Your Advice Requested: How to Manage Fear of the Toilet in a Child with Autism
Wednesday June 6, 2007
A reader writes:
My daughter is 6 years old, she has never pooped in the potty..she has an extreme fear! She holds her poop all day while at school and waits to get home and use a pull-up. If she goes for a sleep over, she'll hold it for days! I've tried everything I can think of, Bribery, rewards, sticker charts, therapy, refusal of the pull-up (which just leads to extreme constipation). I'm feel like a failure as a parent and worry constant when she's at school or friends...please help!My sense is that this mom will need to figure out just WHY her daughter is so anxious about the toilet. Is it a fear based on sensory issues (fear that it will hurt, that she'll fall, of the sound of the flush)? Or is something else getting in the way? Once Mom really has an understanding of the issue, she may be able to alleviate the problem (mild laxative for pain, seat with handles for falling, or eliminating the flush while her child is in the room).
But other parents may have other ideas, experiences, and recommendations. How have you helped your child overcome fear of toileting?
Comments
there are many kids who do this, and at a much older age. some kids do this well into teen years. no one is a failure when it comes to this. at times it can be completely and utterly difficult to figure out why a child does this or that, and then to counter-act it is even harder. it’s really hard to control a child’s fears too. to them, it’s the biggest deal in their lives and very real.
once my son was potty trained, he seen me throw a spider in the toilet and flush. one simple act still affects him 3 years later. it was one of my bigger mistakes I have done and he who knew my son would react that way? it could be a hidden fear she has, or one simple act that caused it. some kids feel pooping is loosing a part of their own body and refuse to give it up. there is in fact the possibility of a ton of reasons kids wont go to the bathroom. for some kids, it requires a monthly hospital visit for a ‘clean out’. I know some parents who do a timely laxative as part of their routine. this also can relate to sensory issues and it’s awfully difficult of all sensory issues, to explain and demonstrate toilet training.
I have no real great fix to offer. I’d try an in depth social story, explaining it is waste and everyone needs to get it out. and it’s a good thing to do. some kids are real interested in science, a book from the library might help. if there is one place she will go, I myself might just be ok with it as long as she gets it out, and slowly work my way to the toilet. there is hope though. I have a friend whose child did this same exact thing, and some where at around age 8, started pooping in the toilet. with what ever you do, be reassuring to her and try to stay consistent on methods and words used.
Have you talked to the teacher at school about your problem?
The school staff should guide you with the process of helping your child.
Perhaps the school could assign a special education teacher to implement a home-based program to help you and your kid to overcome the fears.
Of course this would mean that your child would have too take
Have you talked to the teacher at school about your problem?
The school staff should guide you with the process of helping your child.
Perhaps the school could assign a special education teacher to implement a home-based program to help you and your kid to overcome the fears.
Of course this would mean that your child would have to take some time off from school for the program to work.
I am an adult with Asperger’s Syndrome and I remember as a child being terrified of the toilet! I was especially afraid of seeing it flush. This may be an atavistic fear of floods, which would have been life threatening to our ancestors. (Many features of autism can be seen and understood as atavisms.) No amount of shaming, punishing, bribing, etc, could make me use the toilets at school, which flushed automatically, and I could not articulate that the reason why I refused to use the school toilets was because the flushing scared me. I eventually outgrew this fear on my own. Be patient with your daughter, let her use pull-ups, and be matter of fact about it. Don’t make a big deal out of her fear of the toilet, as the self conscousness will only make it worse. There are worse things than needing to wear pull-ups, and you love her just the same.
Have you tried a positive reward system? Our daughter would pee on the potty all day long, but would never go poop. We tried books, watching mommy, going pull up free all day, all to no avail. When she was 4 1/2 and still wearing pull ups to pre-K, I tried something different. I told her she could have any prize she wanted if she went poop on the potty. It didn’t work right away, but a few days later she saw a Vsmile game at the store she wanted. I reminded her of our deal and the next day she went poop on the potty. We made a big deal of it and I immediately took her to the store to get her game. The next time she went I had a smaller prize I had put away to give her. Over the next few days, the prizes got smaller and smaller, until all she needed was praise. After about 1 week she was, and still is, pull up free!!
PS. Go with her to school one day and see how loud the toilet flush is in the bathroom. Schools usually have higher pressure and large tiled bathrooms that tend to amplify the sound. We had to go with our daughter to the bathroom several days at school to show her it was ok. She still holds her hand over her ears at school and in public restrooms.
any of the reasons offered may be valid
add in wanting mum to know what she has done and what consistency it is especially if mum is worried… once its flushed she cant get it back,has the toilet ever overflowed.. can she get the order of events right eg pulling down pants after closing door sitting down in time what does she do next does she understand etc symbol schedules sometimes help if they understand the aim
I knew a child that had this fear due to the sound. So she would stand up, back away, plug one ear, flush and then plug the other. If it’s a hearing sensory issue, I wonder if trying earplugs or headphones would help tone down the sound. Those automatic toilets are scary to most people b/c you never know when they will go off!! My daughter used to fly off them in mid-potty b/c they scared her so bad. Watch out for cruise ship toilets…those are really scary! Good luck!
My son will be 6 later this summer and still poops in his pull-ups. We held him back a year from starting kindergarten–we felt in a year’s time he’d be more confident about toileting.
Last summer, he was so constipated that he became impacted, started vomiting and I had to rush him to the ER. I’ve never seen such fear in a child’s eyes regarding sitting on a toilet.
The autism specialist in our school district will work with him this fall if he still hasn’t trained. I feel like a failure a lot (mostly because of my impatience with him). I’m praying that he won’t go into his teen years like this. As it is, he has outgrown the pullups but somehow gets them on himself everyday anyway.
He has AS and Sensory Integration Disorder. We’ve tried bribes, withholding toys, positive reinforcement, padded and cloth toilet covers and nothing has helped. I hope I’m not too discouraging for other parents out there. We’ve done everything that the ‘experts’ have suggested; I think that when he trains then I’ll be the expert!
Aside from the potty issues—all the bickering within the Autism community saddens me. We parents of children on the Autism Spectrum feel so isolated and lonely as it is–I just want to find unity from those leaders in the autism research field, not disention. Yes, lively debate is important but it seems a lot of this has become personal.
Blessings on all of us!
If you have children who are afraid of the automatic flushers, try putting a stocking cap over it before the child is sitting on the toilet. Then the child or parent has complete control over when it flushes by removing the cap.
My son is nearly 5 and still holds his poo. I am beyond frustration and enormous guilt of being a crap mother. I give him ducolax twice a week which delivers very large poos in his pants or pull ups. Nothing has worked for us. Anyone I have talked to looks at me horrified and bewildered about how exactly I undertook potty training. He’s in a viscous cycle of fear, praise when he does it in his pants, adulation if he sits on the toilet and terror when after he finaly does it on the toilet he cries his eyes out saying how scared he was of it only to return to holding it in for days on end. He does not have autism but i have been told to get him do Cognitive Behaviour Therapy which there is a waiting list of 18 months. Why is he made to suffer like this
I have had issues with my daughter and son. Both at the beginnig of school this year, neither would use the school bathrooms, my son 5,has gotten over his fear, but my daughter 6,has not, she has always had a fear of public restrooms and locking the doors…My son had an automatic toilet overflow just before school started, which didnt help him at all. My daughter just wont go at school and has even had 2 accidents already in school, she is totally potty trained, I understand what you’re going through and feel they should make kids bathrooms at school more kid friendly and not so BIG AND SCAREY! At my daughters preschool they had shower curtains as doors which didnt seem as scarey to her….?It is scarey and I’m sure they will all get over it, they just have to work through it. I just think that some of the teachers could be more sympathetic, some are, but some are NOT!Hang in there, your child will come around and you will forget all about it.
Just wanted to share my strategy to get a child to poop in the potty. We are not there yet, but are close. After becoming pee trained he started wearing big boy underwear, but would ask for a pull up to poop. I then started insisting that he be in the batheroom when he went. In the pull up is fine but he must be in the bathroom. After about a month of just being anywhere in the bathroom, I said he must stand next to the toilet. After about another month of this, I said he must sit on the toilet, still with the pull up on, but on the toilet. He has been doing this for about a month now. He has tried several times without the pull up and had success 2 times. Usually he ends up asking for the pull up after trying for awhile. The next step will be to cut the pull up so it is basically just a band around his waist so he feels like it is still on him, but the poop will be free to fall in the toilet. Hopefully this will be in the next few weeks. And then from there, hopefully no pull up needed.
Our daughter is 4 1/2 and has never peed in a toilet. She has an acute fear of letting her pee or poo go in the toilet. She wears underwear all day and puts on a diaper when she needs to go. She never has accidents and doesn’t hold her poo. She does not have any clinical diagnosis of autism, yet she is having similar troubles. We’ve gone down the road of having her go in a diaper in the bathroom, then touching the toilet, then on the toilet, but we never got past that point. We tried a whole in the diaper on the toilet, but that freaked her out. We’re at a loss and haven’t heard of this problem for pee issues, only poo.