This week I tackled toilet training with E at exactly 4 years and 2months old. Yes, my child is still in nappies at 4years old. To those, with typically developing kids this might seem almost negligent, but this time frame is fairly common among children with additional needs. Why? Well, there are some key developments needed in children to make toilet training successful. These include things like good communication skills (both verbal and non verbal), awareness of own bodily functions, desiring independence, ability to understand a process and an ability to cope with change.
All these things E lacked until recent months. I decided to wait until he had maturity as an asset which might help balance out delays in other areas. Even with his maturity and progress in development he still did not show the typical signs that he was ready! I think E would have happily stayed in nappies indefinitely.
However, I decided it was time. His language has be increasingly progressing. He now speaks 3-4 words/ phrases regularly. His receptive language is soooo much better than it used to be. He responds to social stories and we are able to work through issues of change with him with much more success and much less drama than we might once have.
I have read about the approaches to toilet training with kids with autism - and the intensive schedule that many suggest. I must admit I got pretty freaked out about the prospect of sitting in the bathroom for 30min at a time and trying to entertain E with toys and books. I kinda knew this was going to be just as much of a challenge as the actual training!! You see, traditional approaches to toilet training do not typically work for kids with autism.
But I decided to give the 'typical' approach a go. If it didn't work then I would try the more 'intensive' approach. I had the added advantage of E having an older brother who of course uses the toilet. He has also been introduced to the idea of toilet for at least 9months now. He sits on the toilet at preschool when the other kids do. He has sometimes sat on the toilet at home.
I have also decided to try and train his younger brother at the same time who is 2.5years old. Although this produces more chaos for me, I think it has helped E, now that everyone is wearing undies and everyone is saying goodbye to nappies.
I wrote a simple social story for E about toilet training. I took pictures of the toilet and the steps involved. I have a laminated 3 step process by the sink with photos (soap, rub and wash, dry) and he loves recounting each of the steps and making sure his hands match the pictures.
In 2 days E has not had one real accident with wee. After initial introduction, he takes himself to the toilet when he needs to go. Sometimes I am not even aware that he is going. It's been no real drama. He was a little concerned about wearing undies at first, but that was ok, we just spent the day without anything on. When he wanted a nappy the second day, we just used distraction methods until he was settled and he forgot about it. Even no 2. have been relatively straight forward.
So, I can't say I can really claim some victory for the last few days. I don't feel like I have done anything extra special for this transition to be so smooth. I think the biggest thing in his favour was that we waited until we had maturity on our side and he had some reasonable communication skills. (Of course, some children won't reach this until a lot later or never). I am really proud of how well he is doing. This is a huge change for him. It fills my heart with joy and I am thankful. It gives me hope for the future.
