Toilet Training Your Child With Autism

"Any tips for toilet training my little guy with high-functioning autism?"

Even for the "typical" child, toilet training is often a difficult skill to master. For the autistic child, there are additional factors that may inhibit toilet training. The things that would encourage the typical child may not be effective with the autistic child.

Social motivation is a critical factor in determining "readiness" for toilet training. An autistic child may not be motivated by the opportunity to wear "big boy pants," or "big girl pants. The autistic child may not understand what is expected of him. Following all the steps necessary for toilet training may be difficult for the autistic child. Changes in the child's routine may also be a challenge. An autistic child may not be aware of the need to use the toilet.

The first step in toilet training your autistic child will be to determine their level of readiness.

Assessment-

* Establish a positive and meaningful routine around toileting and collect data about your autistic child's readiness for schedule training or for independent toileting.

* Use a simple chart to collect the data needed about the child's readiness. On a routine basis, the child is taken to the bathroom for a "quick check" every 30 minutes and data is recorded on each occasion.

* Over a period of 1 or 2 weeks, patterns of data begin to emerge.
  1. Is the child dry for significant periods of time?
  2. Is there some regularity in his wetting/soiling?
  3. Does the child show any indication that he/she is aware of being wet/soiled?
  4. Does the child pause while wetting/soiling?

* If the answer to all of these questions is no, it may not be time to toilet train the child.

* During this trial period, assess other aspects of the process of toilet training.
  1. Is the child beginning to pick up on the routine involved?
  2. Does the child have dressing skills?
  3. Are there any fears associated with the process of toileting?
  4. What is the child's attention span?

It may be beneficial to develop a task analysis of the steps of toileting. This can provide a picture of all the skills needed, and also let us you see where specific trouble areas may be. The task analysis can be very general or very specific, including everything from entering the bathroom, to flushing the toilet and leaving the bathroom.

Physical Environment-

When beginning the toilet training of a child with autism, you want to help the child learn that this set of behaviors (elimination) is associated with a particular place (the toilet). Moving all changing, cleaning, and toileting-related dressing to this setting helps the child realize the purpose of this room.

A second goal for creating clear physical structure to assist in toilet training is to create an environment that is secure and not over-stimulating. The child will be calmer and more responsive with good physical support for his body. Think about adding foot support, side rails, or other physical supports. Think also about the plumbing noises and echoes of many bathrooms. Many children appreciate soft music playing or the addition sound-absorbent materials.

Using Visual Supports-

For the autistic child, it may be helpful to provide pictures to demonstrate the sequence of events that occur surrounding toilet training. At the most basic level, a transition object may be used to let the child know that the toilet routine is beginning. An object that is associated with toileting may be given to the child to serve as the transition object that takes the child to the correct location. Once the transition to the toilet area has been made, it is important to continue to visually support each step of the toileting routine. We need to let the child know each step he is to accomplish, when the sequence will be finished, and what will happen when the sequence is finished. Again, using an object sequence, a picture sequence, or a written list are all ways to communicate this information to the child.

Trouble Shooting-

Once you have begun the process, you may notice areas that are more challenging. Below are some common solutions.

If you child resists sitting on the toilet:
  • allow them to sit on the toilet without removing clothes
  • allow to sit with toilet covered (cardboard under the seat, gradually cutting larger hole, or towel under the seat, gradually removed)
  • use potty seat on the floor rather than up high
  • take turns sitting, or use doll for model
  • sit together
  • add physical support
  • help him understand how long to sit (sing potty song, length of 1 song on tape player, set timer 1 minute, etc.)
  • as he gradually begins to tolerate sitting, provide with entertainment

If your child is afraid of flushing:
  • don't flush until there is something to flush
  • start flush with child away from toilet
  • give advance warning of flush
  • allow him to flush

Only want to flush:
  • physically cover toilet handle to remove from sight
  • give something else to hold and keep them busy
  • use visual sequence to show when to flush (after replacing clothing, for example)
  • when time to flush, give child a sticker that matches to a sticker on toilet handle

Plays in the water:
  • give him a toy as distraction
  • use a padded lap desk while seated
  • cover the seat until ready to use
  • put a visual cue of where to stand

Plays with toilet paper:
  • remove it
  • roll out amount ahead of time
  • give visual cue for how much

Resists being cleaned:
  • try different materials (wet wipes, cloth, sponge)
  • consider temperature of above material
  • take turns with doll

Bad aim:
  • supply a "target" in the water, such as a Cheerio
  • larger target as toilet insert (contact papered or laminated cardboard with target drawn on it), gradually moved down
  • add food coloring in the water to draw attention


Coping with Transitions: Help for Aspergers Students

Transitions are very difficult for children with Aspergers and High-Functioning Autism. It's an interruption to their day and a change in their schedule. In order to minimize difficulty in transition, try to keep their schedule as routine as possible. Always let them know ahead of time that a transition in routine is coming. 


Calming Techniques for Autistic Children

In order to understand what calming techniques will work, you will first need to determine what things excite and upset the child, and have some understanding of the context in which he is throwing a tantrum.

Occasionally the youngster may exhibit a behavior problem at school but not at home, or vice versa. For example, parents may have already developed a strategy to stop the behavior at home, but the teacher is unaware of this strategy. It is important that the parent and teacher discuss the youngster’s behavioral problems since one of them may have already discovered a solution to handle the behavior.


Developing Your Autistic Child's Communication Skills

"Any tips on helping my child with autism to be more verbal?"

Although the cause of speech and language problems in autism is unknown, many experts believe that the difficulties are caused by a variety of conditions that occur either before, during, or after birth affecting brain development. This interferes with a child's ability to interpret and interact with the world.

The communication problems of autism vary, depending upon the intellectual and social development of the child. Some may be unable to speak, whereas others may have rich vocabularies and are able to talk about topics of interest in great depth. Most have difficulty effectively using language. Many also have problems with word and sentence meaning, and understanding.

No one treatment method has been found to successfully improve communication in all kids who have autism. The best treatment begins early, during the preschool years, and is geared towards the individual.

The goal of therapy should be to improve useful communication. For some, verbal communication is a realistic goal. For others, the goal may be gestured communication. Still others may have the goal of communicating by means of a symbol system such as picture boards.

A lack of communication skills may cause inappropriate behaviors and challenging situations for both the child and parent. The Picture Exchange Communication System (PECS) is an augmentative communication system developed to help kids quickly acquire a functional means of communication. PECS is appropriate for children who do not use speech or who may speak with limited effectiveness (i.e., those who have articulation or motor planning difficulties, limited communicative partners, or a lack of initiative in communication). PECS has a number of advantages over other methods of addressing communication. Most importantly, it works, which encourages the child to communicate more often, reducing frustrating situations.

When your child hands you a picture or sentence strip, you can easily understand what they are trying to communicate with you. From the start, communication is initiated by your child, making it meaningful and highly motivating. It is an inexpensive communication system.

A PECS symbol can be as simple as a hand-drawn picture, or a snapshot. The child is able to communicate with anyone, versus sign language. Anyone willing to accept a picture is available, not just those who understand sign language or who are familiar enough with the child to understand him/her. Children are able to generalize communication to a wide variety of situations and people.

A uniform system for using Velcro fasteners on your symbols, boards, and books needs to be established. This will ensure that all of your PECS symbols can be used with any of the boards or books within the child's environment.

If the child doesn't eventually develop speech, printed words will likely be a more convenient and natural means of communication down the road than pictures alone. Also, we want to encourage reading in every child, and pairing words in a system that likely will become very motivating for a child might help hasten acquisition of those printed words.

The efficacy of various types of symbols may have to be tested with your child. Some kids can better interpret photographs, because they look more like the actual activity or object that the picture represents. Others may find all the colors and visual elements of a photograph too distracting or difficult to decode, and may find a simple black-line drawing easier to use. 

There are many apps for the iPad and iPhone that help tremendously with an autistic child's language and communication challenges.


What are the long term outcomes for people with autism?

The long term outcomes for those with Aspergers syndrome (high functioning autism) depends on the severity of their symptoms, their baseline IQ, their ability to communicate and what kinds of interventions and support they receive.

Click here for the full article...

Meltdowns in Children on the Autism Spectrum: Crucial Strategies for Parents and Teachers

High-Functioning Autism (HFA), also referred to as Level 1 Autism, is a neurological condition. The brain is wired differently, making this disorder a lifelong condition. It affects communication, social interaction and sensory issues. HFA is often referred to as the "invisible syndrome" because of the internal struggles these kids have without outwardly demonstrating any real noticeable symptoms. Thus, difficultly assessing someone with HFA is even more impacted.

In this post, we will discuss the following:
  • nine different types of temperaments in HFA children 
  • meltdown prevention
  • meltdown intervention
  • post-tantrum management
 

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