bowel movements

juliaj · 4th January 2008, 15:38

I have a child that becomes so focused he does not want to break off for the bathroom. He has wet his pants and soiled himeself several times. Now he is inserting a digit in order to prolong the ineviatable. What do we do?????

Carey2 · 4th January 2008, 19:11

Hello Julia and welcome to you.

You are certainly not alone in this,many children do this .I have a nephew that was always holding himself till the inevitable explosion took place, he is not autistic but was always deeply absorbed in his interests and this went on till he was at least 10.

My own son has not long grown out of this habit holding on till too late and that is down to extra work by the staff at his school.

There are several issues here,autistic children usually concentrate to much deeper levels on whatever is holding their interest.
They also have sensory issues and often do not really know what the bodily sensations are and also they can be downright stubborn.

Factors , age and level of ability(place on the spectrum) also play a part.( It would help to know your childs age)

Avoid making this an issue or something to worry about , I think praise when your child uses the toilet properly and/or when you have prompted this and an "Oh dear" response when it goes wrong,if they are met with anger or a harsh response they can resist using the toilet even more as a way to avoid the negative responses.
My son has Asperger and is quite high functioning, yet he would always insist he did not need to use the toilet.There have been accidents a plenty but we worked at reminders,and praise and slowly he has got into the habit of going when needed and the issue has been resolved.

Picture prompts are always useful,autistic children will often comply with instructions in visual form where everything else fails , pointing to a special toilet time picture may well help.
Be consistent in response and take things in small steps that are easy to achieve and praise each step that works.
I also introduced the idea that "You can play/watch TV/use PC when you have been to the toilet."
"We are not going to .... shops/grandma's/playground/ etc till you have been to the toliet" etc and got my lad into the habit of "performing" before we went anywhere.
A reward/star chart for each day so they can see when they have done well often works, red stars for accidents and gold for correct performance, then at the end of each day you can check the chart together,this really works with lots of things as the child feels they are in charge of the system.

My son has this system of rewards for time spent in class, the more he stays in the more green stickers he gets, he sits and discusses this each evening with the staff and he can relate his day to the progress on the chart,this helps them relate actions etc to the system and also on their own social responsibilties.

linnysue · 4th January 2008, 19:56

Julia, I wanted to welcome you to the Blue Room Forum. I am so sorry that you are going through this with your son, but you will receive great support here.

As you can see, Carey will provide excellent advice that will help you through these bumps.

I wish you well.

rainbows · 5th January 2008, 03:54

Someone recently told me to be careful with wheat with my son as chilren with ASD can have digestive problems..the doctor never told me this,is this true? He's fine with whatever he eats so i dont have to worry but i just wondered.

Carey2 · 5th January 2008, 08:34

I found some links relating to toilet training that may help, some are obviously aimed at basic training in the younger child but the guidlines can be adapted for all ages.
Autistic children love to be in control of their world so you need to have a strategy which allows them to have this control but under your guidance,involving them in a visual prompt system,let them choose the picture etc ,with a reward system let them choose stars/shapes/object/token whatever will hold their attention and then discuss progress together.

Bed time is often the best time to have a quiet talk,my son is always more receptive to discussion then as he has no other expectations of activity/playing/reading etc and he is more relaxed and able to concentrate on what you say,also some praise while having a goodnight cuddle etc will leave a child happy and relaxed for the next day and subconciously the brain will have processed the information and there is more chance of ideas being retained and used.

http://www.autism.org.uk/nas/jsp/pol...?d=1071&a=3366

http://www.autism.org.uk/nas/jsp/pol...?d=1071&a=8385

http://www.teacch.com/toilet.html

http://www.amazon.com/exec/obidos/AS...436187-2652004

Some more links here Julia, this site I found is amazing, it has so much detail and is supplied by a social worker who is also a parent of an autistic child.

Read the article about the "Rewards Tower" I am sure this approach will help you.

http://www.autism-help.org

http://www.autism-help.org/behavior-rewards-tower.htm

Carey2 · 5th January 2008, 08:49

Quote:

Originally Posted by rainbows

Someone recently told me to be careful with wheat with my son as chilren with ASD can have digestive problems..the doctor never told me this,is this true? He's fine with whatever he eats so i dont have to worry but i just wondered.

There is a lot of discussion about wheat,gluten and dairy products in the diet .

Some people have taken this to extremes where they blame these items for being the cause of autism. Certainly some people are sensitive to wheat and have to exclude it from their diets and there are links to behavioural problems but sufferers usually exhibit other physical symptoms as well as the behavioural ones.

If your child has no digestive/bowel isssues I would leave well alone, you have more than enough to cope with as it is without the stress of playing with diets and trying to find/produce wheat free foods.

Also there is the danger of your child picking up on this and thinking they are even more different than other children. Their "differences" can become quite an issue if handled incorrectly, people can develop obsessions and pschosis that hamper them through their adult life if too much emphasis is placed on these issues.

If you are in any doubt at all a chat with your health visitor or GP should be considered.

This link from the NAS has information on diet ....... http://www.autism.org.uk/nas/jsp/pol...?d=1385&a=3368

This link is from autism-help.org and has information on gluten free diets ..... http://www.autism-help.org/intervent...luten-free.htm

rainbows · 6th January 2008, 17:56

Thanks carey..you are right,there's no problem there so im not worrying.Thanks for that link,will take a look anyway just to know more..

cazhome1 · 7th January 2008, 22:42

Hiya my little boy has bowel and bladder incontinence and the only advice i can give is the ASD can play a major part in them not acknowledging that they need the toilet. My little boy takes Loperimide (Immodium) three times a day and is at the maximum dose for his age. We had been under a gastroenterologist for his bowels until his ASD diagnosis where he then got written off, basically they stated that because of his diagnosis the problems were interlinked. I think that it plays a factor but my son was also born with severe gastro oesphagul reflux where the acidity levels in his stomach after a ph study were found to be very high. He ended up with a gastrostomy in situ which he still has today for overnight feeding. We have tried a number of different diets and they really dont make a difference. If you get the opportunity ask for a referral to a gastro specialist who may be able to help you. Pecs are also a good way of helping with toilet training or perhaps you have a friend who has a child his age who could show him what to do?

vvw1970 · 5th February 2008, 02:49

My son had the same issue as you describe here, coupled with other complicating factors. In the end, the simplest answers turned out to be the most effective.

Depending on his age and communication skills, these tips might help.

1. As Carey said, star charts are awesome to change habits. I found that aiming for a certain number of stars (in our case, 10) before a reward was given was good for reaching long term good habits. (eg: ten days without an accident and you might like to take your son to his favourite activity outside of the home). These should not have to be consecutive days, just a total over time, no matter how long it takes. I tend not to note the number of accidents, because it can be overwhelming for the child to visualise how often they are "getting it wrong". If they have some self-awareness and a tendency to anxiety, they can become very self-critical and develop a sense of hopelessness.

2. Using the phrase "You're a big boy now" seems to help. I tended to try to introduce the idea of a change about three months before a birthday. So, when it came to getting my child out of nappies for bowel movements, it was "Well honey, your birthday is coming up, and you are going to be 5 years old! Such a big boy! did you know that at 5 you're such a big boy that you probably won't need nappies anymore?" I also added that after 5 years I didn't really want to deal with poos anymore and asked would he consider discarding the nappies on his birthday? I then dropped the subject and waited for him to answer. The next day he came to me and agreed that his birthday would be a good time to let go of nappies and to use the toilet for his poos. We got pull-ups for night time.

We then basically went through the same process leading up to his 9th birthday in order to work on night continence.

My son had a lazy bowel from years of self-constipating, which made the whole issue very complex and scary for both of us. (Lazy bowel means the muscles of the bowel are no longer effective at pushing movements through so control is a big issue). But the clear cut deadline worked really well, and was far enough away that it wasn't immediate and terrifying for him. It gave us time to work on getting his bowel back into shape and time for him to be accustomed to the idea. (Recommendation: Paraffin oil for lazy bowel, once or twice a day mixed in with chocolate milk - or with milo if you're Australian :D)

Hope this helps and all peace to you. :D