|
| |
Q and A about Autism
Question 4: I have a 6 year old boy with autism who is
currently in a special class for children with autism. He is a very bright
little boy, lovable, energetic and beautiful. He has a wide variety of
difficulties. The main one right now is his insistence to have BM's in his
pull-ups. He has no problem with urinating and will tell me when he has to go to
the bathroom, most of the time. He will not tell me when he has to have a BM. He
used to play in it but has recently stopped. Now that I have said this he will
probably start again. I do realize that this is just another hurdle to get over,
but it is time for him to do it in the toilet. Do you have any ideas for me, I
am desperate!
Answer: Toilet training is a right of passage for parents as well as
children. Children with special needs, and more particularly children with
autism have this difficulty compounded by problems with communication, limited
control over their bodies, discomfort with strong emotions, and sensory
difficulties. Let me begin by assuring you, based on my own experience with my
son who has autism and from countless other parents of children with autism/ PDD,
that children with autism
DO TOILET TRAIN. They do it in a delayed fashion generally and with difficulty.
They need extra time, patience from their parents and caregivers, and extra
practice and support. They do it, like more typically developing children, when
they are ready and not when their parents are ready for them to do it.
It is a great sign that your child has begun urinating in the toilet. This is a
big step in the right direction. Salute him each and every time he does it.
Many parents in your situation have found that pull-ups do not help with toilet
training. They are merely a diaper in a different form. A child with motor
control problems may have difficulty sitting on the toilet and controlling the
sphincter. For all children, the initial feeling of something leaving the body
may be intense and frightening. This can be even more difficult for a child
with autism who may be over-reactive to sensation or has a poor kinesthetic
sense. The comfort and warmth of a diaper to push against may be hard to give
up. It is essential that you go slowly and patiently (even though you are
running out of patience).
That being said go in small steps. Books and videos which show the problem being
solved symbolically can be a great help for children with autism who have great
difficulty giving up one routine (in this case making a bowel movement in his
pull-ups) and moving onto another routine.
If this makes sense to you so far, go to your bookstore or library (or buy this
helpful book) and read the very specific instructions on toilet training by Drs.
Stanley Greenspan and Serena Wieder in “The Child With Special Needs” on pages
317-319. They recommend setting up a routine where the child poops in the
bathroom and on a schedule after meals even if it is in the diaper. The routine
and scheduling is a prelude to pooping on the toilet.
For help dealing with your own intense emotions, try to keep in mind that you
have every right to these feelings. They are intense and natural but extremely
difficult and usual for parents of children with such disabilities as autism. My own book, “Special Children, Challenged Parents”
may be useful to help you understand
these cycles of emotion that accompany us through parenting a child whose
development veers sharply from the “norm.”
I would also strongly recommend that you find and join a support group for
parents of children with PDD/Autism. There you will meet and learn from other
parents confronting and conquering the same challenges you are facing. In the
support group which I facilitate monthly, each meeting brings the announcement
of another child successfully pooping in the toilet and a hearty round of
applause from all parents present.
RN
|
