I have an 8 year old that uses the toilet for voiding but not for bowel movements. He is a picky eater and is on a routine bowel softener. Does anyone have any ideas to encourage the use of the toilet for bowel movements?
I forgot to mention that he is FASD, no overt signs of SPD, liked deep pressure,higher level motor planning issues.
Thanks muchly.
You may already be trying this, but I would start with transferring his bowel movements from his diaper into the toilet so that he gets the idea that the toilet is for BMs. Can you tell when he is about to have a BM? I have heard of people cutting a hole in the diaper and sitting on the toilet as a transition step. Maybe he likes the deep pressure that a diaper provides around his waist?
ReplyDeleteAs per my email, I've had some really great successes with using small steps. It works especially well for children who request the use of a diaper or pullup to have BMs, but is also successful in other children's cases. My general progression for toileting is:
ReplyDelete1) Work on slowly having the child have a BM in the bathroom (still in their clothes, diaper, etc.) by catching them when they have a BM, and directing them toward the bathroom. Throw a party (i.e. cheer and praise) when they head toward the bathroom even if they don't get there. (If going all the way into the bathroom is hard, start with a step or two steps toward the bathroom, and progress)
2) While in the bathroom, progress to standing by the toilet to have a BM
3) Progress to sitting on the open toilet seat with pants off, and diaper/pull-up on (you may need to start with the lid closed, pants on, then lid open pants on, then lid open, pants down)
4) When the child is consistently sitting on the toilet to poop, cut a "trap door" in the diaper/pull up so that when the child has a BM, the BM will come out slowly, but fall into the toilet.
5) Cut down the diaper/pull up until there is no more pull up to put on and the child can do it without. Consider offering a choice "Do you want to sit on the toilet with a diaper or without?" and honoring whatever the child chooses.
In the meantime, having siblings or parents model having a BM in the toilet, dumping the BM from the diaper into the toilet, always changing diaper/pull-up/underwear etc. in the bathroom, etc. can be some environmental modifications. Keep the diapers/pull-ups in the bathroom, and after the child has a BM, have the child go into the bathroom and get a new one (or even better, if the child is in underwear, but will request a diaper to have a BM, have the child go into the bathroom to get the diaper or pull-up.)