Autism

Independence and freedom are human desires that we crave. As young children, we begin to pull away from our parents insisting that we do things all by ourselves, even if it means that we do it wrong or it takes a long time to complete. Humans are determined and relentless, repeating the same task over and over until it is perfected. Self-care tasks such as dressing and hygiene are first completed by the parent or caretaker however over time the child typically begins to desire to complete these tasks independently.. The benefit of the child gaining independence affects the entire household. No longer is the parent or caretaker responsible for the task and the child gains confidence and self esteem while all those in the household are no longer burdened by the task that is now completed independently by the child.

Of all the self-care tasks that are done routinely, using the toilet is the one that gives the most freedom to everyone. The parent or caretaker is no longer responsible for bathroom hygiene, the child has privacy and independence in the bathroom and the household now has more freedom to be out in public. Learning how to use the toilet is a prerequisite for adult relationships, jobs and traveling. Knowing how to use the toilet makes life a lot more private and clean not to mention more comfortable in general. Using the toilet is far cheaper than the alternative and it gives the person responsibility for their own body.

Children that have Autism may not be as drawn towards independence and freedom. They may not desire to complete self-care tasks independently and they may not seem to grasp what the exact goal of a task is. Attempting to teach a person that has autism a self-care task can be frustrating as it can take much longer to learn than a neurotypical person. As humans we often tend to take the least resistive route so if there is too much frustration and friction, a parent or caretaker of a person with Autism will sometimes stop trying to teach a self-care task and will instead assume all responsibility of the task. This can be emotionally taxing on the parent or caretaker and it does not allow the person to grow or gain independence. Toilet training a person with Autism can be done, with extra steps and extra time.

Regardless of the age of the person with autism, it is possible to toilet train them. Adults with autism that do not use the toilet are the product of frustrated caregivers and parents that stopped trying. Because people with autism typically aren’t self driven to complete self-care tasks independently, once the parent or caretaker stops trying, the child does too. As time grows on, the child with autism becomes an adult with autism and they are unable to use the toilet independently which halts independence and freedom.

The first step to toilet training a person with autism is simple; let go of expectations. Parents often have goal dates set for their child. By age one a parent might want to switch from bottles to cups, or in six months they might want to end use of the pacifier. Let go of those expectations. A person with Autism may take much longer to learn than a neurotypical person. Eliminating a goal date will prevent disappointment and further frustration. Instead, view it as an ongoing process with the end goal being total independence. While it may take extra steps and time, people that have autism are capable of learning the same tasks as a neurotypical person, including how to use a toilet.

Tailor the process to them. If necessary, give them hand over hand assistance but be careful of helping them too much, they may become dependent on the assistance and not progress beyond it. Tell them what to do (i.e. pants down), wait a few seconds with no response and then physically show them how to do it by guiding their hands where you want them to go. Saying the step outloud tells them what the step is called and prompts them to do the task. As you go through each step, say it out loud and help them complete it. Once they begin to complete steps on their own, stop helping them with that step. Be sure to give them plenty of praise. Verbally telling them “good job!” or “awesome!” when they successfully complete steps as it will give them confidence and encourage them to repeat what they have done in the future.

When they are home, put away the diapers and put them in easy to take off bottoms. Set a timer to go off every 10-20 minutes. When the timer goes off, immediately take them to the bathroom. If they are having accidents, decrease the time and once they start using the bathroom successfully, increase the time. Contact their school or training center and try to adjust routines so both home and school or work is relatively the same. Be consistent and create a constant routine. It might seem intimidating at first, but over time it will lead to them using the bathroom successfully. Once they have successfully used the bathroom, be sure to give them massive amounts of praise verbally (“wonderful, hooray!”) and also give them a special treat such as a favorite snack or activity.

If sitting down is a problem, allow them to bring a toy or game to the bathroom to entertain themselves. They should sit for around 5 minutes each time until they go successfully so keeping them on the toilet for long enough is important. Singing songs to them, talking to them or reading to them can often keep them seated for long enough. This also makes the process more enjoyable which will encourage them to not only come back but stay longer.

Teaching a person with Autism how to use the bathroom can be frustrating and discouraging. However, tailoring the process to meet the needs of the person can make the learning process go smoothly. With extra time and patience, a person with Autism can learn to use the bathroom on their own. Establishing a consistent routine will help them learn faster and making the process pleasant will encourage them to continue to try. With help, encouragement, praise and support, a person with Autism can do almost anything.

Melancholy Preface

Preface

They were in a conference room at the mental health department. There were two doors at the entrance. The room was large and about fifteen chairs sat in a semi-circle on one side of the room. On the side there was an easel with a poster on it. It read “Be Respectful, One person talking at a time, What is said in group stays in group” in black marker. Ten of the chairs were full. In the front of the circle sat a stool, and on the stool sat a man about sixty years old. He wore a grey suit vest and matching pants which looked crisp against his dark black skin. His hair was salt and pepper grey and he wore glasses like most people his age.

“Hello, good evening. Thank you for joining us. This is the M-I-S-G or Mental Illness Support Group. I see a few new faces tonight so I will go into a bit more detail than normal. We meet every other Thursday at 6 o’clock and we always have meetings in this location however there could be an alternative place should something happen. So you new folks need to fill out an information card so I can contact you if that does happen.” he said and clasped his hands together on his lap. “We have three big rules here; be respectful, one person talking at a time and” in unison several of the people joined the man in saying “what is said in group stays in group”. He smiled.

“We spend our time talking to one another about our symptoms, our experiences, our life in general. You can share as little or as much information as you like however we do have to keep it reasonable in length because we only have until 7 o’clock.” He said. “Oh shoot, I almost forgot. My name is Albert and I am a therapist here at the Mental Health Department.” he said.

“Now I know we have a few new people here this evening so feel free to jump in to the conversation or sit back and watch, whatever you’re comfortable with. So let’s get started, hm?” he nodded. “Who would like to go first?”

For a few seconds, it was silent. Everyone glanced around and realized no one was really jumping at the opportunity.

“Come on now, don’t be shy.” Albert said.

Slowly, a hand raised into the air.

“Ah, yes, hello! Welcome!” Albert said as he pointed at a young woman. She was thin and tall with her dark brown hair wrapped up in a bun. She wore an oversized sweater that was falling off her shoulder and a pair of black leggings. She smiled. Her eyes were hazel and her skin was pale.

“Hi” she said. “I’m Julie.” In unison the group responded with “Hi Julie”. Julie smiled.

“I, uh, I have Major Depressive Disorder as my doctor calls it, or just regular depression. I feel like I’ve always had it but it has gotten worse over time. I used to work as a waitress. I used to go to the University but my depression got in the way and ruined that.” she said and rolled her eyes. “A lot of my life has been ruined by depression, actually. Jobs. Relationships.” she looked down at her lap.

“It’s hard.” she said. “I try to have a normal life but my depression gets in the way of everything I try to do, be and create. It ruins everything.”

“Yes, that is very difficult.” Albert said as he looked at Julie. He stroked his chin.

“It is” her shoulders slumped. “I feel like a failure, like I’m not trying hard enough.”

“It is difficult to live with a mental illness, I know. Believe me.” Albert paused as he looked around at all the people looking at him. “But let me let you in on a little secret. There is no such thing as a normal life. We are all having a hard time, we are all trying our best, we all have failures and achievements, we all have our ups and downs. Everyone thinks there is some normal person out there that doesn’t have any flaws or challenges, and let me tell you, there's not. No one like that exists.”

“And Julie” Albert said as he looked back at her “You are not a failure. You made it to the university, right?” he asked.

“Yeah” she nodded.

“There ya go. Right there. That’s an achievement. Do you know how many of your high school classmates couldn’t even get in to a university, let alone maintain a higher education? That’s hard work. How many semesters did you attend?” he asked.

“Four.” Julie said with a smile.

“Wow. Four semesters. That’s two years, folks! That’s practically an associates degree.” he said as he stood up from the stool and threw his hands in the air. Albert looked around at everyone, making eye contact with them.

“Living with a mental illness is hard work. You face challenges that those around you do not face. You have to jump higher, run faster and try harder to achieve what others take for granted. Do not sell yourself short. You have achieved a lot. You are doing things that other people can’t do and they don’t even have a mental illness. So you have depression and you hold down a job? Wow! What an incredible achievement. Every day that you go to work is an achievement. You have anxiety but you perform on a stage? Every time that you get on that stage is an achievement. You are not a failure for failing at something, we all fail. You are great, for doing great things. And you are even greater for doing them with a mental illness.” he said as the whole room remained silent.

“Sometimes our inner voice lies to us and tells us that we aren’t trying hard enough. It tells us that if we would try harder, we would be better. Don’t believe that voice when it says that. You are trying. You are here tonight, aren’t you? For the most part, you all have, or are currently in therapy, you are taking your meds, you are attending support groups.” Albert said as he counted out each thing on his fingers for emphasis.

“You are trying and you are trying hard.” he said, almost raising his voice. “Every day you face a battle to live a quote unquote normal life. It’s a battle to sleep. It’s a battle to get dressed. It’s a battle to talk to other people. But look at you Julie, sitting here. You’re dressed. Your hair looks clean.” Albert looked back at Julie. “You clean up good.” Julie and the whole room broke into laughter. Once it quieted back down, Albert continued.

“Living with a mental illness is a struggle, so it is an achievement to survive, let alone hold down jobs, make it into a university, maintain a relationship, go grocery shopping. You are not failures.” Albert said as he looked around the room. “You are all achievers.” Albert paused as the room remained silent.

“Thank you for sharing Julie, and welcome to our group. That was very brave of you.” Albert said and smiled. Julie smiled back.

“Okay, we’ve broken the ice. Who’s next?” he said.

Potty Training

For a few years now, you have been your baby's personal butler and nurse. As they transition from baby to toddler, you also transition from bottle provider to snack provider and from diaper changer to pee-pee reminder. While the transition from baby to child can bring sadness and grief of the baby that once was, the transition to an actual child brings a lot of perks. Along with eventually buckling their own seatbelt and washing their own hair comes the greatest baby-to-kid transition of all: potty training.

Now, potty training in itself can be quite stressful. Changing poopy diapers turns into dealing with poopy Spider-Man undies but the transition is long awaited for many parents. We all count down the day when we no longer financially support the Huggies brand. I just breezed past the diaper aisle the other day and didn't even glance down it. Seven years of babies and I am now ignoring that aisle completely, because I can. That is a glorious feeling.

However, In the midst of potty training, there are great perks which you won't find anywhere else. Hopefully, it is a short phase and you quickly move on to having a child that deals with their own shit for once. But during that time period you get special privileges that are not found in diaper days or once your child is house trained like a German Shepherd. Let me explain:

1. I, myself, have been potty trained for quite some time. While it is now an everyday occurrence, it is still an unsung achievement of mine. As a mom, I do many things throughout the day that rarely receive recognition or a mere “thank you”. I am simply expected to do them and the tasks themselves are only noticed when they are not done. With a potty training toddler, I now have a personal cheerleader who accompanies me to the jon. Not only do I receive a round of applause when I complete the task at hand, but I also get immediate verbal praise by way of “Good job mommy, you big girl!”. Finally, some recognition for once. And you're right, Mommy IS a big girl. Thank you.
2. Along with a musical miniature potty and flushable wipes, potty training also brings a ground-breaking item into your bathroom: a stool. Not only does it serve it’s purpose as a one-step access to the big throne and ease dangling toddler legs, but it also gives you the extra six inches to reach the high shelf in your linen cabinet that has been neglected since you shoved the blankets up there last April. Most importantly though, the stool can be used when you are having your own visit to the bathroom. Medical professionals recommend placing a small stool beneath your feet when going numero dos. The added height to your feet places less strain on your big intestine making the process easier with less struggle and strain. Less strain means less hemorrhoids and I think we’ve all had more than our fair share of those during pregnancy. So use the luxurious stool ladies, you’ll never view bowel movements the same again.
3. Toddlers in the midst of potty training have grasped the concept that they are supposed to relieve themselves into a toilet instead of their pants, however they are not too good at holding it. When a little voice peeps up “Mommy, I go pee-pee?”, you have 7.3 seconds to get that kiddo to a toilet before all hell breaks loose. While the rest of us seasoned potty-users can hold our pee-pee until we find an acceptable and accessible facility, toddlers in potty-training boot camp must have access to a toilet at all times. As life continues during this training, you may find yourself at a business that has a red CAPITALIZED sign shouting EMPLOYEES ONLY on the door of their bathroom. While some businesses guard their bathroom like Taylor Swift’s dressing room and others have accessible public bathrooms, all businesses have one thing in common: none of them want tinkle sprinkles in their foyer. So while the receptionist may glare and point to the EMPLOYEES ONLY sign if you ask to use the facilities while out and about, no one (and I mean no one) will deny bathroom access to a potty-training toddler doing the potty dance. Think of it as a backstage pass to a room you would otherwise not be allowed to access. Under lock and key, armed guard and glaring signs, you are suddenly given access to the backstage bathroom. Enjoy the sights and potpourri smells of off-limit bathrooms, this is really a once in a lifetime opportunity.
4. Trying to teach a toddler to use a potty can be very stressful. Along with the frustration, comes added laundry because going through three pairs of pants a day is actually considered a good day. Then, you also have the 15-minute schedule set by alarm which interrupts every single thing you are doing all day long. The chiming of the alarm going off becomes so consistent, that as soon as it starts, your toddler heads towards the bathroom. The mexican-hat-dance ringtone will forever signal to your child that it’s time to go potty (for psychological fun, start playing the ringtone around them when they are school aged and watch them cluck like a chicken as they head towards the bathroom). Potty training is stressful, it’s messy and it is just downright chaotic. So when the PTA President contacts you to host the bake sale this coming Wednesday night, you can confidently say absolutely not. Why? Because you are potty training your toddler, that’s why. And without even missing a beat, the Prez will smile and say she completely understands because she had to do it with her kids too. Every parent understands the hold on life that is created when you are in the middle of potty training and no matter the obligation or project, you have a perfect built in guilt-free excuse that every parent understands and does not object because we have all been there before and we all get it. So sit back and enjoy the mexican-hat-dance.
5. The greatest perk to potty training your child is seeing them transition from a baby to a “big boy” within a matter of days (or weeks..). When they laid out spread eagle on the living room floor waiting for you to deal with the mess in their pants, they were a baby, no matter if they were three months old or thirty-six months old. Once they begin to take themselves to the bathroom, wipe their own butts and return to the table as if nothing magical had happened, they are officially no longer a baby in your eyes. The change is dramatic. You no longer have to lug around a suitcase full of wipes and diapers, you no longer have to worry if that stinky child in the room is your own. Gone are the days of having to do a sneak-peak into their shorts and say goodbye to finding a changing table in a busy airport. Just like that, your baby transforms into a kid. No transition is more astonishing, exciting or anticipated as potty training. The level-up from baby to kid is officially complete and right before your tired eyes your child is growing up. You may cry a bit, but be sure to wipe away your years with the money you’ve saved by no longer buying diapers.