My son was diagnosed with autism. He is a happy, well adjusted, highly functioning 7 year old. My concern, though, stems from his refusal to do BMs in the potty. He is potty trained for #1, wears underwear during the day and has very little issue. He has NEVER done a BM in the toilet, adamantly refuses and says he is scared. He waits until he has his Overnight diaper on, then he will go. It is hard with the autism - hindsight is we should have gone after this more aggressively but we were sensitive to his challenges. Now we are in a rut - he is older and more determined and I am at wits end on what to do. Bribery, having his brother tell him it is not scary, etc, etc have not worked. I cannot decide if he is truly scared, or just in a comfortable habit that he refuses to give up. Any suggestions on how to address this?
Firstly I would say that you are not alone, many people post with problems around toileting. If your son is verbal and saying he is scared about using the toilet I would believe him and go with that feeling. Has he given you any idea of what is scary about it? Could he have a problem about his BMs going into a dark scary pipe?? Although it is different, my son has sometimes been very upset about throwing away a tissue that he has blown his nose on (as if he is upset that his snot is going in the bin!).
I tend to find autistic children are very honest about what they are experiencing so I would believe what he is saying even if it makes no sense to you. Have you tried explaining to him about the process ... eg. it goes down the pipes ..... to another place where bacteria eat it and without it the bacteria would die .... Then he might feel sorry for the bacteria??? But apart from the scary feeling, he is probably also in a routine. When my son is at his nans house he will go to the toilet, wipe himself etc no problems. At home he has a routine that I am trying to get him out of which includes me having to do a final wipe to check he has wiped himself properly. I am slowly getting him out of this routine, but it is hard and there are tears when I refuse to check he has done it properly and sometimes I give in just so I can get on with the rest of my chores. He is also 7 but is slowly coming round to being more independent in this area.
Have you tried using Social Stories to explain that everyone (including him) gets too big for diapers. You could start preparing him (Social Stories etc) and start asking him everytime he goes to the loo "Are you going to do a BM?". You could tell him that he is now a big boy and big boys do not wear diapers and they do BMs in the toilet. Then during the summer break you could stop diapers at night and see what happens. At least if he makes a mess it is during the holidays and you can clean it up. Do you think he would do BMs in the bed if he wasn't wearing a diaper?
You could even tell him that the store has no more diapers and so now he will have to do BMs in the toilet. It depends on how your son would react to this. For example if my son is pestering me to go to the toy shop I will tell him its closed for a holiday and he never questions this. If I tell him that we can't go to the toy shop because I don't have time or I don't have money then he just throws a tantrum. I don't use that approach often, simply because I want him to learn the truth, but sometimes it is the only way that works.
I don't know any HFA adult who still wears diapers at night (not in my circle anyway), so I suppose they must all get the hang of it in the end, but just not necessarily at the time when their peers are.
Thank you so much for your comments. Your son sounds very much like mine in personality, sometimes just knowing that helps. My son loves details, your idea about the describing the process is a great one - I have not tried that yet. I am focused on getting through this by the end of summer vacation - have tried to tell him that everyone needs to be trained by 2nd grade. I will look for Social Stories to support the idea, he will sometimes model things that appeal to him . He says he is afraid but does not really get into specifics which is why I think it is some of that (probably was more so at an earlier stage) but mostly routine today. Would love to get rid of the Overnights, however I have a younger son who would still require them so I could not manage that one well at this point. We have, though, used the "sunday" and "closed" story for toys etc too, makes me smile to see someone else with the strategy.
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