Category Archives: Autism Strategy

Autism Strategy, Toilet Training

Top Tips For Toilet Training when your Child is Autistic

Getting your child toilet trained is one of the hardest tasks for any parent, but when your child is autisitc and non-verbal, it provides even greater challenges.

But it can be done, you just need to gather a lot of patience, a support network and realise you are in it for the long haul.

Here are my top tips for toilet training when there is an autistic twist:

  1. Follow the advice and steps from any toilet training search on Google. The general guidance is still the right way to tackle this. This includes reward charts, regular visits to the toilet, positivity and encouragement. Steps 2 to 20 below are the enhancements to the standard process.
  2. Skip the potty and go straight to the toilet. You don’t want your child to finally grasp toilet training and you then have another challenge of ditching the potty. Limiting the number of transitions is key.
  3. Get a toilet seat for comfort and a little step to support your child’s legs and to allow them to get up to the toilet.
  4. Keep to simple language. Use the single word “Toilet” to state what is going to happen. If your child is non-verbal, use the word with the associated Makaton or photo image.
  5. My son would not sit on the toilet. All the guidance on putting them on the toilet morning and night, and getting him use to it etc. didn’t work. His nappy was all he knew and it was working for him, so why change that? We just jumped right in on day 1. It avoided confusion of when to go and although a big change, helped communicate that this was how it was going to be going forward.
  6. Become cleaning experts. Accept that your child is going to have loads of accidents, and this can be for a number of weeks before you even get one sucess in the toilet.
  7. Let your child do whatever they want if they sit on the toilet. Let them watch the iPad while eating a ice-lolly and holding their favourite toy. Remember the main objective, everything else can go out the window.
  8. Get a support network, you can’t do this alone. This includes family, friends, nusery/school and any other professionals. You all need to be following the same plan and sharing what has happened that day to ensure you are working together.
  9. Forget hand washing (I can’t believe I typed that!). But seriously… focus on getting the wees and poos in the toilet. The tasks about pulling their pants up, wiping their own bum, flushing the toilet and washing their hands can come afterwards. Wipe your child’s hands quickly with a wet wipe afterwards and you can also add some antibacterial gel if you want.
  10. Dont force anything. You may want to forcefully put your child on the toilet and shout “PEE!!!!” at them. I’ve been there. After a week or two of battling and struggling, you may find yourself doing this. But don’t. It will set you back weeks. Take a breath and get someone else to step in if you can. Otherwise just walk away and come back calmer.
  11. Run the tap to tempt your child to wee, and make sure you get them to drink loads of liquid.
  12. Get them to blow bubbles when on the toilet – helps with the poos!
  13. Don’t worry about night time. Pull-ups go back on at bedtime, and then pants back on in the morning. Bedtime training will come later.
  14. Give a reward for any small step or just encouragement. We used chocolate buttons. One button before the request (so he knew what he was going to get – he had the taste in his mind) and a second as a reward.
  15. Don’t feel you can’t go out. Get your child to sit on a towel in the car and take loads of changes of clothes, wet wipes and cleaning products. Stick to outdoor areas and make sure you have a pack of anti-bacterial wipes and kitchen towel in your bag – to clean the slide or other equipment in the event of an oops moment.
  16. Once you have your child going to the toilet start thinking about the other steps and add them on slowly, one at a time.
  17. Print out a picture sequence of what is required, and point to the stage you are doing.
  18. The whole process is going to take a long time. Break it up into small tasks. It will all be worth it.
  19. Be creative and use your initiative. I have heard people planting wee trees for their sons to encourage weeing standing up. Use your child’s interests and remember the main objective – getting wees and poos in the toilet.
  20. Don’t give up.
An example picture sequence to use when adding on the additional steps

Has this helped you? Can it help someone else?
Share with your friends or support groups.

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Autism Strategy

Bikes Are Not Just For Riding!

Rhys sat on the floor, his balance bike in front of him, on its side, the wheels spinning.

I looked at the bike, with an image in my mind, of him sitting on the seat, his legs pushing off the ground as he glided down the small path at the top of our road. An image I had seen of other children his age, while out with their family. High pitch screams of excitement as they felt the warm air glide through their hair.

Rhys however continued to sit and spin.

I knew he was happy, to him moving wheels was just the best thing ever. But somewhere in my heart, I wanted him to enjoy the movement of the bike and the feeling of freedom, it taking him on an adventure.

I consulted Google for advice, and there were a few printouts about riding a bike. They were structured into a number of pictures which sequentially formed a story, with a beginning, middle and end. The social story around the activity seemed like a good idea, so I printed it out and arranged it ready to show Rhys.

Bending down to his level, I held up a picture of a little boy. He was wearing his helmet, with the words ‘ride my bike’ stencilled in bold above the image. “Rhys, ride bike?” I asked.

Rhys’ eyes remained transfixed on the movement of the wheels, ensuring their continuous motion with a swift flick of his hand every time they started to slow down.

He did not acknowledge my picture.

I held up the second picture in the sequence. The boy was now climbing onto the bike, the words ‘sit on seat’ stencilled once again in bold above the image. “Rhys sit on bike?” I asked, taking the bike in my hands and lifting it up onto its wheels.

My social story suddenly took a different turn. Rhys got angry! His wheels had stopped moving. His fun had ended with no explanation except for some crazy woman holding up pieces of unrelated paper! He pulled the balance bike towards him, letting it fall back onto the floor. Lifting his hand he spun the wheel once again, and watched it move.

No fancy social story printed off the Internet was going to work. I realise that I would need to accept that objects didn’t necessarily need to be used in he way they were advertised.

Later that day we sat watching Peppa Pig. She was on the way to the dentist, every step of her journey described in her own little bossy way. The journey in the car, the waiting room, the dentist’s chair – it was all methodically described, with a happy ‘jump in muddy puddles’ ending.

I had an idea.

I grabbed my phone and searched. It didn’t take long, but I found a Peppa Pig episode where the family went on a bike ride. They had a race, they had fun while seated on their bikes.

I put the episode on the telly and we watched it on repeat. Then I searched YouTube and found a video of a little boy on his balance bike. I played the clip in the background as Rhys spun the wheels on his bike. After a while, I saw his eyes notice the screen, and then start to watch the movement of the bike as the boy rode up and down the road.

Picking up the bike, I placed it in front of Rhys, and he reluctantly sat on the seat as I pushed him over the carpets and around the house.

He rode his bike just like Peppa, just like the little boy on YouTube.

A social story does not need to be a paper sequence of pictures. It can be anything to describe and explain an activity or social norm.  Being in the technology age, I used the device at the end of my finger tips. A hub of resources just waiting for a search term.

We still have a long way to go on the bike. But we will take one step at a time. Thanks to Peppa, she got us one step forward.

🚲🚲🚲🚲🚲🚲🚲🚲🚲

Read about social stories and how to use them here.

Let me know your thoughts. Go to Facebook and comment if you have tried any strategies.  Share so others can try them too.

Autism Strategy

Planning for Success

Twelve little picture cards are placed sequentially down the wall. Each one in the green coloured section showing that they are still to happen.

I remember the process we went through to get to the full list of the day’s events. Initially I had placed them all on the wall and somehow expected Rhys to acknowledge the process – I was obviously delusional, or maybe just had a lot still to learn!

Three years ago we had mastered the first-then strategy. The use of two pictures to move Rhys between activities, communicating a clear sequence and managing the transition. Pictures became the basis of everything. I used them to communicate with him, reducing anxiety and avoiding meltdowns.

I would place little pictures onto a green card showing where we were going and what would happen next. Crouching down to Rhys’ eye level in carparks, shopping centres and play areas with my sequence of pictures got a number of stares from the passers by, but I didn’t see the on looking eyes, I saw my son and the need to do everything to communicate with him and avoid a meltdown due to confusion and frustration.

The miniature schedule worked extremely well, and I continued to use it in a portable fashion.

After a few months, I changed to a red and green card adding a few extra activities to the sequence. Hand-over-hand I helped Rhys move each activity card from the green section to the red section to signify its completion.

It didn’t take long for Rhys to master this second step.

Once comfortable, I implemented the final stage. I took the schedule card we had been using for a number of weeks and stuck it to the hallway wall. The perfect central location to communicate our plan. As the activities were completed, I would take Rhys to the wall for him to move the card to the red section.

He soon knew where to see his plan. Now consisting of over twelve activities per day.

As I finished making the dinner this evening, I spotted a mop of blonde hair walk up to the communication wall. The little hand reached for the dinner card and moved it across to the red, “All finished” he said. But he wasn’t finished, he kept going. Bath, pyjamas, brush teeth were moved across too, and then the hand tapped the last card, “Bedtime!” it said, and two little legs walked down the hallway and up the stairs.

Schedules can help communicate the events of the day, but they can do so much more, like communicating when your little one is done.

👕🍳🚗🛁🛏

Click here to get a step by step guide to schedules.

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Autism Strategy

Countdown to Bed

“Rhys wash hair” I state, holding the little toy watering can where he can see it. I use simple words to explain what I am about to do, so he wont be taken by surprise.
“Ready, steady, go” I announce, and being careful to not get any water in his eyes, I lift the watering can up to his head, and start to count.

With every canful of water I count down, making Rhys aware of how long the activity is going to take.
“Five” first canful of water weting the top of his head.
“Four” the water running down the back of his head.
“Three” making sure the left hand side is saturated.
“Two” then the right.
“One” pouring the last canful on the top.

“Well done, Rhys” I say excitedly, wiping his face clean from any stray droplets of water. I take some shampoo in my hand and lather his long hair into a Mohawk, more for my enjoyment than his!

I then begin the process again.
“Rhys, wash hair” I say again, the watering can held high. “Five, four, three, two, one.” Lifting the towel to his face, I give Rhys a few seconds to breathe and reset. There is still a lot of shampoo in his hair, so when he is ready, I start the cycle again.

Washing Rhys’ hair use to be traumatic. Without any means to communicate with him at the time, it resulted in force and a close call to water boarding 😮 (or so it seemed). I had no way of getting him clean without a swift quick-as-I-could dunk in the bath. We both grew very quickly to hate an experience which was meant to be fun, engaging and relaxing.

“All finished” I announce. Lifting Rhys out the bath and wrapping him up in a large fluffy towel. His big blue eyes and contagious smile peep out from under the folds, confirmation that his bath had been fun.

I leave Rhys to put on his pyjamas, which I have laid out in order on his floor. Picking up the hair brush I wait for him to be ready. The brush is a pink anti-tangle one with unicorns on it, and actually his sisters, but it works a treat.

Kneeling down on the soft carpet and looking up at the dressed pyjamas I state, in the same way I did ten minutes earlier “Rhys, brush hair”. With each stroke I count “five, four, three, two, one”

Once I am done I scrunch Rhys’ hair into its natural curl, and give him a huge cuddle, breathing in the fresh fragrance of the bath.

“Sleep well Buddy!, you did great!”

🛁👨‍🦰

Click here to get a step by step on Countdowns.

I have used countdowns in so many ways to communicate time with Rhys and how long events are going to last. From hair washing, to brushing teeth and even during haircuts.

I use the Ready Steady Go technique to communicate the start of the activity, which is a great foundation for many other strategies. See more details here.

You can also add traffic lights to help with the length of the activity, and pictures or sequence cards to supplement the communication.

Be creative and combine strategies in ways that will be able to help you communicate and enjoy activities with your child.

Most importantly – sometimes things don’t always work first time, so assess what you are doing, keep trying and if needed, ask for help.

If you have missed any of the other strategies, find them all detailed here.

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Autism Strategy

Sock It Up!

It was early January and Rhys was due to start school after the summer. At the age of three and a half we had overcome so many challenges, but hundreds more lay ahead. I wanted to keep smashing down the barriers and not let his autism be a blocker to his achievements. Things were harder. Goals took longer to achieve. Additional support was needed. But together we could work out a way to succeed. 

I opened his drawer and gathered up his clothes, with a goal in my mind that I was keen to work on and see him accomplish. I wanted him to be able to get dressed by himself, a simple but hugely challenging task for my little boy.

I looked at the socks in my hand and thought about how I pulled my slightly larger versions onto my feet daily without thinking. A task that had become a habit, but had probably taken me a lot of practice from a very young age. 

Walking back to my room, I took a pair of my own socks from the drawer. Sitting on the end of the bed, I purposely concentrated on my actions, as I slipped my naked foot into the fluffy material. Gather up the sock, place over my toes, pull over my foot, around the heel, and then pull up over my ankle. A simple task for me, but a five step process which my son would need to master.

I gathered up Rhys’ clothes which I had collected from his room and started to lay them out on my bedroom floor. They formed a sequence, a visual schedule of clothes, with the pair of socks placed at the very end.I then grabbed my phone and took a picture of the setup and put it into my First-Then app followed by a reward of some bubbles.

“Rhys, get dressed, then bubbles” I said.

I sat Rhys down in front of the clothes sequence, and from left to right, I got Rhys  dressed, with no expectation or request for him to do any of the actions himself. It was not about Rhys trying to put on any of the items, that was my job. The plan was for Rhys to complete the final step, and we would move backwards from there. I moved along the clothes sequence dressing Rhys, first his pants, then his trousers, and finally his T-Shirt, we finally approached the socks. I moved behind him and thought through the task breakdown I had identified earlier. I gathered up the sock, placed his foot into the opening, then pulled it up his foot and over his ankle. Coming to the final step of the task sequence I took hold of Rhys’ hands to help him do this part himself. Placing his thumbs between the sock and the skin of his ankle, I hand-over-hand, helped him pull the sock up his leg.

“Well done Rhys” I cheered, and hugged him with delight. He had accomplished the first (or last) step of the task. Following my promise, I filled the room with bubbles.

Over the next month, Rhys mastered the goal of pulling the sock up his leg all by himself, and we moved onto getting it pulled over his heel and then continuing backwards through the routine, to him placing his foot in the gap, finally gathering up the sock in his hand. Socks proved to be one of the most challenging goals, but step by step we got there, and Rhys managed to put on his own socks after a few months of hard dedication. 

Every morning and every night when Rhys got ready for bed, I continued to lay out his clothes and pajamas in the same order to get dressed. As soon as he had mastered his socks, we continued to set goals from the end of the clothes sequence, breaking down each piece of clothing into simple steps.

It took a year in total, to get Rhys independently dressing himself, and now three years later Rhys still has his clothes laid out in the same order for him to get dressed.

Break down the goal. 

Persevere. 

Never give up. 

It took Rhys a year, I would have kept going even if it had taken two! 

***

Click here to get a step by step guide on using Backward Chaining.

*The content which I have shared is all a result of my own experience. I am not a qualified speech therapist or OT, I am just a parent who wants to share what has worked for us, and hopefully help others with my knowledge and experience.

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