toilet training: what worked for your little one?

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We are getting down to the wire here with kindergarten starting in the fall and another failed intensive attempt at toilet training.

The main problems we are having are that DS just doesn't WANT to use the toilet, rewards/positivity don't motivate him (we can't find anything that motivates him), and he often resists doings things when people WANT him to do them.
He fully understands the process (we have picture charts, books, watched videos, been through the process hundreds of times), we have identified no sensory issues with using the toilet or positive sensory experiences attached to a dirty diaper (he doesn't like having stinky diapers or poop).

We've tried all the well-known approaches to toilet training/learning with adjustments for him.

What I want to know is what worked for your kid, was there one thing that made a big difference?
How old was he? How long did it take? If you had to do it again, how you would you do it to make the whole damn experience easier/better/faster ?

Thanks.

There's always spanking. According to my parents, when they were still alive, as well as my grandparents and relatives, they'll learn real quick once their hide has been tanned a few times. A lot of people around my neck of the woods still believe in spare the rod and spoil the child, even at the slightest infraction.

I don't know what unfortunate "neck of the woods" you hail from, but the use of physical violence or threat of physical violence is not something I would ever consider. Not only has it been proven extremely ineffective by research but it is horribly damaging to any respectful parent-child relationship, and especially one in which the child is autistic.

Both of my kids just one day decided to use the toilet. Of course, this was after failed potty training attempts, so they knew how, like your son.

For my daughter, she wanted to be able to go to school all day. She was in an all-day program, but only allowed to stay 3 hours. We told her that she couldn't stay all day until she no longer needed pull ups. She went home, took off her pull-ups, and put on underwear and that was the end of that. My son was more random than that, but he also just one day reported he would no longer need diapers.

Maybe you could find a "bigger" motivation than stickers? Does he want to go to kindergarten?

It took around a year to train my son. In hindsight we probably started too early (just after he was 2) on the advice of a pushy health visitor who insisted that if he was autistic it would be better to train early before he got too used to nappies. It started out good. He's always been really into sweets as we don't have them in the house much so we showed him one of his teddies pulling his pants down and going on the potty and getting a sweet and he picked it up quickly. Then a day or 2 later he just seemed to be bored with it. He would occasionally go on the potty but most of the time he went in his pants. I think a big problem we had was that he has never been bothered by the feeling of being wet or dirty so had no other motivation to use the loo. We kept going with varying success/witholding etc until he was managing to stay clean most days with us taking him to the toilet every 2/3 hrs - he seemed to have cracked the 'not going in your pants' bit but not the 'going in the toilet' part . We then moved on to just taking him before we went out and as he got more reliable we just leave it to him now. Fingers crossed I can't remember when he last had an accident (night time is another matter which we haven't even approached yet).
I think he just needed to be of the age where he could take himself as any suggestion from us that he should go only ever made him adamant he didn't need to even if he clearly did and had an accident a minute later. It also helped that he developed a bit of a fascination with my phone so I let him play with that for 5 mins in the evening if he had a clean day.
If I could do it again I would have started training a lot later.

Bear in the Big Blue House. Potty Time.

https://www.youtube.com/watch?v=HKaobXtm6xo

http://www.amazon.com/Bear-Big-Blue-Hou ... B0002J4ZKK

They watched it over and over for a couple of weeks.
Job done. Easy peasy.

Good luck!

I highly recommend this old book by some of the top experts in toilet training:
"Toilet Training in Less Than a Day"
It's written for parents of neurotypical kids, but the techniques are still applicable for ASDs. Depending on the kid, it may take longer than a day (maybe closer to a week). Many of the principles in that book can also be generalized to other aspects of parenting (modeling, positive reinforcement, fading prompts and reinforcers, etc.). Good Luck!

Have you tried cloth pull-ups? They are not quite as comfortable as the paper ones to be wet in, and if he is on the cusp, it might help.

*Sarcasm* What a VIDEO? I wish I would have thought of that! No really, I wish it were that easy. If it were that easy I wouldn't be here. Yeah, we've watched videos. Countless videos. Over and over. And read books. I already said I even made a picture chart of the whole process step by step.

We tried training pants, yes. They led to giant meltdowns and an aversion to the whole process. My boy is a bit of a clean freak.

We've tried taking diapers away and going pantsless- this led to withholding and meltdowns and more aversion.

We've tried taking him at timed intervals. It didn't seem to click. We had a few chance successes with pee in the toilet but DS didn't care about the resulting rewards and potty dance and all the crap they tell you will motivate kids to repeat the success.

The last thing we tried (are still trying) is just making it a habit of going at certain times of the day- after breakfast, before we go out, when we get back, etc. Sometimes he will cooperate and sit on the toilet, sometimes he will throw a huge fit because he doesn't want to.

Frankly, I'm just so tired of this issue I almost just want to teach him to change his own diapers but they won't allow that at school.

I'm going to make a guess that no one has any revolutionary ideas I haven't thought of. I was just hoping.

Thanks anyway.

Our son got the hang of it in two weeks when he had just turned 3. We waited till summer so he could just wander around without any pants on and had the same potty in every room. Could be a boy thing but he would never sit on it properly, but straddled it like a bike so we had to get one that was high enough to allow this. Another thing was up to the age of 2.5 he had bad guts and only did loose poos and toddler diarrhoea despite being on an adult, solid diet. It would have been very hard for him to potty train then as he didn't know when it was coming. That cleared up before we started potty training. We had some accidents the first few days, but then it all clicked for him. He hated soiling himself so was pretty quick picking it up once the nappies went.

To the poster who suggested spanking; WTF? I'm all for spanking for some things, but not for things like toilet training. That's not a discipline issue.

I've got four kids, and I'm the one with AS in my family, although I think my youngest son might have a mild case of it but we haven't had him checked for it or anything. I'll tell you this about toilet training, it's the same as weaning or sleeping through the night - each kid has their own timetable for it and you can't force it. My youngest wasn't trained until she was about 4. Really. She had outgrown most diapers and pullups they had then, and finally I just took her pants off and put the little potty in the livingroom where we stayed most of the day and told her it was that or nothing. Yeah she had a few fits over it but she figured out that she wasn't getting her pullups back during the day so it was that or nothing. You mentioned withholding, but you can only hold it so long. Eventually it's coming out and they aren't going to like that when it's just in the floor. I do understand that it's different with autistic kids than NT kids, and I don't know where your kid is on the whole functioning level thing, or what other issues he may be dealing with, but I want you to know that it's not uncommon for even NT kids to still be having problems with it at that age. I also know that meltdowns are different than temper fits, which my daughter threw when she had to go without bottoms during the day, but if you can deal with it for a few days he may start to figure out that he's not getting the pullups back during the day. I also know a lady who has a son with AS and she said it was sometimes hard for her to figure out if he was having a meltdown over something or throwing a fit over something when he was young like that.

So, I would say that unless you are absolutely sure it's a meltdown and not a fit, and if he's on the milder end of the spectrum, then I'd really suggest letting him go without bottoms during the day except for naptime.

Also, I just skimmed some of the replies, so I was wondering if since he's at an age where he can talk to you, have you asked him why he won't go to the toilet? Another thing is have you told him he has to rather than that you would like him to, or rather just presented it as a "this is what's gonna happen now" instead of "it would be nice if you did this, would you please?" type of a thing?

Good luck, potty training can seem like hell on earth, but it does pass.

Something that could help with meltdowns when you take him to the toilet could be using a timer and showing a visual. So tell him before setting the timer that when the sand is gone it's time to go to the toilet then take him. My son used to like to take the timer with him which provided a bit of a distraction as well.
We also had a rule that before certain activities (such as toddler groups where I knew he'd be really absorbed in the toys) he had to use the toilet first. If he didn't want to go to the toilet I'd say 'ok it's your choice we can use the toilet and play or if you don't want to we have to go home' and he'd always choose the toilet followed by the activity. Granted this wouldn't probably work for the supermarket shop or something similarly boring but most activities we do during the day are for him anyway. He did sometimes still have accidents at toddler group but as he'd recently been to the toilet it would generally be a wet patch on his trousers rather than a river of wee across the hall so a lot easier to deal with.
Apologies in advance if you have already tried/do these things.

Well, I don't know if you have tried this particular video, but it has a lot of songs and my twins watched it, then immediately watched it again, and again, and again. Many times a day for weeks. This thing hooked them. They knew all the songs by heart. And we really did not have to do anything but be encouraging when they had few timing accidents.

Good luck to you.

This stands out to me as a big issue. If he doesn't care about the reinforcement, then it's not really reinforcement. If that's the case then the whole ordeal of going to the potty is just taking him away from things he'd rather be doing.

So how do you get a good reinforcer? You should first try making a list of all the things that he seems to like, then rank order them to get at the most powerful ones. Then there are two things that will increase the power of the reinforcer (also referred to as reward salience) - choice and scarcity. Choice means having several options and letting him select whatever he prefers in that moment. Scarcity means removing the reinforcer from other parts of his life. Going potty needs to be one of-if not the only way that he can get what he wants most (not basic needs).

The scarcity part can be very hard for parents, especially if your kid is content to watch Barney all day, and every once in a while you need that 15 minutes of peace. But at some point, you may need to make a decision to make that thing that he loves so much become scarce and only available as a reward for potty time.

There are, of course kids with ASDs who are content to stare at the ceiling and twirl their fingers for hours, with no interest in toys or videos. Usually these kids will still respond to food, and this is the situation where I would opt for a food reinforcer. When using food reinforcers, you can save certain special treats for the potty (like preferred candies). It also helps to cut them into small pieces, again to avoid satiating him on them, so he'll keep wanting to work for more. I used to spend the first 10 minutes of every session with a kid, using scissors to cut up gummy bears. Some kids are really good at getting at their preferred food without needing your permission, and for those instances it is important (especially when using food reinforcers) to develop a security system for your food (childproof doorknobs, fridge-guards, etc.). If your child is non-verbal you'll want to do something like this anyway so that you can start teaching him to ask for foods, rather than just taking them.

Hope that helps!

EmileMulder,

I am not the original poster, but I am asking this b/c I am curious about this particular strategy. No snark is intended. I am asking as a legitimate question. If you create artificial scarcity for something that has previously been unrestricted or at least relatively freely available (especially a food item, albeit not one necessary to sustenance) to attempt to accomplish some goal, are you not eroding your child's trust?

If someone had taken something away from me as a child just so they could offer it back in exchange for me doing something I had very strongly not wanted to do, I am pretty sure I would have resented it, and possibly remembered it for a very long time.

I think there is a big difference between offering something new and making it available on a limited basis, and holding a favored thing back in exchange for compliance. It understand that it is hard to find new reinforcers, and easy to use an existing one, but I am not sure this is a good idea unless it is already something that is a rationed thing and you are offering extra access.


Worse yet, what if you do this, get your kid all riled up, and it turns out he is not developmentally ready for said goal (in this case toilet training)? Then your child doesn't trust you not to unfairly and capriciously take away valued things and you have not derived any benefit,

Wow - we have experienced both of these outcomes in our forays into toilet training. Unfortunately. My son has a limited diet too- so he has very few "treats" and these exact things have happened- he was upset that his favored treat was now only a reward. He does have a good memory, our trust is fairly intact but he is very obviously resentful of the whole reward system. He's a smart one.
It's hard too because as a parent, you WANT to be able to give your kid something fun and delicious like other kids get to eat. And with so few options, to make everything good into basically a bribe is pretty crappy for mom and dad too.

I appreciate the detailed response though, EmileMulder. I will revisit these strategies and see if we can improve on how we do things around here.