|Potty training is no fun, but it’s even less fun to have an older child who is not ready for potty training, or requires the use of special techniques to learn.
Of course, many children with special needs will always be incontinent, through no fault of their own or their parents. Charlie might be one of them. Over the years, I have spoken to many parents of adult children with special needs who feel that their child could have developed the skills, but for whatever reason, never did. If I’ve learned one thing about potty training from these parents, it is this:
They wish they had tried.
If they did try,
they wish they had pushed harder to get help.
It would have improved quality of life for everyone times a million.
We are working on it every day. I tried all of the usual techniques that worked for my older daughter, but, without modifications, these approaches often do not work on a child with special needs. To see how some of these techniques are adapted for a kid like Charlie, this article on potty training advice from the UNC TEACCH Autism Program is a great read. Charlie receives behavioral therapy and has the autism diagnosis. Our behavioral people have a lot of great ideas which include using “reinforcers” such as the iPad or foods, and all of these strategies will require consistency and persistence.
Indeed, the standard approaches are just too pedestrian for a complicated man like Charlie. As you can see from the photo above, a potty chair makes a great office chair to sit on fully clothed and bark orders to his imaginary secretary with his imaginary phone.
I will admit, I am pretty discouraged.
Charlie doesn’t really communicate his needs in a functional way unless he is whipping his cup at me and saying, “DWINK?” so it’s really difficult to teach him to tell me when he needs to go, and I have to rely on his “tells.” So, for example, he will be at the windowsill where he likes to play with his toys, and will start doing what I like to call the slow motion James Brown move, crossing his legs and crouching. This is the point that I am told by behavioral experts that I am to implement an approximately 400-step plan (or at least it seems that way) that involves verbal cues, reinforcement, praise, shadow puppets, and interpretive dance. This process usually results in him sitting on the toilet with a goofy grin doing nothing, with me and at least one therapist kneeling on the tile floor, sweating and saying/singing ridiculous things to him to encourage him to go, finally deciding that we must have been mistaken and he DOESN’T have to go after all, pulling his pants up, and him throwing his “reinforcer” toy in the toilet…
…then pooping his pants in the living room five minutes later.
Alas, I’ll never know unless I try.
Meanwhile, back in the real world, Charlie needs diapers. Lots of them, and big ones, because he is six years old and big for his age. What kind of diapers should I buy now that Charlie has outgrown the biggest size of Pull-ups but the smaller adult size is too big and bulky for his (adorable and) ambulatory self? Will my insurance help me to pay for these diapers? Here is a great article on diapers for big kids.
As for obtaining and financing Charlie’s diapers, this has been a seemingly never-ending nightmare of red tape and trial and error for the last three years. I am lucky to live in PA and have Medical Assistance, a wonderful, magical secondary insurance that picks up a ton of what my private, employer-based insurance doesn’t cover, such as therapies and diapers. However, until recently, I was unlucky that I had to jump through crazy hoops every month just to use the insurance to get Charlie’s diapers. I would have to call and sort something out, send in a form, confirm a standing order, or otherwise keep the diaper supplier on my to do list for at least two weeks out of every month, and even then, the shipment was often delayed.
For all the trouble involved, I could have used that time to make handcrafted, artisanal diapers from recycled organic fibers and still would have had time leftover. Don’t you hate it when “services” that are supposed to make your life easier actually become your part-time job?
Once again, I turned to my Facebook family for advice. The other moms didn’t seem to be having so much trouble, and recommended that I switch diaper suppliers, so I did, last month. I have to say, the prospect of changing suppliers was intimidating. It was one of those “Devil you know” type of situations. I am SO GLAD I SWITCHED! After a few brief, initial consultations to get insurance sorted and assess our needs, they sent me two sample diapers to see what would work best, then they processed my order right away after I told them which diaper was best. Best of all, they let me do many transactions online, something very important to me because it’s really difficult to discuss diaper absorbancy when Charlie has the same ten seconds of an episode of the Dora the Explorer on his iPad on repeat, full blast volume in the background. I would like to give a shout out to J&B Medical Supply for making the process go smoothly! So, the moral of the story is, if the process seems to be too much of an ordeal, maybe it’s not you…it’s them…and switching suppliers can solve the problem!
Does your private insurance carrier cover diapers? If not, be sure to check this site for a list of potential sources for coverage in your state. What are some of your potty training tips?