Potty Language and Much More

*Warning*:  If you don't want to read about the toileting habits of my 4 year old, please skip this post.  I'm posting this kind of stuff because other parents are always searching for advice on potty training, and even more so when it relates to Autism.  If you keep reading and you're disgusted, it's on you for not taking my caution seriously.

There have been a couple of huge events in the Brown household this week.

First, Kendall cut all 4 of her 2 year molars in one week (yeah, the week leading up to that was fun :-(  ).

Secondly and most importantly, Cole pooped in the potty.  (Poor boy, he's going to be so embarrassed if he ever reads this one day.)

Autism and potty training is usually tough slugging.  Breaks in communication processing, and sensory issues, make toileting a real challenge.  This has been true for Cole.  If you remember we started potty training last August. 

Cole has s-l-o-w-l-y made progress over the last 10 months.  I remind myself of this whenever I get frustrated about our present progress.  Cole has gone from not even wanting to sit on a training potty, to now doing both manners of business on a regular toilet. 

This last hurdle (pooping) was a biggie.  Since the beginning of our journey, he has just refused to have a bowl movement in anything other than a diaper, and then a pull up (when we switched).  The boy has amazing control.  We're talking days of holding things in because, the only time he wears a pull up is at night, when he's sleeping, when he goes to nursery school 2 afternoons a week, or when we got out to do something in public.  So as you can imagine we get smelly greetings when we open his door in the mornings.  Also, public errands are usually interrupted by awkward "diaper" changes, or abandoned midway ... and God bless his preschool teachers!

So how did he do it?  How did he finally get over such a "blockage", so to speak? ;)  Two words,  A BRIBE.

Now we've been using a reward system off and on this whole time.  The thing with Cole is that there was nothing he wanted bad enough that would persuade him.  Stickers mean nothing, and he just doesn't care for sweets or food that much.  My Happy Meal toy collection from my youth had been exhausted.

Cole got a Leapfrog Tag system for Christmas.  He ADORES this and plays it for hours over the course of a week.  You should see his reading skills as a result, it's amazing.  During my Mom's last visit for Kendall's birthday she brought a present for Cole as well.  There was one condition ... he ONLY got it IF he pooped on the toilet.  The "poop present" (as we dubbed it) was a "The Cat in The Hat" book for his Tag.  He REALLY wanted it.  We put it right out in the open on the bathroom counter next to the toilet, where he could see it every time he sat there.  I'm going to tell you right now that it sat there for a couple of weeks.  Cole tried everything from asking, pleading, sweet talking, even telling us that it was not a "poop present" but a "pee present" in order to convince us.  Finally one morning we found him in his room, in what I like to call, his "poop stance".  Dave quickly got him to the potty, and with one last push he technically did poop in the potty.  Now since he did push, and he recognized that he had indeed pooped, and then put the equation together that it meant he got his present, we praised him highly and let him have the book.  We figured maybe this would break that barrier in his mind and reinforce the desired behavior.  But weeks past and we never had success again.  We began reassuring him that if he pooped in the potty again, he could have another Tag book.  Nothing.  Finally Dave came home one day with a Chuggington book for his Tag system.  It took a few days but finally after sitting on the toilet by himself for a long while, I went to check in on him and he told me he pooped and began to talk about his poop present.  Of course I had to verify for myself, and it was true.  He had pooped, completely and on his own!!  We called Daddy at work to give him the good news, and Cole got his book.  He was so proud of himself, and of course THRILLED to have his prize.  To make it even better he did it again later that day, and after one accident, again the next day.  He even gave us a tally after the last one and he was right!  There's been nothing today, but hopefully he's gotten the idea that this can be done and stick with it.

Unfortunately we still have one huge hurdle to overcome, and that's initiation.  Cole will NEVER tell you that he needs to go to the bathroom (in either circumstance).  He will not take himself to the bathroom, or ask for help to use the bathroom even despite detailed explanations of how to do so.  The boy will be squirming, dancing and in pain and will always have to be told to go use the bathroom.  Even then, sometimes he refuses and we have to force the issue (sometimes with hostility).  The flip side is that he will simply wet or soil himself and then do nothing about.  He will not call out, or come find you.  He doesn't get upset about it.  He just remains glued to his spot going about his previous business.  Why he does this, I can only guess.  Probably because he hasn't figured out his body's signals yet, even though its obvious to everyone else, and despite trying to make him aware of this at the appropriate time.  It's just like if he's hungry, rather than telling you he is or asking for something to eat, Cole will just get cranky and angry.  Also Cole continues to struggle with his communication, especially in the area of requesting.  Presently he is in speech therapy where we work on the simple task of getting Cole to ask for things.  If we are making a puzzle, he must verbally ask for each and every piece without us prompting him.  Initially it took Cole a long time to grasp the concept that he actually had to ask each time to get what he desired (for eg. each puzzle piece).  Then he had trouble transferring the skill to a different activity for example, a ball popper, where he had to request each ball.  Each time the "rule" of requesting had to be modeled for him.  He has made amazing progress with his "I want ..." phrases over the past several weeks.  However there is a long road between "I want that toy" and "I think my body is telling me I need to go pee. I should go use the toilet".

We have learned from Cole's development that along the way there are huge walls, that take time to scale in his own way, when he is ready of course.   Trying to push Cole too soon, ends up with his head butted against the wall half-way, and he's left disoriented and sometimes shy to try the challenge again.  However, we know that sometimes Cole is content to simply sit at the bottom of the wall and make no attempt, or worse yet, he manages to convince us to continue scaling it for him.  The trick is finding the right time to give him a gentle nudge in order help him make success on his own.  Believe me, we are left questioning and second guessing when this opportune time is in each and every circumstance.  When do we need to be sensitive to our child's "disability" and when do we need to make sure we are not sheltering them to their own detriment, because of it?! 

Now I'm not sure if all those who read this blog know that I'm a pastor's wife.  I obviously have certain beliefs in God and faith.  What I have to say next expresses this.  If you're not the religious type, I hope that you will continue reading because it is been extremely helpful and I hope by sharing such thoughts, it may be helpful to you as well.  Now back to my previous question about sensitivity vs. sheltering ...

I regularly pray for wisdom on this very dilemma because it is continues to be beyond my insight and knowledge.  As a parent we tend to believe that we know our children better than anyone else.  But who knows our children better that God?  A God who doesn't see the world or our being as "normal" or "autistic".  God understands each of our inner workings because we are his creations (Psalm 139).  Who better to ask for instruction on a most precious possession than the one who constructed and assembled it themselves?  This is how I've learned (and continue to learn) to walk through life with Cole, and as a result, autism.  All of the therapy and professional help has been a blessing.  I am so thankful to live in a country that allows our family to have access to all these medical aids without financial burden.  But after our few hours of therapy are over, there are many long hours at home, hard at work by ourselves.  I am even more thankful for that we have the heavenly support "up above" to give us the strength we need, and will give us his ear whenever we need it.  No voice mail or ext. number needed.  Though on the hardest days I wish God would just give us Cole's user's manual.  Of course, as a kid, I think I would have been extremely annoyed if my parents knew about everything I was going to do and why.  On second thought, I think I'll keep free will.  Trusting God it is!

The A Word. A Diagnosis.

Back at the end of February we had a follow up appointment with the developmental pediatrician concerning a questionnaire both us, and Cole's preschool filled out regarding his social behaviour.  Apparently our answers were so similar, that the doctor asked us if we filled out the questionnaire together.  We even came to the same score, which never happens.  It was the social component of Cole's assessment back in August 2011, that required further observation before making a final diagnosis.  If you remember Cole was given the label of "Global Delays" after his initial assessment in August 2011.  After the parallel consensus of the questionnaires, the Pediatrician finally gave us a diagnosis of high-functioning Autism Spectrum Disorder.

Since then life has been a bustle of various appointments for Cole regarding different therapies, as well as preparing him for Junior Kindergarten in the fall.  Every time I've thought about blogging this significant milestone in our journey, there just hasn't been what I have deemed enough time or the clearness of thought after putting the kiddos down for the night.  So here I am, with a terrible sinus cold, and possible infection ... unable to sleep.  After hearing from a couple of friends perhaps just starting this journey of diagnosis, I thought it was about time I shared the end result of ours.

We've been told by several professionals that we are taking the diagnosis quite well.  This can be a devastating blow for many families.  Frankly, to be honest, it was more of a relief.  For myself, personally, I have suspected Autism since Cole was almost a year old.  At two years, I was almost certain.  The next almost 2 years was more of a waiting game while jumping through the proper hoops amidst a move across the country and provincial health systems.  I'm not pretending that this was at all easy, but I think I did the bulk of my "grieving" 2 years ago.  I say "grieving" because I'm not sure of how else to describe the feeling that a diagnosis like Autism gives.  I think this may be a whole other post in itself.  I'm going to  have to save that one for another day.  I don't think my aching sinuses could handle the emotional release that rehashing those feeling would give.

So what does Cole's new diagnosis mean for us?  As a family, not much.  Cole is still Cole, just the way God made him.  Like any kid he has his own challenges and learns at his own pace.  These challenges are a reality that we have learned to accept and work with since he came into our lives.  We will continue to help him achieve, learn, grow, love and gain Independence just like any other child.  How we approach this may just be a little different.

What does Cole's diagnosis mean for him?  Cole doesn't know that he is different from anyone else at this point.  He has always been Cole, and that's normal for him.  This diagnosis will merely give him the resources in our society (for eg. school) to help him navigate his way in a world that functions differently than he does.

What does this diagnosis mean for others?  I believe it means that people can now have a reference point as how to relate to our son.  An awareness of what Autism is can result in an understanding of why and how Cole does what he does. 

One final thought ...

I read a number of blogs written by parents whose children have ASD (autism spectrum disorders).  One mom in particular at MOM - Not Otherwise Specified, did an excellent presentation to her son's class about what Autism is and blogged about it.  She titled it "A hair-dryer kid in a toaster-brained world" I highly suggest you read it.  It will make you think about Autism in a very tangible way and she expresses it better than I ever could.