There have been many days over the last ten years where I thought we would never get here, but Alex is finally reliable enough in his toileting to move past massive rewards, at least a little.
We've adjusted the reward schedule. Now a BM in the toilet earns a McDonald's ice cream and a letter towards a trip to Montreal. Unlimited screen time is now earned by having clean pants from Monday to Friday. I've created a token system where he can get a token at the end of each day if he hasn't had any accidents.
Unfortunately, yesterday was the first day of our new system and he had an accident just before bedtime. So not a great start, but it was unusual. Last time we did a change in the reward system, the number of successes went down for the first few weeks before beginning to improve. Perhaps we're in for the same cycle again.
Our goal in shifting the rewards is to encourage independent toileting, where Alex uses his daily opportunity of sitting on the toilet to produce rather than having accidents. We know he's capable of withholding for extended periods and releasing when given the opportunity, now we just need him to understand that it is a desirable skill across all days, not just school days.
One more step in the right direction.