Potty-Training Children with Autism Spectrum Disorders: Special Considerations

"Any tips on potty training a child with an Autism Spectrum Disorder?"

Potty-training success hinges on physical and emotional readiness, not a specific age. Many children with Autism Spectrum Disorders (ASD) show an interest in toilet-training by age 2, but others might not be ready until age 3 or even older — and there's no rush. If you start toilet-training too early, it might take longer to train your youngster.

Is your ASD youngster ready? Ask yourself these questions:

• Can your youngster pull down his/her pants and pull them up again?
• Can your youngster sit on and rise from a potty chair?
• Can your youngster understand and follow basic directions?
• Does your youngster complain about wet or dirty diapers?
• Does your youngster seem interested in the potty chair or toilet, or in wearing underwear?
• Does your youngster stay dry for periods of two hours or longer during the day?
• Does your youngster tell you through words, facial expressions or posture when he/she needs to go?

If you answered mostly yes, your youngster might be ready for toilet-training. If you answered mostly no, you might want to wait awhile — especially if your youngster has recently faced or is about to face a major change, such as a move or the arrival of a new sibling. A toddler who opposes toilet-training today might be open to the idea in a few months.

There's no need to postpone toilet-training if your youngster has a chronic medical condition, but is able to use the toilet normally. Be aware that the process might take longer, however.

When you decide it's time to begin toilet-training, set your youngster up for success. Start by maintaining a sense of humor and a positive attitude — and recruiting all of your youngster's caregivers to do the same. 

Next, follow these practical steps:

1. If your ASD youngster has frequent accidents, absorbent underwear might be best. Keep a change of underwear and clothing handy, especially at school or in childcare.

2. Some ASD children respond to stickers or stars on a chart. For others, trips to the park or extra bedtime stories are effective. Experiment to find what works best for your youngster. Reinforce your youngster's effort with verbal praise, such as, "How exciting! You're learning to use the toilet just like big children do!" Be positive, even if a trip to the toilet isn't successful. 

3. After several weeks of successful potty breaks, your youngster might be ready to trade diapers for training pants or regular underwear. Celebrate this transition. Go on a special outing. Let your youngster select "big kid" underwear. Call close friends or loved ones and let your youngster spread the news. Once your youngster is wearing training pants or regular underwear, avoid overalls, belts, leotards or other items that could hinder quick undressing. 

4. When you notice signs that your youngster might need to use the toilet (e.g., squirming, squatting holding the genital area, etc.) – respond quickly. Help your youngster become familiar with these signals, stop what he/she is doing and head to the toilet. Praise your youngster for telling you when he/she has to go. Teach females to wipe carefully from front to back to prevent bringing germs from the rectum to the vagina or bladder. When it's time to flush, let your youngster do the honors. Make sure your youngster washes his/her hands after using the toilet. 

5. If your youngster resists using the potty chair or toilet or isn't getting the hang of it within a few weeks, take a break. Chances are he/she isn't ready yet. Try again in a few months. 

6. Accidents often happen when ASD children are absorbed in activities that — for the moment — are more interesting than using the toilet. To fight this phenomenon, suggest regular bathroom trips (e.g., first thing in the morning, after each meal and snack, before getting in the car, before going to bed, etc.). Point out telltale signs of holding it (e.g., holding the genital area). 

7. Place a potty chair in the bathroom. You might want to try a model with a removable top that can be placed directly on the toilet when your youngster is ready. Encourage your youngster to sit on the potty chair — with or without a diaper. Make sure your youngster's feet rest firmly on the floor or a stool. Help your youngster understand how to talk about the bathroom using simple, correct terms. You might dump the contents of a dirty diaper into the potty chair to show its purpose, or let your youngster see family members using the toilet. 

8. If your youngster is interested, have him/her sit on the potty chair or toilet without a diaper for a few minutes several times a day. For males, it's often best to master urination sitting down, and then move to standing up after bowel training is complete. Create a potty-training social story, read a toilet-training book, or give your youngster a special toy to use while sitting on the potty chair or toilet. Stay with your youngster when he/she is in the bathroom. Even if your youngster simply sits there, offer praise for trying — and remind your youngster that he/she can try again later. 

9. Occasional accidents are harmless, but they can lead to teasing, embarrassment and alienation from peers. If your toilet-trained youngster reverts or loses ground — especially at age 4 or older — or you're concerned about your youngster's accidents, contact his/her doctor. Sometimes wetting problems indicate an underlying physical condition (e.g., urinary tract infection, overactive bladder, etc.). Prompt treatment can help your youngster become accident-free. 

10. Most ASD kids master daytime bladder control first, often within about two to three months of consistent toilet-training. Nap and nighttime training might take months — or years. In the meantime, use disposable training pants or plastic mattress covers when your youngster sleeps. 

11. ASD children don't have accidents to irritate their moms and dads. If your youngster has an accident, don't add to the embarrassment by scolding or disciplining him/her. You might say, "You forgot this time. Next time you'll get to the bathroom sooner." 

12. Have plenty of patience, keep it simple, and make it fun!

Resolving "Homework Battles" with Children on the Autism Spectrum

"Getting my son to do his homework has become a nightly battle. We are at the point of arguing constantly, which clearly is making a bad problem worse. Is there a way I can help him understand the importance of education and to develop some interest in following through with schoolwork?"

Homework can be very difficult for kids with Aspergers and High-Functioning Autism (HFA) to understand for the following reasons:

·         they do not understand why they are expected to do schoolwork at home

·         they find school stressful and do not want any reminders of it at home

·         they might have difficulty with organization skills

·         they find it difficult to remember to write down all the homework and remember deadlines

However, there are a number of tips that can help these young people in the future:

1.       Allow kids on the spectrum to make choices about homework and related issues. They could choose to do study time before or after dinner. They could do it immediately after they get home or wake up early in the morning to do it. Invite them to choose the kitchen table or a spot in their own room. One choice kids do not have is whether or not to study.

2.       Doing homework can suck on its own. It’s even worse when your youngster is hunched over the books alone thinking that the rest of the family is having a party in the other room. Sit with your youngster, review the work, encourage and help (but don’t you dare do the homework yourself!). If you must get things done, at least park your youngster in the same room so you can answer questions as you make dinner, pay bills, or post of Facebook.

3.       Eliminate the word “homework” from your vocabulary. Replace it with the word “study.” Have a study time instead of a homework time. Have a study table instead of a homework table. This word change alone will go a long way towards eliminating the problem of your youngster saying, "I don't have any homework." Study time is about studying, even if you don't have any homework. It's amazing how much more homework Aspergers and HFA children have when they have to study regardless of whether they have homework or not.

4.       Only help if your youngster asks for it. Don’t do problems or assignments for kids. When your youngster says, "I can't do it," suggest they act as if they can. Tell them to pretend like they know and see what happens. Then leave the immediate area and let them see if they can handle it from there. If they keep telling you they don't know how and you decide to offer help, concentrate on asking than on telling. Ask: "What do you get?" … "What parts do you understand?" … "Can you give me an example?" … "What do you think the answer is?" … or "How could you find out?"

5.       Disorganization is a problem for most of these special needs kids. If you want them to be organized, you have to invest the time to help them learn an organizational system. Your job is to teach them the system. Their job is to use it. Check occasionally to see if the system is being used. Check more often at first. Provide direction and correction where necessary. If your youngster needs help with time management, teach them time management skills. Help them learn what it means to prioritize by the importance and due date of each task. Teach them to create an agenda each time they sit down to study. Help them experience the value of getting the important things done first.

6.       If your child can’t do his homework at school, he might need to unwind and relax when he first comes home, instead of launching straight into work. Giving him time to reduce his stress levels may mean that he then finds it easier to focus on the work later on. Some kids may also benefit from using either a reward system or a behavior contract. If he successfully completes his homework every day for a week, could he get a reward at the weekend? Alternatively a behavior contract could be drawn-up with everyone in the family, with everyone agreeing to do one task every day - and it could be agreed that completing his homework will be the thing that your child will do.

7.       If your child finds it difficult to understand why he does homework at home, could he do it at school instead? Some kids find break and lunchtime very hard and they may find it preferable to sit in the library or a quiet place in the school and do their work. Some schools also have after-school clubs or homework clubs, which your child may find of use.

8.       If your child has more than one piece of homework, it may be useful to ask the teachers in each lesson to either make sure your child has written down the homework in his diary, or write it in for him. They may also need to provide written instructions to take home which breaks the task down further as well.

9.       Keep the routine predictable and simple. One possibility includes a five minute warning that study time is approaching, bringing their current activity to an end, clearing the study table, emptying their back pack of books and supplies, then beginning.

10.   Replace monetary and external rewards with encouraging verbal responses. End the practice of paying for grades and going on a special trip for ice cream. This style of bribery has only short term gains and does little to encourage kids to develop a lifetime love of learning. Instead make positive verbal comments that concentrate on describing the behavior you wish to encourage.

11.   If homework is something your children have to squeeze in between karate, piano lessons and soccer practice, they’re not going to think of it as important. And, unless you really enjoy over-dramatic tears and hearing every excuse in the book, avoid doing homework right before bedtime at all costs.

12.   Time slams to a crawl for many Aspergers and HFA children when faced with a stack of papers and a #2 pencil. Set a timer for 15 minutes and, when it dings, tell your youngster to take a quick break to stretch, get a drink of water or collapse on the floor and moan “I hate doing homework” over and over again. Really active children may need to run around the house before they get back to the books.

13.   Use study time to get some of your own responsibilities handled. Do the dishes, fold laundry, or write thank you notes. Keep the TV off! If you engage in fun or noisy activities during that time kids will naturally be distracted. Study time is a family commitment. If you won't commit to it, don't expect that you kids will.

14.   You need to use leverage to get some children to do anything. Do they love television? Computer games? Guitar Hero? Unplug it all until homework is done. You can even exchange homework time for something they love: 15 minutes of effective homework time = 15 minutes with their beloved plugged-in whatnot.

15.   There comes a time when your child has to accept that homework is his responsibility. So, if you’re really tearing your hair out and aging prematurely due to the nightly fighting, it may be time to let your little bird fly on its own. Let your youngster go to school with an unfinished assignment and accept the consequences. Collaborating with the teacher ahead of time may insure an appropriate response to “the dog ate my homework”. 

==> Preventing Meltdowns and Tantrums in Kids on the Autism Spectrum

Behavior Problems At Home - But Not At School

"I have great difficulty with my 6-year-old daughter (high functioning) at home due to frequent tantrums and meltdowns, yet her teacher states that her behavior at school is quite good. Why is this – and what can I do to get the same results at home?"

First of all, just because the behavior occurs at home doesn’t necessarily mean the “cause” of the behavior lies there. Your daughter may find school very stressful, but keeps her emotions bottled-up until she gets home. Most kids with Aspergers and high-functioning autism (HFA) do not display the body language and facial expressions you would expect to see when a youngster is feeling a particular way. While your daughter may appear relatively calm at school, she may be experiencing very different emotions under the surface.

Asking an HFA youngster how she feels may not get the correct response, because most of these young people struggle to explain their emotions to someone. Some find carrying visual “stress scales” helpful for overcoming these communication problems. These scales can be either in the format of a scale from 1-5, a thermometer, or a traffic light system. The idea is that when the youngster indicates that she is at a '4' or 'amber' (before she reaches a '5' or 'red'), she needs to be helped in some way to calm down again.

Instead of adults asking your daughter how she is feeling, she can show them the appropriate number or color. Scales can turn “emotions” (which are abstract concepts that require imagination to understand fully) into concrete examples of numbers or colors. This is something that kids with an autism spectrum disorder find easier to understand. If your daughter finds it difficult to use a scale, she could use a “help card” instead. This could be a red card, or have the word ‘help’ or a meaningful symbol on it, which she could carry around. When she begins to feel stressed-out or mad, she can show it to a teacher. It is important that everyone in contact with your daughter knows what to do if they are shown a card or a stress scale.

Some of these kids may need to be redirected to a different activity, have a quick run outside, or retreat to a quieter part of the school. It can be difficult to find a quiet area, especially in a big mainstream school, but it does not need to be a big space. Some schools will have an area (e.g., the library) where your daughter can listen to her iPod (for example) in order to filter-out external noise for a few minutes while she calms down.

Teachers may be concerned that by giving your daughter a card to leave the room, she may abuse the privilege (e.g., showing it to avoid activities she doesn’t want to be in), thus disrupting her education. Strict boundaries need to be given to your daughter regarding the use of a card or stress scale (e.g., clear instructions about where your daughter gets to go – and for how long). On a positive note, effective use of the card could ultimately reduce the amount of disruption to your daughter’s education. Instead of her being kept in a permanent state of anxiety during class, she may return to the classroom much more relaxed and focused.

Some moms and dads report behavioral difficulties in their HFA kids when they first come home after school, which might be because they are releasing the stress of the school day. If your daughter does this, it might be helpful to have a period of time right after school when she can relax. You could do this by reducing the amount of social interaction your daughter has immediately after school and by providing an activity which you think may help her de-stress. This activity will depend on your daughter’s preferences. If she is relatively physical in her method of stress-release (e.g., kicking or hitting), providing a trampoline, punching bag, or letting her run around the yard may help relieve the stress. Others like to clam-down by watching television or listening to music. Some find lights especially soothing (e.g., a bubble tube or spinning light).

For some kids on the spectrum, the timetable of the school day provides enough structure and routine to help contain any anxiety and stress. They have a strong preference for routine, and this is automatically incorporated into most school environments. Your daughter may benefit from having a visual timetable for home as well (it will make the environment more predictable for her). A timetable can either be constructed showing the whole day's activities, half the day, or simply the activities that are now and next.

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PARENTS' COMMENTS:

•    Anonymous said… And routine..... And as Angela says, giving a few days notice of things happening, like dental or drs appointments, or visits to family etc
•    Anonymous said… At school barriers are put up. All This takes mental energy and it just runs out by the time you get home. Imagine you are an actor on stage in a 18th century play. Only the play is 8 hours long. Once you're done, you'll be exhausted. One way to take care of it is a stimming regiment after school. Hot bath or hot tub at a gym, heavy blanket nap, meditation, yoga, sports. Video games are okay for at most an hour. Then it's okay to be at home. You know how some men go to the man cave after getting home from work? Or some people hit the bar or gym after work before getting home. Same concept can be applied here. Rest and recharge before being part of the household
•    Anonymous said… Figuring out causes of meltdowns can take time and detective work. Not advised during the actual meltdown - when she's calm, she may be able to give her some clues, and when you're calm, you can think it through easier. Think about 2 categories of "causes" (there may be multiple, not just one): Triggers (what sets them off) & Consequences (what reinforces/keeps them happening). A very short list of possible triggers: exhaustion from holding it together at school, change in environment, change in amount of structure, interactions with siblings, sensory overload (can be really subtle), homework (performance/anxiety) issues, too much information coming in at once, not being able to communicate her needs, picking up tension in another person or the environment, not getting her way (since home is often less structured than school this happens more frequently). Possible Consequences that reinforce the meltdowns: increased sensory or emotional overload from reactions of others, increased desired attention, escape from things she doesn't like or want to do or cause her distress. There's a book by Jed Baker called "No More Meltdowns" that you might find useful.
•    Anonymous said… I always hear that my son is well behaved at school...or even with other people. At home though, or with just me and his dad, my son lets loose.
•    Anonymous said… I feel like my kid spent all day at school trying to be good and figuring out how to accommodate his challenges and how to get by in a neuro-typical world, that he was DONE when he got home. All that overstimulation is emotionally draining, I'm sure. He's 13 now and doesn't have melt-downs. He's able to control his anger and emotions a little better.
•    Anonymous said… It's because home is a safe space where they can let off steam. They have spent all day concentrating and remembering the rules and are totally stressed out. As bad as it is, I always found my son loved a bath to unwind; a snack and if possible, no homework. As he became better able to manage himself, to relax himself, then the homework began to be done. It's still difficult at times, once he's absorbed in something woe betide anyone who interrupts him, even if it is for him to have dinner, or to go to sleep....
•    Anonymous said… I've read that because they try so hard to deal with school, their brains are on overdrive and anxiety high, when they come home they just relax, let it go and meltdown.
•    Anonymous said… Learn the techniques that the school applies while she is there and apply the same ones at home.
•    Anonymous said… My Aspie daughter did horribly in school. It was incredibly stressful for her and have been homeschooling her for years. She is 14 now and we only havery melt downs every now and again. They are not school related as they used to be, I feel blessed to be able to homeschool her but feel bad that she may be missing the social interactions it provides. Her best friend lives in Nova Scotia and they talk online till 4am sometimes. The melt down have eased up so much with age too though. I don't feel like I'm losing my mind anymore. LOL.
•    Anonymous said… My son had this issue .... routine and attention. My son likes to know in advance what and when and how. It relieves anxiety and an irrational fear of the unknown that can lead to meltdowns. It takes extra time to stop and explain things ... little things ... like first we are going to the store and this is what we are going to buy etc. Then we will stop for pizza etc. Even though I am making the decisions he feels in control because in his mind he knows what to expect. Then if things do not go as planned it is good to have practiced a "response" such as a breathing exercise or counting to 10 or whatever ur child likes so that in an instance where there is a loss of control they have a way to get it back.
•    Anonymous said… Same problem so after school pick up we went to the park or for a swim to unwind. We put up pictures of home routine on the wall. But it gets better. Letting off steam from school stress is normal. They do it at home because it's a safe place to let it out.
•    Anonymous said… Same situation with my daughter. As she matured it got better.
•    Anonymous said… Set routine in school and in school some dont like the lime light as such so stay quiet out of fear of being heard(social aspect of it all)..at home where safe and familiar they let loose...is there a change in the home a noise that sets the child off suprisingly even a ticking tock can drive them mad as there senses are heightend...?? Few ideas but who knows really...keep calm keep smiling and loving x
•    Anonymous said… Thank you! I never understood till now frown emoticon
•    Anonymous said… We use a trampoline to calm sensors we find it the best. However sometimes he won't go on it. We have a few other things he can choose from. We have this problem too. It makes me super happy to read it does get much easier. Thank you.
•    Anonymous said… Yes I had the same experience. I'm happy that my son can manage at school as well as what he does. It means in the future he will be able to cope with a job. At home we need to recognise when his brain is frazzled and back off and lower our expectations. As he got older he could handle more. It's tough sometimes and it is stressful and chaotic at home sometimes. Best wishes to you
•    Anonymous said… Yes this is exactly like my son. Home is safe so he can let go of all the stress and tension he holds onto during the day at school. This can happen the second we walk in the door at home, but has often happened in the school car park, or even in the school grounds at school pick up. We try to help him to release some of this built up anxiety by stomping to the car, deep breathing and using his sensory toys. It's not easy and there is no quick fix!

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The Misunderstood Aspergers Child

This video reveals the true reasons behind the behavior that some teachers may view as insubordination. Is your Aspergers or HFA student "misbehaving" - or is he simply experiencing some "autism-related" symptoms? Either way - you can help!

Note to parents: Please email your child's teacher(s) and send them the link to the video below. Copy and paste the following URL into your email:  http://www.myaspergerschild.com/2012/04/misunderstood-aspergers-child.html

==> Teaching Students with Aspergers and High-Functioning Autism

The Strengths of Aspergers and High-Functioning Autism

Aspergers and High-Functioning Autism possess a combination of strengths and difficulties. 

This video focuses on the strengths:



Most Aspergers children:

• can stick to routines…
• are able to forgive others…
• are accepting of others…
• are gentle…
• are honest…
• are not bullies, con artists, or social manipulators…
• are not inclined to steal…
• are perfectly capable of entertaining themselves…
• are smart, they study hard, and they respect authority…
• are talented…
• can make amazingly loyal friends...
• don’t discriminate against anyone based on race, gender, or age...
• don’t launch unprovoked attacks, verbal or otherwise…
• don't play head games, and don’t take advantage of other’s weaknesses…
• enjoy their own company, and can spend time alone…
• have a child-like innocence, an exceptional memory, and have no interest in harming others…
• notice fine details that others miss…
• prefer talking about significant things that will enhance their knowledge-base, rather than engaging in chit chat…
• will not go along with the crowd if they know that something is wrong…