Crazy meltdown

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My son is three and non-verbal, he is partially toilet trained. He knows how to use the toilet, and can, but after he somehow put together he never leaves the house without a diaper on he started demanding to have a diaper on 24/7. He even fights and screams and has meltdowns when we change a dirty diaper and clean him up, he doesn't want it to come off at all. He has no interest in the soiled diaper after, he just never wants to be without one.

Tonight we had just had enough of this, he was again fighting us to take off a badly soiled and soaked diaper so we decided he needed to go without one for a little while at least as once we got it off and him cleaned up in the shower(it was that bad!) he had horrible diaper rash.

He ran around the house just screaming at the top of his lungs, tearing down anything he could or throwing himself into things and furniture, slamming his head and body against the floor, wall and furniture. Screaming and screaming until he forced himself to vomit three times, once coming up to me and vomiting on my feet seemingly on purpose(he has been doing this during bad meltdowns since younger). We left him for almost thirty minutes with the melt down just getting worse.

I don't know what to do, I know this was probably the wrong thing in my heart(I know sudden changes to routine never helped me) but I just couldn't take putting another diaper on him with the extreme diaper rash he has(he will not let us apply creme either).

We have tried to do this slowly, transition to underwear or pull ups but he just meltsdown there too.

oh so sorry.

I know he is non-verbal, but does he seem to understand you? Is it possible to explain what needs to be done to him and prepare him for what you are doing?

I'm a little out of my depth here but if there is any way to prepare him for the transitions, take it. Invest the time.

Does he respond to picture cards? Could this be explained that way if not verbally?

I'm guessing he thinks it's taking the diaper off that makes him feel pain and doesn't realize it's wearing the soiled diaper that's causing the problem. I wish I had an answer but the only thing I can think of is to try those thick cloth things.

I'm guessing going back and forth was too confusing for him, so maybe things will get easier if he can get used to not wearing a diaper.

Does he like water? If there is a diaper less activity that is a positive sensory experience, that's likely to soothe him and make things easier.

We had an issue like that with one shirt that my son would want to wear. Sometimes he would be OK with no shirt (but not always) but he never wanted to wear another different shirt. It was hard to clean it, sometimes I had to mend it. I know that is not as hard as dealing with a dirty diaper, but I thought telling you this might help b/c it is a similar thing. There is something about having the same clothing item on, that appeals to dislike of change. it is obviously comforting in some way.

The only thing I can think of is to gradually increase the amount of time between diapers. I don't know that you can do that while he forcing himself to vomit. As someone else suggested, if he can stand a bath without screaming (mine couldn't until he was out of his one-shirt stage) would serve multiple purposes.

If he any soothing/stimmy toys you could distract him with that might help a little. The only other thing I can think of is to make sure you visibly show him the fresh diaper first, keep it close to him and explain to him what you are doing. Maybe have one person change him while the other reassures him he is getting another diaper, if you can manage that sometimes. (It might help if he has receptive language, or at least build foundations of the fact that you are trying to explain things.) I don't know how to explain pain and rashes in PECS.