bathroom. He doesn't care to go, doesn't want to go and still afraid to go today unless we force him on. Only when nature is truly calling will he go on his own and still wants help. When he started school last year (Full day, everyday kindergarten), he didn't go to the bathroom at school until the 3rd month. We let him buy a new potty and bring it to school with him in hopes he'd go, he was the only kid in class with a potty seat but he was comfortable going with his EA afterward. He still uses that potty seat today.

So maybe try a new potty seat idea, decorated style with his favourite tv show, worked best for us. He doesn't like to stand because he 'misses' his target too often and thinks he failed.

We had a hard time training my now 4yr, soon to be 5yr. For him it was a naked weekend when he was about 3 ½ filling him full of fluids and a making him sit on the toilet every 15 minutes which we slowy moved up to every hour through the course of the day. Before the weekend started we had him pick out his big boy underwear and told him that he would get to wear them after he was potty trained that weekend. The first two days he got stickers and hoopla every time he sat on the potty. He got a small treat, two M&MS, each time he sat on the potty. After a certain amount of stickers he got a bigger surprise(dollar store stuff). If he went in the potty he got a prize and a treat and big yeahs! After a three day weekend he was 60% potty trained. We had some messes and it was a looong weekend but it seemed to work for him. We continued with the potty sticker chart and treats. He was pee potty trained after another month or two. We weaned him slowly of the stickers and treats.

Poop was about 6 months later. Sometime when he peed in the potty he would poop too. We would make a huge deal of it and he would get treats and prizes. For him it was more of a timing issue. He just couldn?t recognize when he needed to go. Often he would have us take him to the potty 3 or 4 times with nothing and then he would poop his pants 5 minutes later. I am not sure what clicked for him. We did make sure he saw that we didn?t like cleaning his underpants and told him that Thomas/Elmo didn?t like it when he pooped on them. Very slowly he got it, it took about 3 months before he didn?t have any accidents.

He wasn?t afraid of the potty, I know that is common though. He didn?t have any regression, but we were really committed which was hard. The previous potty training we got small results but didn?t stick with it. I also don?t think he was ready before 3 1/2 .

I don?t know if my method will work. Best of luck and know as difficult as it is, life on the other side is soooo worth it.

This wasn't an issue for my son, but I came across a book that might be helpful when I was looking for something else:

Toilet Training for Individuals with Autism or Other Developmental Issues: Second Edition by Maria Wheeler

My boy has just defeated four months of pretty intensive toilet training, two BCBAs with extensive experience in toilet training people with ASD including adults, their lead (a Doctorate pyschologist) and Messrs Azrin and Fox and etc. In their words they have never met an individual more determinedly resistant to toilet training. A weekend where the BCBAs were there from Friday to Sunday and with him the entire time he was awake was fruitless. Rewards, aversives, you name it hasn't worked - for poop at least (wees he has got and is OK with).

I'm seriously thinking of trying this book
http://www.amazon.com/Teach-Toileting-R ... olutionary

It seems to have an alternate approach, which from what I read involves the child going on the bathroom floor to start with or something like that. Gotta be easier doing that than dealing with the likes of the huge mess I cleaned up off the lounge carpet this morning.

Do you have any idea what triggered the regression? It sounds like, from what you described, that he is capable of going pee on the potty but that he is refusing to. Were there any big changes at home around that time? Did he have a negative experience in the bathroom maybe?

Since he CAN go, it's just about him being MOTIVATED to go. Do you still use a reward that is special only for going potty? He may need something really reinforcing that he ONLY gets when he pees in the potty. That way you can check in with him and remind him that if he goes pee in the potty then he gets to have __________. (make it sound like the most amazing prize in the world.....gotta sell it!)

It seems like he is resistant to any control over going, so you are going to have to make him feel like it is his choice and he is in control. A really good prize can sometimes be motivating enough for kids to choose on their own to go in the potty.

Another thing you might need to do, if that doesn't work, is desensitize him to the potty sequence in general, one step at a time.

Sorry to be a wet blanket, but this has actually back fired on us. We used Katy Perry's "Roar" video as his special treat that he ONLY gets when he goes pee in the potty. Well, after two months of this, he now WILL NOT go unless he can see the IPAD set to play that particular YouTube video. I have tried EVERYTHING to undo this conditioning and failing miserably. This means that we have had major accidents and a total messing up of our TT schedule when we are outside the home or simply don't have access to this video (for whatever reason).

Since his receptive language is sketchy, he probably does not even understand it when I try to explain why it is he isn't getting his video for using the toilet.

Sorry to be a nay-sayer, but this technique has totally screwed us over.

Yes the reward thing never worked for us either. I started out by reading him books while he was on the potty (to keep him on the potty). As he got a bit older he insisted I read to him every time he had to go whether it's a #1 or #2... well sorry but that simply had to end as it just wasn't right to continue doing it. It created meltdowns but eventually after some months he got it that I wasn't going to read to him on the potty. It was in those awkward moments when I felt others had it so easy lol.

Is the toilet seat cold? Those porcelain seats can feel really cold at first and that annoyed me as a kid (and as an adult too). I prefer the plastic seats.

No worries! There are many different reasons why kids have a hard time potty training, and each kid has different motivations, fears, etc. That strategy works for many kids, but it definitely is not going to work for every kid.

If this can be of any help to you at all, I wanted to share my experience. I remember how difficult potty training can be! My now 18 yr. old daughter was potty trained a month before her 5th birthday. I started to try to potty train her at about 2 yrs 3months. So it took a lot of stops and starts before it worked. My daughter has Asperger's and NVLD. I had tried rewards, books, videos, etc...nothing seemed to work for her.

One day I found a "musical potty chair" ...I had been out shopping for a new one as she refused to sit on the 2 I already had. Basically, it played a little musical tune when she would "go potty." I think I poured some water in it to show her how it worked at first...after that I let her drink a lot of her favorite drinks through the day and she was willing to sit on the potty and eventually used it all in one day. At the time it seemed like a miracle! I can't say 100% that it was the music that helped, but part of me really thinks it was. She has always LOVED music and maybe it just clicked with her then? Anyway, I know all kids have different ways and motivations, but I wanted to share just in case it might help.

I like this video:

https://m.youtube.com/watch?v=lUssJK8vYPI


The first thing is recommend doing is to make an extremely consistent daily routine. Then, have him SIT (not stand, poop can't be successful that way) at one specific time per day (such as, after lunch, he always sits on the toilet to *try*). Then, do something he enjoys afterward--don't focus on the sitting if he doesn't go. Just, keep giving him the daily opportunity to try.

When that becomes comfortable, add one more time per day, etc. If he poops the same time each day, aim to start your first try a little before that.

If possible, I'd also have him help with clean up at whatever level he can. Not as a punishment, just because it's a job that needs to be done as a result if a choice he made.

Some good suggestions on this thread. I just wanted to say we also had a really difficult time training our son. My NT kids trained at 2.5 yo (boy) and 11mo (girl), but my AS son was almost 4.5 by the time he was trained, and it took longer to get defecation under control (he had leakage through Kindergarten, re-occuring in 2nd grade). My son is very high functioning, and verbal, but no amount of reinforcers would work. He would hold it until he got a diaper put back on for pee, and would hold poop until it just leaked out Honestly, I'm not sure what really worked. Just consistently trying and trying, I guess. He's totally trained now, but will still hold pee for an extremely long time.

I had the same thing happen. My son toilet trained around 3 then at about 4 1/2 he regressed. It was a battle for the next year and a half. The only thing that I found helpful was consistent routine bathroom breaks. Whether he had to go or not, we made him sit on the potty every hour. We found that often times he was so consumed with what he was doing that he would forget to go potty or didn't want to be "inconvenienced" by the time required to stop what he was doing to go potty. By making the potty time mandatory and routine he realized every hour he had to stop what he was doing to sit on the potty anyway, so he might as well utilize that time haha. It was a long process but in the end that's the only way it worked for him. Good luck!

Interesting that he was peeing before, but now struggles, and also that he clearly understands and dislikes the feeling of having had an accident (wanting to be cleaned right away) and yet doesn't feel invested in going back to using the toilet. Seems like for whatever reason, he and the toilet had a "falling out"...

We had a *really* tough time training my now 7-year-old. He was 5 before he was out of diapers, and we too struggled with him having outgrown everything (he's also very tall for his age)-- we had to put him in the overnight pants they made for bedwetting older kids and use those as daytime diapers. In the case of my son, he definitely knew WHAT to do, but he just didn't do it. I think some of it was laziness (not wanting to take a bathroom break) but I also think some of it was sensory-- he wasn't getting the proper "feedback" from his body to let him know that he needed to go. In the case of #2, I've learned that that creates a vicious cycle where their body does literally lose sensation and they will just keep building up feces until they start leaking (encopresis). That's another journey.

For us, books and videos and sticker charts did NOTHING to motivate him. Again, he *understood* what to do... he just didn't want to (still not sure why)... so materials like that, which focus on "how" to do it, didn't really interest him. What we needed to do was to make the toilet (the actual environment) more appealing for him. We did that by letting him do whatever he wanted on the toilet. It started out with him sitting on the toilet sometimes for over an hour, with an iPad, playing games. I don't know if that's an option for you or if your son would be interested in that, but basically, whatever he really enjoys, make that available for him while he's sitting on the toilet. (Maybe even put a TV in there!) Hopefully that will take away whatever negative feelings he has now associated with the bathroom. It doesn't even really matter if he goes or not, at first. It seems like you need to take a step back and get him to "make friends" with the toilet again and feel safe and comfortable in there. I know someone else mentioned that this type of approach really backfired for them, but it sounds like you're at the point (and I've been there) where you are at your wits' end (and so is your son, probably) so my thinking is, what have you got to lose?

Good luck and try not to despair-- he will get there! I know sometimes it seems like it will never happen.