I need some help with something...

[laborcat]

I know at least one of you in here has Asperger's, and my alpha son (supposedly) has it too, according to his current therapist. In my own research, it does seem to fit.

Here's the thing...

He's ten. And still not fully toilet trained. As in, he'll be playing games on the computer, and will poop his pants, and claim to not know it has happened until someone calls him on it. Then he throws a tantrum. He acts like having to sit on a toilet is the absolute punishment. Sometimes if we can catch him before he makes a mess, we can get him in there and we try to praise the hell out of him when he uses the toilet. But he just doesn't seem to "get it". Most of the time it ends up him screaming, saying he doesn't deserve to live with us and he wants to live in a dump, me crying in my room, his father outside chain smoking, my MIL trying to lecture me and my husband at the same time from the middle of the house, and my younger son scared and confused.

This child has been a struggle from the word go. It's very frustrating and I'm seriously down to my last nerve when he gets like this. I am starting to feel like a serious failure. I can't stay home with him because the loss of my income would strangle us, and if I spent that much time with my MIL (we live with her) on a daily basis, I'd go insane. We've been to a wide range of medical professionals, with no physical reason for him to be this way (no physical problem with his bowels, etc) so I'm stuck, and clueless. I hate this time of year, my depression is really starting to dig its claws in me again, and work is really overwhelming me on top of everything else.

So is something like this normal with Asperger's, or is it something else that I'm missing? His therapist is working with him on it, but everytime the subject of toileting comes up, he throws that wall of rage back up. Even getting him into the bathtub is hard. I'm hoping this is making sense, because I'm sure I'm rambling at this point. Thanks.

[Andara Bledin]

Wow. I ... don't think I've ever heard of anyone with such an aversion to the bathroom. I know my former co-worker with the Aspie kid doesn't have a problem like that at all, and while I'm only barely borderline Aspie, I'd be far more mortified to go in my pants than go where it belonged.

^-.-^

[Ratha]

It's partly a control issue from the sounds of it. It sounds similar to a phase I went through around that age, only my issue was wetting myself. It could also be a phobia of using the bathroom. Or it could just be that he gets so involved in what he's doing that he doesn't want to leave it for anything.

There's so many things it could be. Asperger's symptoms tend to be atypical and different for every individual.

As for dealing with the problem, you're doing the best you can, and it's never easy dealing with Asperger children. I know. I still give my mom fits sometimes, and I'm almost 30.

[Seshat]

He's ten. And still not fully toilet trained. As in, he'll be playing games on the computer, and will poop his pants, and claim to not know it has happened until someone calls him on it. Then he throws a tantrum. He acts like having to sit on a toilet is the absolute punishment. Sometimes if we can catch him before he makes a mess, we can get him in there and we try to praise the hell out of him when he uses the toilet. But he just doesn't seem to "get it".

He gets great reward neurochemistry from playing the games.
He gets low 'punishment' neurochemistry from pooping his pants.
He may in fact not realise it - he may be too deeply into the reward neurochemistry to notice.

The tantrum, the 'I don't deserve to live with you', and so forth is probably a combination of being taken away from the reward neurochemistry suddenly, realising the situation, and the shame effect.

I don't have a solution for you, I'm sorry. Just an explanation.

[Cazzi]

My daughter with Aspergers, has aversions to bathing and teeth cleaning. I can more or less wheedle her into the bath on occasions but have lots of trouble getting her to use a toothbrush. I have also heard of others who cannot stand bathwater touching them and have to wash with wet wipes.

I also have no solutions sorry, just that you're not alone in finding such behaviours frustrating.
Is it possible you can get your counsellor to help or refer you to someone who has experience in combating these behaviours... and maybe family counselling to try & get your MIL to see that lecturing is only making things worse

[Seshat]

My guess is that he dreads toileting now. Toilet sensations have become attached to severe overstimulation: the MIL lecturing, the scared younger brother, etc etc etc.

If you can quietly handle toileting without making a fuss over it, perhaps with noone else even becoming aware of the situation, you're more likely to get him to relax.

Consider asking him to just sit on the toilet and open his bowels twice a day. No straining, no effort, just .. letting it happen if it happens. Perhaps just before bed, and on waking up.

[Fire_on_High]

I dunno, I'd be likely to say the exact opposite.

Games give him "great reward neurochemistry"? Dig your heels in, no games til extended perfect compliance. If that means the next time he touches a game, everything released is too new for the machine, well...his own choices.

You don't win battles with stubborn by anything other than breaking it. Take away the rewards entirely, no bargaining or half measures, and don't give them back in any form until that defiant will is entirely broken.

[trailerparkmedic]

Can you get some family counseling on how to handle this, even just for 1 session? Everyone screaming at each other doesn't seem to be working very well for anyone involved. Maybe an outsider giving some suggestions about better coping mechanisms will help calm the house down, and that can't hurt.

You are NOT a failure. I think you are doing as good a job as you can, which is all any parent can do. I also think that by seeking out help everywhere you can, you are being a great parent.

[Seshat]

You don't win battles with stubborn by anything other than breaking it. Take away the rewards entirely, no bargaining or half measures, and don't give them back in any form until that defiant will is entirely broken.

See, I don't think it's stubbornness. I think it's a combination of a child's inability to manage delayed gratification, and an Asperger's different neurochemistry from the neurotypical.

[Chromatix]

Okay, I'm going to drop in my suggestions:

1) Get rid of the screaming, panicking, loud noises and recrimination. This is *critical*. It winds everyone up, including yourself, and it also counterproductively makes him associate the toilet with punishment (even if *you* don't think it's a punishment, it's unpleasant for him and therefore it counts).

It's probably going to take some practice and skill to achieve the above. You essentially need to think from his point of view and try to be sympathetic. While holding your nose. It might help to introduce some kind of damage-limitation mechanism so that the problem is easier to deal with - nappies/diapers are available in larger sizes - simply to limit your own stress.

Remaining calm is important because Aspies have a particular inability to handle social stress. It could even be that absorbing himself into the game world is his way of avoiding social stress from a normal day. That's over and above any sensory hypersensitivity he might have.

2) Once you've achieved that, it's time to start subtracting the distractions, as and when he shows himself incapable of managing them. Don't take away anything that's necessary for doing homework or writing letters, even if that means you have to supervise him on the computer, or even get him a separate (possibly very old) computer just for working on.

For example, if there is an accident while playing a particular game, uninstall that game and lock away the discs. Make it clear that the discs will be unlocked and the game reinstalled when there are no accidents for, say, a continuous week ("it's now half-past six on Tuesday evening"... be that precise).

Remind him, at this point, that the game would still have been there after he came back from the toilet. Don't forget to remain calm and matter-of-fact while doing so. It's not a punishment, it's just something he clearly isn't mature enough for yet.

Some games may be difficult to disable individually, for example if they are managed by Steam. In the case of Steam, you may need to change the password (to prevent him logging in) and put Steam into offline mode, to prevent simply downloading the game that way. If he works around it somehow while you're not looking, *then* you take away the whole computer (see below). That *is* a punishment, not for the accident, but for flouting your authority.

If it is genuinely impossible to divorce a problematic activity (eg. Web surfing or Flash games) from the machine, disallow him from using the machine. If it can be moved out of his sphere of influence, do so - put the family computer in your own bedroom, take consoles and handhelds out of his bedroom, stuff like that. At the very minimum, ensure that you can enforce supervision of it. Nanny software isn't good enough, trust me on this one.

Don't restrict this to computer games. Other toys can be a problem too, and potentially (though hopefully not) even books. I recommend handling books by series, author or genre, since the collection might otherwise be too extensive to be effective.

3) When it becomes time to unlock something, make it *one* game, activity or book set. Let him choose which one. After a further week with no accidents, let him choose another game to add to his collection.

Also consider small, short-term rewards on a daily basis, or even if he cleans up after himself after a lapse. The stick isn't much good without a carrot.

4) If you can write down these rules in advance and put them within sight of the computer, so much the better. Refer to them yourself to make sure you're sticking to them; don't change them arbitrarily. What Aspies do tend to know about from an early age is logic and justice, especially where it applies to them.

Now, there may well be a period where he has regular accidents, but only once a week after getting absorbed in the game again. This is a very good reason for noting the exact time you take away the privilege, so that it is returned at that time and day of the week as well. This prevents it from becoming a regular routine, where it appears that he is "allowed" to play one particular night a week.

It's also particularly important that the rules are not changed at this point, either - if they are made more severe, that's an injustice; if they are made more lenient, he'll just take advantage of them.

At some point he might want to know why being clean should be more important than playing a game. It seems obvious to the rest of us... but in his case a diagram may be useful, specifically Maslow's Pyramid. Explain that being clean is on the bottom, Physiological step of the pyramid, along with breathing, eating and sleeping. Playing games is on one of the upper levels, such as Self-Esteem. Be prepared to answer obvious questions about the other levels as well. The fundamental point is that the upper layers of the pyramid can't stand up without the ones below them.

[Seshat]

Chromatix, that's *fantastic*! That's just .. absolutely wonderful.

[laborcat]

Wow... that was amazing. Four years of therapy and psychiatrists and I get something that makes sense from a website forum. I'm going to print that out and take it to his current therapist and see if we can tag-team something similar.

I know I'm not the best parent, but I do feel lots better knowing that the frustration isn't just mine to deal with.

[Chromatix]

Well, sometimes you really do need the insider's point of view - which is often very difficult to get. Not every Aspie is a Temple Grandin, either in specific symptoms or in ability/willingness to talk about it. AFAIK, virtually no Aspies are practicing psychologists or psychiatrists, for fairly obvious reasons.

I'm glad to hear that my suggestion makes sense to you. It was really just a case of combining your description of him, other posters' observations, and my own experience of how not to do it - I'll spare you the details - and then "engineering" a viable incentive scheme with the desired result in mind.

Of course I don't have a solution for the MIL.

You'll notice that it's very fine-grained, so there are plenty of opportunities for repeated reward, which is essential to forming a virtuous habit. I do also suggest combining it with rewards for cleaning up his own mess, which I would consider almost as good as pre-emptively avoiding making one (since the extra effort is it's own incentive to improve). Can he be trusted to operate a washing machine himself? If not, provide a stink-proof laundry basket for the purpose.

FWIW, I've noticed that most psychiatrists take a palliative approach to autism-spectrum disorders, even in "gifted" cases where decent rehabilitation should be expected with an appropriate career choice. I think this mostly stems from lack of deep understanding combined with pressure for short-term results. The worst cases are when large groups of "patients" are formed for "efficiency", mixing very different ability levels and symptom groups... absolutely toxic. People survive that kind of therapy, rather than being improved by it.

[Andara Bledin]

The use of Maslow's Pyramid is absolutely brilliant.

^-.-^

[Chromatix]

The use of Maslow's Pyramid is absolutely brilliant.

It's just something I was introduced to at university. As it was an engineering major, there were a few management courses thrown in because engineers are potentially required to perform project management. Maslow's Pyramid is (or should be) a pretty fundamental part of management, even at that basic functionary level.

I have absolutely no idea how widely it is taught in America.