Potty Training With Special Needs

The Hairy Farmer Family’sWife wrote about her struggles with toileting training her son, Harry.  It reminded me of what a struggle we had with our oldest son.   It is so difficult sometimes to distinguish between can’t and won’t especially with such young children who aren’t able to express, “Mommy, I’m terrified of perching my skinny ass on that giant hole above water disappears in a loud scary noise!”

 

I remember when I was pregnant with my oldest child.   We toured daycare centers and  one center told us proudly that children at their center toileted on their own schedule and that they had FIVE year olds still in diapers.   I was NOT impressed.  Of course, five years later, I find that I have a different opinion.  MY children would potty train early; that was the key to successful training.

Why is it that whenever I get snotty with my opinions about how things should be or shouldn’t be I get a big fat slap in the face?

Along comes my oldest…. a child terrified of loud noises with balance and gross motor problems who is very much afraid of any position where he doesn’t feel steady.    We talk about every child developing at their own pace but we forget that there are sometimes real, physical reasons why that pace might be significantly delayed.

At 18 months, I bought him a baby potty and started putting him on it.  He peed the first time.  Oh was I proud!  He was so clever!  Yeah.   That was probably the high point of potty training in our house for a long time.

He didn’t object to sitting on the potty before his bath and he would occasionally pee in it but by two, if I got pee once a week it was a good week.   So I made the huge mistake of trying to bribe him with suckers.  Mind you at this point, I don’t know anything was wrong with him other than the fact he was very sensitive and that his ear infections had impacted his hearing and his balance.    He started refusing to use even  the baby toilet altogether.  I decided to pause for a bit.  He wasn’t ready.
That year, we tried again four or five more times.   I tried the naked baby method, the bribe method, the timer method.  I failed  or maybe I gave up.  I had a new baby, I had an open wound from my c-section for 3 months, I was getting horrible news about his development left and right.  My husband was traveling some and in school the rest.   Honestly, I thought my world was ending and was beginning to wonder if the people saying such awful things about my son could be right.   Could he really be retarded or autistic?

Finally as the new baby exhaustion began to clear and I began to see progress through his speech therapy, I began to believe in his ability and decided to give him time.  I bought some underpants, potty videos, potty books and just kept telling him that one day he would put all his pee and poop in the potty all the time.   Other than asking him to sit on the baby potty before his bath, I just let go for a bit.    But one day, about the time he turned three, he wanted to stand at the toilet to pee and he began to do that every night before his bath.

He finally asked to wear his underpants 2 days before we were to attend a wedding.  I didn’t care.  I was ecstatic.   Lots of accidents but still, he wanted to wear his underwear.  The diapers went away except for bedtime.   We took three changes of clothing with us to the wedding.     I was diligent about taking him to the toilet but disaster struck!  Automatic flush!  Hand dryers! It was so overhwelmingly loud!  He was terrified of using the toilet and refused to pee in the toilet while we were there.    We went put him in his last dry clothes we left.

We had a lot of wet clothes for the next two months but he eventually got the hang of it.  He refused to sit on the toilet but would pee standing.  Going out was an iffy project.  He refused to use most public restrooms and would have complete meltdowns if we insisted.    A museum bathroom had him hysterically on the floor screaming. It was awful.   There were only two public places I KNEW he would use the toilet, one certain handicapped bathroom in the hospital where he had speech therapy and the family restroom in the mall.    What did they have in common?   There was a single toilet and sink, they were larger than a stall.

Despite the fact that by 3.5 he was dry most of the time, he still would hold his poop until he got a diaper at bedtime.  As soon as he was in his diaper, he would poop.  Only he got his diaper then was read a book and put to bed.    We shut the door and he pooped but he didn’t tell us and we would discover in the morning he had been sitting in poop all night.   We had to adjust our bedtime routine to bathe him earlier so that we could change his diaper.

By the time we approached four, I was starting to panic about the pooping in the diaper thing; his doctor told me that I basically had one year to get him potty trained properly.  I am not sure what the or else was.  So I made him a reward chart with a picture of his potty with poop in it= some toy he wanted.     I told him when he put poo in the potty I would order that toy.   He did it that day and his toy was there two days later.  He was SO happy.  So I made another chart.  Two poops = a toy.  Then three, then four. then six.  By then, he was in a routine.  He pooped  before his bath every night in the potty.   Honestly, I was thrilled.

He still refused to sit on the regular potty.  In fact, he would become hysterical whenever I put him on it so I stopped trying.   I decided it was more important for him to be comfortable and independent using the toilet, any toilet, than using the regular one.  I taught him to empty his potty after using it and left it at that for almost a year.

His special education teacher was less than impressed when I mentioned that he refused to use the regular toilet.  Actually, I think she rolled her eyes.    I knew she was just thinking, “Make him.  Take the baby potty away.”    I don’t think she realized what a struggle it was to get him there or why it had been so hard.

At five, we moved and I threw out the baby potty when we left.  My husband panicked and I told him that our son hadn’t pooped by the time we got to our short term housing (3 days) I would buy another.  Fortunately, he’s a big boy and he had to  poop.  So he tried the big potties  the hotel.  He had grown enough in the last few months that he wasn’t having to hold himself up and could easily steady himself.    I officially declared him toilet trained.  I still have to flush for him in public but I can live with that.

What was the common theme with his toileting problems?   It wasn’t refusal (at least after 3).   It wasn’t mechanical (he developed the control).  It was fear.  He was afraid of the noise in public restrooms (still is in some though he has adjusted somewhat) and he felt unsafe perched upon a toilet seat even with modifiers.   He doesn’t have the strength to hold himself steady for long periods of time.   He was afraid.  No punishment, no bribe will overcome that kind of fear.   His fear seems stupid to someone who isn’t bothered by sudden loud noises or who never spent months in silence.    His fear seems unreasonable to someone whose sense of balance and muscle control were with normal ranges.   But that wasn’t what he had to work with.

Everything is harder for my son (except for some academic work) than it is for other kids.   Like every other skill, like every other milestone, we had to break it down into smaller chunks, we had to be patient, and we had to find a way for him do it given his current abilities.