No, not you honey – my other valentine.
The little guy. Stephen is 7 years old and still not potty trained. We’ve had our share of challenges. Stephen has special needs. He’s non-verbal autistic and legally deaf-blind. This past summer he finally graduated to eating solid foods. Now we have our sights set on the next big milestone. I’m going to need you to cheer me on for this one. In all honesty, I’d rather go mountain climbing.
Since we have a long weekend with Friday (Valentines Day) and Monday off, we’re going to attempt to tackle this. This week I got my son’s report card. Enclosed was a newsletter with an article on potty training “persons with developmental disabilities.” To me it sounds like a horror story, but I’ve got to be honest. If it’s successful it will transform from a horror story to an inspirational tale.
My son is way too big for this potty chair now. So we went to the children’s hospital for an adaptive equipment evaluation. Now we have one that looks something like this:
If we had a walk in shower to hose it down in we’d be all set 😉
We have our PECS (picture exchange communication system.) We have our potty chart. We have stickers. We have our potty time songs and videos on the ipad…
We’re ready to go!
Now here’s the directions (tell me if this makes you want to cringe.)
Guidelines for Potty Training Program – by Foxx and Azrin – “Toilet Training Persons with Developmental Disabilities”
1. When beginning the potty training program, be sure the child is wearing regular underpants. Diapers or pull-ups may only be worn each night while the child is sleeping, but should be replaced with underpants when they awake.
2. Keep the child’s bladder full most of the day by giving the child as much fluid as they can drink. Do not give the child salty foods in order to create and EO to drink. Salty foods will cause the child to retain water.
3. Take the child to the bathroom every 30 minutes. Stay on the potty for 10-20 minutes or until the child voids. If the child does not void, instruct them to put their clothing back on using minimal prompts and allow them to leave the bathroom. Boys should also be sitting on the toilet.
4. If the child voids during this time, provide tangible reinforcement and praise immediately. Prompt them as little as possible to pull their clothing back on and allow them to leave the bathroom.
5. Every 5 minutes, check the child to see if they are dry. Put the child’s hand on their pants so they can check themselves. If the child is dry, provide reinforcement and praise.
6. If the child is not dry during “dry checks”, be sure they touch the wet pants and tell them where they are supposed to urinate. Then immediately take them to the bathroom. Prompt them to sit on the potty, and then prompt them to stand and pull their wet pants back up (use the minimal amount of prompts required.) Immediately return to the spot they urinated in and follow the routine again. Repeat this positive practice procedure five times. Use full prompting if necessary. After the fifth practice, change the child into dry clothing and have the child clean the spot where the accident occurred. Do not provide a lot of attention at this time. The positive practice procedure is not fun for the child.
7. Typically, children will have many potty accidents when you first begin this procedure. Do not get discouraged. Continue to implement the positive practice procedure.
8. The first time the child self-initiates, stop scheduling the child for potty time. At this point you will not schedule them again. If you continue to schedule the child they will become dependent on the schedule and not initiate.
9. Be sure to continue to fill the child’s bladder with fluids. Initially, more accidents will begin to occur. Use the positive practice procedure when this happens.
10. The accidents should cease within a short period of time. Usually the child will then begin to initiate frequently. If the child self initiates one time and never initiates again (over the next two weeks), start scheduling them again.
11. A requesting repertoire is not a pre-requisite for this procedure. You should not be requiring the child to mand for the potty during training (do not prompt them to ask for the potty.)
12. After the child has had 20 consecutive initiations with no accidents you may stop forcing fluids.
13. When you are ready to try to take them to the store or other public places use the following procedure: Fill the child’s bladder before you leave so that they should need to go as soon as you get there. Find the restroom as soon as you get to the store. Walk in with the child but say nothing. Walk to the stall and show them the toilet. See if they will initiate. If they do not, try using minimal prompts.
14. Bowel training: Accidents of this type will continue to occur after the voiding is under control. Resist the temptation to put the child back in diapers. Do not use positive practice for BM accidents. Only require that the child clean the mess. Eventually the child will begin using the toilet for BMs also.
15. If the child has a fairly regular bowel schedule you may want to try to schedule them and have them sit on the toilet for a while during that time.
16. Once the child is voiding and having BM’s in the potty, it is then time to teach the boys to stand while urinating.
17. Once the child is self-initiating for a period of one month with no accidents, you may then teach them to mand for the potty by stopping them when they are walking to the toilet, temporarily blocking access to the toilet, and prompting them to mand for the potty. Do not teach the child to mand until self-initiation is strong.
In the past, we attempted to get Stephen to try to communicate the need to go to the bathroom. I had a feeling that the communication issue was hindering our efforts to potty train him. Then I tried practicing the routine so that he could initiate by himself. Stephen wants to learn but just pulling his pants up and down is exercise for him. If anyone out there has experience potty training a child with special needs (or just potty training in general) – feel free to share your experience!
For now it looks like I’ll be getting pooped on for Valentines Day 😦
Those of you who have no grand plans for Valentines Day can think of me and be grateful – lol.
P.S. Honey, I’m sorry I couldn’t come up with a better Valentines Day present. The good news is if this works you won’t be needing to change any adult diapers until you need them yourself 🙂
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