The importance of toilet training

I have a question for those who aremedically incontinent. I have a friend who has a child that hasAutism. He has it in a rather severe form. He is not potty trainedbut does have control. For example he likes to stand at the top ofstairs and pee down along with other tricks when he wants to. Shehas tried, in vain, all the modern techniques. Being in my seventiesI know a number of old time methods that are not too nice.
What we are concerned about islimitations. As he gets to be a teen and is not toilet trained howwill this affect his life's opportunities. And compared to some ofyou he probably will need help in dealing with diapers etc. Wouldyou say we need to push the acceptable to make his future how muchbetter?

I'm suffer from urinary incontinence due to a birth defect and have always had to wear nappies. I'm a university student now and I've found it to been accepted quite well as are most people with disabilities. At school I was bullied really badly though. Kids just aren't as understanding and I had to leave class to change at least 3 or 4 times a day.

As I see it, the main problem is not in necessity of toilet training, but in it's possibility. Either way, there will be difficulties, only in one case only some part of his life will be difficult (the training period) and in another, he may have to deal with diapers (himself or with others' help) for the rest of his life.
For me incontinence isn't much of a problem, but still, if you ask me, the decision is obvious. But then, I've never known anyone with autism closely and don't know what's it like.

If the methods are "not too nice" I wouldn't try them. If he's able to potty train he will with normal methods in his own time if he has the motivation. That last part often being a key bit. If he's able to understand a good way to motivate is to break down how/why using the toilet consistently benefits him. Use cold hard logic and don't skip steps that might seem obvious.

Say he likes playing video games. Explain that by not using the toilet he's making a lot of work, things have to be clean because if they're not he'll get sick, and that he's going to have to do all that work himself soon, so if he doesn't learn to use the potty he'll either get sick or not have time to play video games.

You really have to be careful in judging if he truly has control, but if he does then it's time to remove the nappies and let him be wet (depending on age, again you cannot expect autistic children-traits depending- to follow neurotypical children's developmental timelines!)

I should have mentioned it earlier, he is going on 10.

It's not unusual for more severe autistic children to have to wear diapers. My son and his wife have two foster children with severe disabilities. The boy is autistic, maybe six or seven years old and he has always been in diapers. They've tried potty training but haven't been successful.

Age doesn't really tell us much without knowing his specific circumstances which aren't necessarily things random people on the internet need to know. I'm sure your friend is doing everything she can, there's probably not much people on an internet forum are going to be able to tell you that can help your friend.

Whether he has traits that impact muscle tone and control, and how severely are going to play a HUGE part in his ability to potty train. He may have some control but not full control, in fact frustration over that is a big contributor to acting out with pottying like the stairs thing.

Whether he has sensory issues making it difficult for his body to register the difference between underwear and diaper can slow the process down dramatically. Even with neurotypical kids without major sensory issues that can be a problem which is why letting them run naked at home is a pretty common training tactic, but that's not as feasible with a 10 year old.

Also on sensory issues it's possible he's getting stimulation from pottying in his diapers/pants/etc, this is another thing where he will have to understand WHY it's bad to stop. That it might be embarrassing isn't going to do the trick.

There's a ton of other things that could impact his potty training, and like previous poster said it's really not uncommon if he does wind up staying in diapers. Depending on how well he can function there's a good chance that peers he will interact with will also be in diapers. The best people to help your friend will be her son's doctor and therapists, depending on where you/she live bringing up needing a specialized O/T to help with potty training, and potentially P/T too if it's related to muscular weakness, standard o/t usually doesn't cover this but it doesn't hurt to ask at all.

Thanks all for the information. I think some of this is coming from frustration. But it always good to ask a lot of questions. Thanks again!

Feyranna said:

Age doesn't really tell us much without knowing his specific circumstances which aren't necessarily things random people on the internet need to know. I'm sure your friend is doing everything she can, there's probably not much people on an internet forum are going to be able to tell you that can help your friend.

Whether he has traits that impact muscle tone and control, and how severely are going to play a HUGE part in his ability to potty train. He may have some control but not full control, in fact frustration over that is a big contributor to acting out with pottying like the stairs thing.

Whether he has sensory issues making it difficult for his body to register the difference between underwear and diaper can slow the process down dramatically. Even with neurotypical kids without major sensory issues that can be a problem which is why letting them run naked at home is a pretty common training tactic, but that's not as feasible with a 10 year old.

Also on sensory issues it's possible he's getting stimulation from pottying in his diapers/pants/etc, this is another thing where he will have to understand WHY it's bad to stop. That it might be embarrassing isn't going to do the trick.

There's a ton of other things that could impact his potty training, and like previous poster said it's really not uncommon if he does wind up staying in diapers. Depending on how well he can function there's a good chance that peers he will interact with will also be in diapers. The best people to help your friend will be her son's doctor and therapists, depending on where you/she live bringing up needing a specialized O/T to help with potty training, and potentially P/T too if it's related to muscular weakness, standard o/t usually doesn't cover this but it doesn't hurt to ask at all.

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As a 60 year-old Autistic with Cerebral Palsy, I concur with your thoughts here regarding this.

have to think about this one to he may be 10 by the calander but he may only be 1 or 2 years old from the autism messing with things in his brain what about getting some testing done to find out where he is in that area then look at what way to go from there sorry if i did not word this the best i to have trouble in learning things myself

dwayne said:

have to think about this one to he may be 10 by the calander but he may only be 1 or 2 years old from the autism messing with things in his brain what about getting some testing done to find out where he is in that area then look at what way to go from there sorry if i did not word this the best i to have trouble in learning things myself

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Mental age can often be an insulting thing for a person due to each person having their own capabilities. When I was a kid, doctors said my mental age wouldn't go past 10, but I'm in college.
Anyway, potty training on a child with autism can be difficult. Obviously, determining how much control is there is essential. Does he have 30 seconds of warning, does he know when he needs to pee but not poo, that sort of thing. That will help determine if potty training is feasible at all. If he can't feel it, he can't be expected to use the toilet.
As with other individuals with "severe" autism, he may get extreme sensory pleasure from diapers, or even not understand that what he is doing is wrong. For years before I was incontinent, I liked to use my diapers because it felt good. Eventually, I became medically incontinent.
There should be a reward system in place if he is capable of understanding. For example, if you tell mommy when you have to go potty three times today, you can have a cookie. Easy things that he can comprehend, especially after being told in simple terms why going in his pants isn't good.

My oldest brother is severely autistic. I'm four years younger than him, and when I was being potty trained, he was still in diapers, at least for night time and car trips. So when I was potty-trained, my mum said something along the lines of "I've had enough of changing diapers" and apparently he looked at her, grinned, and never wet the bed since. Of course, every person is different, and I'm not trying to be mean, but it might just be laziness if he has shown to have bladder control.

Also, just a random idea: If he likes "peeing games", why not stick a target on the inside of the toilet bowl for him to aim for?

Obviously if he is capable it would be better to potty train him than to not, lots has been said already that may help/work; the only thing I can add is that different people learn differently and I think potty training is probably the same; what works for some likely won't help at all for others.

i have alot of experance with autistic children including my oldest... 95% of older autistic children still in diapers are not incontinent.... it's just that the only thing they know and change a routine. or going to strange places like public bathroom is a overwhelming experance for them.....

I have limited experience with Autism but robertabdl74 I think I am in tune with you. It seems that every method should be tried until, hopefully, success if achieved. Starting with the most conventional and then more unusual. Now I am not saying methods using a horse whip or hanging by the thumbs methods.

Cerebral Palsy means my bladder is somewhat neurogenic and out of my cognitive control.
Of course, I am of course Autistic, and cognitively, despite my high IQ, I have always had issues with bodily self-awareness.
I never realize I have gone pee or poop or both until "after the fact".
To be honest, as a Senior Citizen with Autism and Cerebral Palsy, I am mentally happier completely not being toilet trained anymore and in diapers 24 hours a day around the clock.

Pottie training at that age may not work being that he has to want to give up diapers.
We have so many nerves there they may feel that good to him .
And being changed gives him the attention that he may need also.
You gotta understand if he's that old it's all he knows he's been in diapers most of his life.
Just because there are unpleasant to deal with doesn't mean it's not unpleasant for him.
You have to decide if the battle is worth it his mental state being forced or not.
You might have to reconcile that he's in diapers for life.
When I was put back into diapers at age 6 or 7 they felt so very good.
From that time on I love diapers I love the feel and they give me a lot of comfort.
So I'm pretty sure he's in special education already so teasing hopefully is not in teasing and bullying situations.
That can make his love for diapers more because they're comforting to him.
It's going to be hard to have some people give them up.
I know some people who still suck their thumb and there pretty old actually it just done it all their life.
We all have comfort things we do one thing is eating spending money to feel good.
Those are acceptable things but I wonder if I was trying to get everybody to fit in the round Peg when there a square peg is worth a lot of things.
Mr. Hawkins was disabled He wore diapers so what's the difference between an autistic being the same.
Except that nobody wants to deal with the diapers.

Well I guess I need to reiterate my concern. For someone who can live independently being in diapers might be fine. But if you are dependent on others to change them etc. Things can go along fine. But say it is your parents taking care of you and they get old (I'm 71 and healthy but...) or pass away. Who will step up and do the care provider work? Or are you increasing the odds you will be dumped into a nursing home? I didn't think about the day when I get old but it has snuck up on me. And it will happen to all of us who don't die young. It is that person at say fifty who now has no one to care for them and they aren't continent. Just scary and that might be why I'm some what aggressive.. Just about everyone whats to stay out of a nursing home.

woodenpotty said:

But say it is your parents taking care of you and they get old (I'm 71 and healthy but...) or pass away. Who will step up and do the care provider work? Or are you increasing the odds you will be dumped into a nursing home?

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If you're talking about the nephew and not yourself, I have a unique set of information for you:

I used to work in transporting the mentally and physically disabled back and forth to 'workshop', where they actually had a job and got paid money for it. The amount earned depended highly on what they chose to do. Some of them only got $5 a week but I know of at least two who threw themselves into the job and would pull down $300-400 a week. (The $5 group were mainly there as therapy/babysitting for their parents, they never HAD to do the work, it was up to them.)

There are 'group homes' that exist to allow people with basic skills to live as roommates with other similar folks. A lot of the 'funtional-but-can't-be-left-alone' folks live in them. They have a group of aides who work at the house making sure everyone gets the right stuff, like when they go to the store, making sure that Bob doesn't just buy a grocery cart full of raisins and chicken soup because that's what he felt like eating. XD They also deal with anyone who might be IC. And usually the guys who live at these places have regular kinds of lives, just with an aide tagging along to make sure everything is cool. The group homes are generally divided by gender, guys all live together in one house and girls live in another. I suppose you might think of these as a dorm or 'assisted living facility' because everyone has their own room and they share chores.

If you aren't able to deal with basic skills, then yes, you are greatly increasing the risk that you'd end up in a specialized care facility. They aren't the same thing as just a 'regular nursing home', the staff are trained to work with the mentally and physically disabled. When I was doing transportation work one guy had to go into the local one because his mother passed away and his sisters all worked too much to take him in. He was actually pretty OK with it because he got to hang out with some of his buddies from workshop. (He only got grumpy because they told him he couldn't just eat nothing but candy for lunch and he needed something else, too. Not that he couldn't have the candy, but that he had to eat a sandwich or something as well. LOL)

So that point is all up to the nephew and how cognitively aware he is. If he can do basic tasks like picking up his toys, and eating with utensils, he could probably transition into a group home. And this is providing that he doesn't actually develop a rather good set of skills and be allowed to live on his own in an apartment. That happens too. With the kid being ten, and not having met him IRL, I couldn't hazard a guess, but there ARE alternatives to 'dumping in a nursing home', you just have to contact the Board of DD locally and ask them for help. (That would be what was once called the Board of MR/DD, they dropped the "MR" a while ago.)

But that's up to your family to decide if they want/need to go that route.