Summer – 30 Minutes at a Time

Elmo has wheels

I found this skateboard/scooter thing at a garage sale, and it seems to satisfy R.’s new craving for wheels.   She calls it a bicycle.  She won’t actually ride it yet, but she is having fun.

We have been doing what I’ll call official potty training for four weeks – since summer school ended.  I put her in underwear when we are home and take her to sit on the toilet every half an hour.    It is going well from the perspective that she is compliant about sitting, and when I say time to go potty, she will usually get up and go right into the bathroom.    She has only had one success so far, and she put her fingers in her ears when she heard herself peeing.

She can go a long time between peeing.   So after it has been an hour or so, I reduce the amount of time between trips to the bathroom.   It makes the day feel kind of endless, so I’ve been trying to make the best of our five minutes.  We still look at books, but that is not as exciting now that we are in there so often.  I’m letting her put stickers on the bathroom wall while she sits, and I moved a small TV table into the bathroom.    We are using it for coloring and drawing, doing sticker books playing with legos and anything else I can find.  I’m trying to teach her to play memory type games – the ones with cards you flip over to make pairs.

At first it seemed like she was intentionally going right after sitting on the toilet.  She did not give any indication that she noticed she was wet.   But she stopped doing that, and it seems like she is becoming more aware.  In the last couple of days she has actually said something either after or while she is peeing.  The other day she was sitting at the table and she jumped up and said wow.  She had peed, and after she had new clothes on she kept going back to look at the wet spot on the chair.  This afternoon she said oh, and grabbed herself.  I asked her if she had to pee, and told her to pee in the bathroom.  She ran in, but it was too late.

When she has an accident, I take her into the bathroom and have her sit on the toilet and help her get changed.   I don’t have her sit for the full five minutes.   Everything we are doing is based on the the advice from the behaviorist.  She had ABA sessions for the past three weeks (this is the last week until school starts), and I’ve been having her go sit multiple times during the session.

I realize that this is going to take a long time.  I remind myself that every time I get frustrated waiting for R. to do something particular, just when I’ve nearly given up, she gets it.

Just a quick update

Summer vacation is here.   Friday we went to R.s classroom for an end of the year party.  The teacher made a slide show of all the pictures she took all year and showed it to all of us.  The kids liked watching it, but I think they liked the cupcakes more.

We also had our monthly ABA team meeting this week.  We decided to wait until after summer school to start all day potty training.  I’ll admit I kind of pushed for the delay after thinking about it a bit.  We have taken such a slow approach to potty training – we started in November, and she is just now up to sitting for two and half minutes.   It hasn’t even been a week at that length of time.  She was so aversive to sitting at first, and progress has been pretty easy lately.  I think it is worth waiting a few weeks and using that time to gradually work up to the five minutes like we have been doing.

R. never pointed.  In the past year she started pointing at things in books and naming them, and she also started using my finger to point.   Now she is pointing on her own.  Not all the time, but enough to be incredibly useful.  It kind of looks like she’s acting on a stage, her whole body is invested in the pointing motion and she gives me an expression that seems to say -hey I’m pointing pay attention.

Yesterday R. said to me Want chicken.  She won’t each chicken in any form, I could not think of a toy, so I just repeated it back to her with a questioning tone.  Want chicken? Then she said, Want chicken!  Bock bock! So I bocked like a chicken.  What a strange thing to ask for….

Summer of potty training

School ends next week, it seems too soon.   Summer school (ESY) starts two weeks later, it is at a different school.  We will have the same teacher, so that puts my mind at ease.   ESY starts on a Thursday, and they extended the day by fifteen minutes.  I’m guessing that must be some crazy math to limit the number of days of school.

It looks like we will be spending the summer working on actual potty training.  R. can pull her pants and the dreaded pull-up up and down.  She started doing this independently, and she’s quite proud of herself.  I have to thank the ABA supervisor for pushing this.  It has been tedious.  R. has to pull her pants and pull up down and then sit on the toilet for sixty seconds four times in a row.  They started with a full prompt and reduced the prompt in my opinion quicker than usual.  Last week she started doing it all on her own.  They tell her pull your pants down, and then she does.

I never realized just how complicated pulling your pants up can be, we could show her the pulling part, but she figured out on her own that she has to wiggle her butt a bit to get the pants over the pull-up.   I’ve been trying to let her pull her pants up and down on her own, and even when we are in a hurry she “helps”.  She’s trying out her skill on her own, I find her pulling her pajama pants up and down in bed and she is trying to remove pillowcases from pillows.

Today the behaviorist increased the amount of time she is sitting on the toilet to two and a half minutes.   She has not peed on the potty yet, she seems to go in between attempts.  It is kind of obvious that she is holding it.

They want me to start during the two weeks between the end of school and ESY.  I’m supposed to put her in underwear all the time when we are home, and have her sit on the toilet for five minutes every thirty minutes.

We still have to work out the reinforcers.  I have candy saved for when she actually goes (hopefully she will eat it and it won’t get stale first).  We have been giving her reinforcers after she sits.  I’m using some special books she likes and a light up wand.  The behaviorist says that when we go to actual potty training we should not reinforce her for sitting without peeing.   I want to start offering her the books while she sits.  Five minutes is a long time.

She wants me to go away

R. is talking a bit more all the time.  Her requests are becoming more natural.   For nearly a year we had to verbally prompt each word. Last month she started saying some words if we held the item she wanted up and waited.   Now for most items we just have to wait.  At mealtime she is just speaking up and saying what she wants.  It almost feels normal.  E. and I will be talking and she’ll just interrupt with her demand.   It is just one word, but I’ll take it.

She is also self correcting herself.  She’ll say cookie, bagel, or open, cookie.   She’s saying more words in response to situations, oh no, wow and after years of me working on it – she is saying hey.  I know that sounds like a silly word to be excited about.  But I’ve been trying to get her to say hey or stop instead of crying.

Her echolalia seems to be changing slightly.  Sometimes when she echoes she changes her intonation. It is subtle, but definitely deliberate.

She is very into spending time with E., and she wants him all to herself.  She’s been saying Hey!  What you doing? When I come into the room.   If she is being nice she will hand lead me into another room.  But often she just gives me a shove.  I’ll say, you want me to go away? And she will say go away! I think this is really funny, and it doesn’t bother me at all.

I feel like I’m documenting every second of potty training.  She is up to sitting for eight seconds.  The therapists tell her she will sit for eight, and they say only the first, middle and last number.  R. counts on her own, and insisted on staying until the count of ten once and twenty another time.  Nothing happened, but she was and is happy to sit there.  I’m almost looking forward to summer so we can devote more time to this.

I do have to say that I really hate pull-ups.  They leak like crazy, and trying to do up the sides makes me feel like I’m all thumbs.   Maybe it is because I have so many years practice with diapers.

Catching up

You’d think I’d be all caught up since R. went back to school on Monday, but it is not happening yet.   I’ve been on a mad reorganizing binge because R. has found her way into drawers and cabinets that she did not bother before.

I was quite surprised to find out we had a box of caps stowed away in a drawer.  I saw her with a box, and saw small bits of what looked like paper all over the floor.  As I walked over to investigate, I stepped on the paper and heard pop pop pop.  What a mess!

She also discovered the china my Grandmother gave me that belonged to my Great, Great Aunt.  In R.’s defense, she wanted to set the table with them.

She is finally sitting on the toilet with her pants and pull-up down.  That just started this week, and it is going a bit better than expected.  She only has to sit for four seconds at a time.  They want to phase out the counting, but give her a cue, so they say for a count of four, and then just say one and four.

We just got our new ipad today.  I haven’t had much time with it yet.  I know it will be yet another distraction…

January ABA team meeting

We had our monthly meeting today with the ABA team.  One of my concerns is that R. is over generalizing the mand, want book.  She is saying want book for nearly everything she wants.   The supervisor thought that this was typical for R, and she’s right. R. does have a tendency to over generalize specific mands when they are first learned.  She also said that they are working on an object identification program that will help R. increase her vocabulary, and this should help.

R. will come to me and say want book, while she hand leads me to what she wants, which is rarely a book.  If she wants a cookie, I’ll say want cookie and she will only repeat the word cookie.  I know it is common for children with autism to repeat just the last word.  I do find I can get R. to repeat two word requests when they don’t contain the word want.

We discussed this for quite a while.   They suggested that when she says want book, we should give her a book, even if we know that is not what she wants.  Then when she refuses the book we should prompt her to say the correct mand.  We decided that we should limit our use of want, okay I pushed for this, but it wasn’t hard to get them to agree.    So instead of want cookie, I’ll say eat cookie, instead of want water I’ll say drink water, instead of want open, I’ll say open door.    They modified their mand program so they will work on eat cookie, play ball and want doll.

R. has started saying Hi spontaneously, mostly to inanimate objects.    She was cold so I put a sweater on her, she looked at it and said Hi, with the most joyous, glad to see you tone.  She said Hi to the water in her shower, to the box of cookies, to the new straw I put in her cup, always with that pleased as can be tone in her voice.   The behaviorist and supervisor thought this was a little weird, but cute.  The therapists said they thought it was typical behavior for  an early talker.

They are increasing R.’s sitting on the toilet to twenty seconds, up from ten seconds this week and last.  Her pants are still on while she is sitting.  We discussed the fact that she needs to sit for the entire twenty seconds with out any prompting.  They are giving her a reinforcer after sitting, and they wondered if they should give her the reinforcer while sitting.  I said that I would like to keep reinforcing her after sitting, until we get to her sitting with her pants down.   Then when we switch to pulling her pants down, she’ll also have the addition of a reinforcer while she is sitting.  They agreed.

R. has been doing jigsaw puzzles with the image on the background, so it is really matching.  They are going to start doing the same puzzles without the background.  I’ve been doing a jigsaw puzzle with her lately with no background, and she is starting to get it.   I think she has memorized the picture, but that is okay, at least she finds it interesting.   She’s bored with her insert puzzles, so I’m looking for other activities like that.  It’s like it needs to be a little challenging, but not too easy or difficult.

They are working on a new tracing program.  R. is supposed to trace a dotted horizontal line.  She needs a little bit of a prompt but she seems to like doing this.   I know she likes to have me hold her hand and we do dot to dots or write the alphabet.  The behaviorist wants me to stop doing that until she gets further along in this program.   It bugs me a little, but I do get where she is coming from.  We’ll do more coloring.

I finally asked about being provided a list, even a short one of activities that we could do with R. on days off and sick days.  She seems to be bored and looking for more to do on those days.   They said they could give me a list of the programs that were on maintenance, and seemed to think it was a good suggestion.

One of our therapists is leaving, Friday is his last day.   It happens all the time, but it always makes me a little sad, and he says he is too.  R. really loves him, I hear them both laughing throughout their sessions.

She sits

Last Tuesday the supervisor adjusted the potty training program again.  Instead of sitting on my lap, she had R. sit on the toilet ten times for one second.   R. fought the first few tries but by the end, she seemed resigned to do as asked.  A new, never seen Elmo potty training sticker book helped.   I should also mention that she is sitting while wearing her pants and diaper.

She did well all week, and by Friday she was laughing when the therapist sat her on the toilet, like she found the whole thing hilarious.    This week the supervisor extended the time to five seconds.  The therapist places her on the toilet, and she has to sit independently.  We count to five.   That doesn’t seem like a long time, but it is just long enough that she has to willingly decide to sit there on her own.

I’m sure we will have to start over again once her pants and diaper are actually pulled down.  But for the first time I’m actually letting myself imagine what a diaper free life might be like.

What ever it takes

We are in the beginning stages of potty training, it is like we are in the training for potty training stage.    Starting in November, we spent several weeks just taking R. into the bathroom at the end of her daily ABA session.

The supervisor decided that the next step was to get R. to lift the lid of the toilet seat.  She wrote the program so that R. was supposed to open and close the toilet seat lid ten times in a row.   I stepped in immediately and said no way are you having her do that ten times in a row.  I mean talk about teaching a repetitive behavior.   It did not take too long for R. to master lifting the toilet seat lid once.

Sitting on the toilet is a problem for R., she does not want to do it at all.   If I want to get her out of the bathroom all I have to do is suggest she have a seat on the potty. (Maybe I should stop doing that).   The supervisor’s suggestion for the next step, is to have me sit on the toilet and put her on my lap for 30 seconds.    I did mention that this happens during R.’s ABA session.

So yesterday here I am in the bathroom sitting on the toilet with R in my lap, her male therapist watching and counting.   Counting out loud to 30 was the only way to get her to stop screaming and fighting.   To his credit, the therapist did not seem the least bit embarrassed or flustered.     I’m just going to have to get over it.