Sunday, 23 February 2014

A Pleasant Side Effect of Being Ill

Struggling with this cold has brought at least one silver lining to our family.  As my husband goes down for the count with his infection, it suddenly occurred to me that I haven't had to clean up a toileting accident for my youngest in over a week. 

I checked with Dave to make sure I hadn't just missed an accident and after a moment of befuddled thought, he agreed with me.

Sometime over the last three weeks, my youngest has learned to listen to his body and just go to the toilet.  We had been using screen time as a motivator but with being so sick, I wasn't enforcing that any more.

I believe that it wouldn't have happened if we hadn't guided him up to that point but clearly, the last hurdle had become something of a battle of wills between the two of us.  One I could never really hope to win without his consent. 

I'm really proud of him.  This wasn't easy.  We're probably not completely out of the woods, but we've definitely turned another corner.

For any families struggling with similar issues, here are the steps we took:

First, we associated the washroom with pleasant things (treats and toys).  He didn't have to actually sit on the toilet, just come voluntarily to the washroom.

Next, when he had a 100% success rate with the previous step over a period of several weeks, we upped the requirements.  Now he had to sit down on the toilet to get the treat.

We started preparing the next step with a social story I wrote about "Mr. Mucky" about what happens to leftover food in your body and how that food much prefers going on a waterslide ride in the toilet than being squished in your pants. 

Next we had him sit on the toilet with his pants pulled down.  After 30 seconds, he could get up and get the treat.

Then we started having him sit on the toilet for longer periods.  We used an iPad to let him watch movies and videos.

Next we started restricting the iPad to make it exclusive to the bathroom.

(I also began using a gentle laxative at this point to make sure any BMs were easy to produce.)

After he started to get the concept, he would get a reward for taking the BM from his pants and putting it into the toilet (usually by shaking the underwear, we didn't make him touch it.)

When he was comfortable with that step, we upped the ante again, giving him a little reward for putting it in the toilet and a really big reward for actually going in the toilet.

We restricted screen time (as we discovered it was often too distracting for him to pay attention to his body) and held it as a reward for going in the toilet.  If he had an accident, he lost his screen time for the day.

Then we began making him have to do several days in a row to get the unlimited screen time.  That's pretty much where we were when I fell sick.  We hadn't been able to successfully move to the next level where he would just go without a specific reward.

It was a long process.  Almost two full years from the start to now.  But we stuck it out and if I dare jinx us by saying so, it looks like we've succeeded.

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