Looking forward to your ideas!
Hi Dr. Mathis,
I saw your profile on Parents.com & I realize you're based in New Jersey but I just wanted to ask for recommended literature. My long-time boyfriend has a 6 yr old daughter with Autism--plagued with severe sensory issues, and currently now takes 0.5 ml of Risperdal daily for extremely aggressive behaviors toward her peers when angry. Now those behaviors have almost been totally extinguished at this point, and as a totally nonverbal child until 2010 she just began to talk, single repeated words, then in phrases & now uses language constantly over the past 1 year of being on this medication--she is basically a chatter box now as she practices trying out new words, sings, and shows-off her adorable voice.
She is quite low-functioning in some areas that relate to handling difficult sensory experiences therefore potty training has been totally impossible. She hates the toilet, sitting on it is very distressing for he no matter what potty, where it is, etc. She's just fine eliminating on the floor if her pull-ups are removed (or even if they're not & she's having a breakdown).
As the girlfriend to her father and the next most vital part of the home support system for her along with her mother & father, I want to know if its even possible to imagine this child being potty trained? How? And how do we begin approaching this at home in our own way of making it as comfortable as possible---while of course following all routines set-forth by her IEP plans/school specialists/parents/doctors?
No one has given a definite yes or no to even the physical possibility of fully potty training her, but all involved agree that this is such a huge burden, such an unresolved issue as she's constantly struggling with demanding to change or not wanting to change her pull-up.
I need to find some real solid clinical research and information for my own knowledge.
I truly don't know if it's possible at this point, but I want to be as informed as possible.
Thanks so much for considering these questions & possibly directing me to the most valuable and relevant journals, research and info available!
Dr. Liz's response:
I really commend you on seeking information for your boyfriend's daughter.
Your next best source of info is to consult with the child's occupational therapist who can advise about actual sitting on the toilet and the pull up given her knowledge about your boyfriend's daughter's sensory profile. For example, she/he may suggest giving deep pressure prior to sitting on the toilet. She may also give you insight into why she may actually enjoy the wetness that comes with a full pull up. She may be hypo-reactive to sensation on her skin and enjoys the feedback.
The other variable in effect here is the anxiety associated with the actual letting go of her feces and urine into the toilet. Keep in mind that toilet training is a big control issue and you want it to be as much on her terms with lots of praise but in line with her sensory needs.
In terms of is it possible for her to become potty trained, the answer is absolutely but it will take time. I'm sure you read my response to the potty training question on Parents.com and saw that there is a long list of strategies and possibilities.
Don't get too lost in the literature but rather in engaging with the little girl and understanding her experience. This will give you far more useful information than the books and articles that you think are going to offer you the solution.
Good luck and please write to me as you gain info from the occupation a therapist and as you venture out on the potty training adventure!
Dr. Liz Matheis