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Children on the Autism Spectrum and High Pain Tolerance

It is not uncommon for Aspergers and high functioning autistic (HFA) youngsters to experience great pain and discomfort that goes unreported, unnoticed by others, undiagnosed, and untreated. Enduring pain and allowing it to become chronic is extremely detrimental to your youngster's ability to function, grow, and learn. Untreated pain and discomfort will also seriously affect your Aspie’s behavior and ability to communicate with others.


Urinating In All The Wrong Places

Question

My son is peeing in corners …on his lounge chair …on his Frisbee (toys). He suffers from ASD, ODD, ADD, ADHD, SPD, ANXIETY NOS. Does anyone else’s child do this?? If so, how have you got them to stop?????? We need help ASAP!!

Answer

In summary, children who pee in all the wrong places do so because (a) they can, (b) it brings them a sense of pleasure, and (c) it gives them a sense of control …let me explain:

About 25% of kids can be strong-willed, and they can find unique ways to "express their will" – and peeing on toys might be an expression of dominance, anger, or mastery (e.g., “look what I can do”). Your son’s emotional state when he pees on toys will help lead you to the underlying issue, (e.g., anger, dominance, mastery).

Usually this kind of behavior is seen when an ASD youngster is feeling stressed, unfairly disciplined, overlooked, or over-controlled. It seems to be a kind of secretive rebellion, a way of "marking territory." Regardless, you obviously want to redirect this behavior immediately so he doesn't start falling back on it whenever he's angry, stressed, or seeking some form of control over his environment.

What can you do? Here are some tips:

1. Use a “praise and rewards” system. You want your statement, ''You remembered to use the potty every time today! Great Job!'' to feel so good to hear that he'll want to hear it again every day. Also, you will get better cooperation if you use positive discipline in general, which is even more important for your child, in case he is rebelling against your discipline practices.

2. Do the “clean-up” together. Say, "Oops, did you pee here? Come on, let's get this cleaned up." Stay calm, hand him the paper towels, and have him help.

3. Consider play therapy. You may want to initiate a play session with his stuffed animals, and have one of them pee all over the house. Make it funny. If you get him laughing, you'll know you're on the right track. You might even have one stuffed animal you're holding ask the one your child is holding, "Why is he doing that?!" You might be surprised at the answer. Your son’s answer will give you some clue as to his motivation for pursuing this bad habit.

4. Consider a reward chart. Some therapists do not recommend reward charts in general, because they get children focused on the external reward, rather than on the rewarding feelings of "doing the right thing." More importantly, if you don't get to the feelings underneath that are causing your child to pee in all the wrong places, it won't work! However, if you do give him help with those feelings, a reward chart could be helpful as an additional incentive to help him break this habit. To try this, every time your child pees in the toilet, he gets a star, and a certain number of stars get him something he really wants – within a few days. Make sure the stars seem really valuable to him. In fact, you might want to launch this by giving him a small reward that he values (e.g., a snack, a small piece of candy) every single time he pees in the toilet. This may seem like overkill, but you need to make the toilet MUCH more rewarding than the lounge chair.

5. Give your child permission to pee outside if he wants. Tell him the rule is that people are allowed to pee outside sometimes, but only over there behind the shed where no one can see and it won't hurt any flowers. That way he will be able to have the satisfaction he's getting from this behavior, but in a more appropriate way.

6. Help your child with whatever feelings are driving him. Your child won’t be able to explain what feelings are driving him. Your job is to help him vent any feelings of fear or anger that are causing him to act-out. The best way to do that is to notice when he is close to a meltdown, and then to "love" him through it.

7. Be patient as he learns to restrain his “impulsivity” (“Hey, peeing right here - right now - sounds like fun”). Aspergers kids can be very impulsive, and it takes a little practice to overcome this “not-so-good” trait.

8. Increase his visits to the bathroom to make it less likely that he'll find himself with a full bladder and feel tempted. Make rules about bathroom habits: "The rule is that we use the bathroom before we go to bed, before and after a snack, after dinner, etc." When he doesn't like the rule, empathize: "I know, you don't want to go right now, but that's the rule. We all go right after meals." Externalizing the rule reduces the chance of a power-struggle between the two of you. Many Aspergers kids are very attached to rules and will follow them as long as they don't feel bossed around.

9. Just in case he's rebelling against what feels like too much control, give him fairly constant choices. Don't overwhelm him with ten choices at a time, just let him choose, whenever it would be ok for him to decide between two things.

10. Make it clear that "all people pee in the toilet" – but don't get into a struggle with your child about this. You can't win it, because he can always continue the behavior, and it will just require that you “up the ante” to a level of punishment that would be clearly inappropriate. The truth is that improving your relationship with him will have more impact on eradicating this behavior than any kind of punishment you could devise, and punishment always undermines your relationship.

11. Most young kids are feeling their testosterone. They need opportunities to wrestle, play superhero, and demonstrate their prowess in any way they can. This is totally age-appropriate, including when he brags to you that he is stronger than Superman. (Your response to that? "Wow!") Make sure he has plenty of opportunities to feel powerful, so he doesn't need to use his territory-marking strategy.

12. Shower him with unrequested love, appreciation and attention. Setting aside a regular daily time just to spend with your child can be challenging, but that may be the most important action you can take. You want him to feel so connected to you that he just can't bring himself to do something that he knows displeases you.

==> My Aspergers Child: Preventing Meltdowns and Tantrums in Aspergers Children

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