The following is a reposting of my featured post in Happy House of 5’s Potty Training Series.
I’m a major bargain shopper, so when I saw an awesome sale on children’s clothing at our local Sears department store one afternoon, I stocked up big time. Luke was only nine months, but I bought an entire wardrobe all the way through size 2T – including (you guessed it) underwear, because certainly, we would be potty training by then.
Looking back, I have to laugh at my presumption – at how much I took for granted back then. Instead, just as Luke was fitting in to those 2T sizes, we were learning that Luke had autism.
I figured that potty training would just have to wait until Luke could speak and understand language, but by the time he was three-and-a-half, he was still only speaking a few single words, and his understanding was extremely limited. He also didn’t seem to mind being wet or dirty in the slightest. I started to realize that for Luke, my idea of “ready” might never come. There aren’t many books for parenting special children. How would I ever make him understand the concept of toilet training when words failed?
Like teaching most things to an autistic child, potty training is a total commitment. You approach it as a soldier prepares for battle. You stiffen your resolve, put on your battle armor, and send for reinforcements. My first step was to enlist the assistance of Luke’s therapists.
They gave me a procedure to follow that went something like this:
Give Luke plenty of fluids.
Have him sit on the toilet every 15 minutes for 5 minute intervals (this gives him many opportunities per day to get it). Prior to taking him, make the sign language sign for “bathroom” and say the word “bathroom.” Prompt him to do the same.
If he goes, he may get up immediately. Praise him with great excitement and give him several rewards. (In Luke’s case this meant he received the iPad for five minutes and yogurt bites to eat). Reset the timer for another 15 minutes and start over.
If he doesn’t go reset the timer for another 15 minutes and start over.
If he has an accident, say “bathroom” while making the sign. Prompt him to do the same. Then have him sit on the toilet for a minute. Have him help clean the mess and change his clothes. Reset timer and start over.
Every three days Luke goes without an accident, increase the time between each potty break by five minutes until he is going every two hours on a schedule, or preferably using the bathroom as needed.
I can’t even begin to tell you how overwhelmed I was when I realized that I would be living my life (with two kids) in fifteen-minute intervals. Thankfully, Luke’s therapists helped me for a good portion of the day. I just had to keep it going between therapy sessions, in the evenings and on the weekends, and to my surprise, it wasn’t as bad as I had feared. I really did adjust to taking life fifteen minutes at a time.
After weeks of practically living in the bathroom (and plenty of tears on both our parts), Luke finally understood the concept of using the toilet, and even if he could only squeeze a few drops, he would go every time and receive his rewards.
Once we had worked up to 25 minute intervals and I started making short trips outside of the house on outings where bathrooms were readily accessible. The first outings were a little awkward. I know that it must have been strange for the others to watch me run to the bathroom with Luke every time his timer went off, and it felt constant, but an advantage of autism parenting is that you get over what others think rather quickly. It is what it is. You just accept it and do what your child needs.
It wasn’t long after this, however, that Luke started independently signing and requesting “baa-toom” when he had to go. Around this time, he also started to dislike feeling wet. We were able to discontinue the use of the procedure and just take him on demand. We also gradually faded out the use of rewards.
Since then, there have been triumphs and setbacks. Learning to poop in the toilet took several months longer. I would dump the contents of his dirty underwear into the toilet and let him watch it flush so he understood where it was supposed to go. I also had to start making him sit longer at the time of day when he would usually go. Eventually, he did go, and after that first time (and an overload of praise and rewards), he improved rapidly.
Another setback was that every few months Luke would suddenly start having accidents again. I can only attribute this to the fact that there were other things that were much more interesting than going to the bathroom. My response to this is to start making him sit on the toilet every hour whether he needs to go or not. Since he doesn’t appreciate the interruptions, he gets back with the program immediately.
Today, at age six, there are still things we need to work on. Luke still needs to learn to wipe himself thoroughly (he does try), and he still wears a diaper overnight (although I’m convinced this is a problem for many boys – even typical ones). Also, in new places, I still need to insist that he go every couple of hours because he won’t go on his own if the bathroom isn’t familiar, but these are all very manageable and I expect he will continue to make progress in this area.
So, dear parent, if you find yourself faced with the seemingly insurmountable task of potty training a special needs child, do not despair. It can be hard, and it takes time, but it is also very possible.