Saturday, November 22, 2014

How to Potty Train an Older Child with or without Special Needs

 I am not kidding when I make the following suggestion. When you are potty training your older child, set out a jar or piggy bank and put in a dollar every time someone tells you to have your child pee on cheerios or any other ridiculous, ineffective, and unhelpful suggestion. Put in a dollar every time your voice cracks as you're telling a fellow mom about your potty training difficulties only for them to tell you they know exactly how you feel.  After all, their 18 month old is just not getting it.  If I'd done this I would've had enough to pay for Christmas presents this year! If you're looking for a magic bullet, keep searching, you won't find one here.  If you have been unable to toilet train your child after multiple years of attempts, there is no magic bullet. Realizing this, and settling in for the long haul actually reduced the stress for us.  It's already taken years, plan for it to take at least the next three months. 

About My Son, 'G'
Running away from the Potty Training Experience
     We do have a diagnosis for my son, but most don't consider him to have special needs. He's smart, funny, and very sociable if you get him one on one. He does have mild hypotonia (low muscle tone), some sensory processing issues, anxiety, and he's always been very uncertain of new things. Even as a little toddler he would take off running down the sidewalk behind his walker push toy, but refused to take even one step without holding on to something until he was 14 months old. He just doesn't like to do things unless he's sure he can do it perfectly. My little perfectionist is now fully potty trained at 4 and a half years old.


What Didn't Work
     Attempt #1 Occurred in August. It was a few months after G turned 3 years old and the first day of entering the 3 year old preschool class was fast approaching.  This attempt was comical. First, I tried spending hours camped out in the bathroom with him sitting on a potty seat on the toilet waiting for him to go. We had a portable DVD player, and I gave him unlimited sugary drinks in order to encourage him to go as much as possible. G had NO CLUE what was happening. Seriously, he would look down after he already started urinating and say, "IT'S HAPPENING!" It was a complete surprise to him, every time. We also tried the allegedly easy peasy potty train in 3 days method. HA! It can't work if the child is not feeling the urge to go, and doesn't even realize he's had an accident.  People talk about 'signs of readiness' as being interested in using the potty and being able to tell when they are about to go pee pee or poo. At 3 years old my son didn't display either of these signs. At times he can be a particularly oblivious child (possibly by choice?), and potty training just wasn't going to happen at that time. We nervously explained all this at our first teacher conference and thank goodness the teacher said to just send him to school in pull-ups. She promised he wouldn't be the only one, and assured us that 'boys take longer'.  We happily stopped all potty training efforts.

   Attempt #2 We still held out hope that our March baby would be potty trained by the time he turned 4 years old. After the excitement of the holidays ended we decided to switch to underwear cold turkey (except at night).  I talked to G a lot about it beforehand and told him when the new year started, the diapers weren't going to fit him anymore because he was such a big boy. We let him pick out his underwear and the morning of Jan 2nd we took off the diaper, put on underwear, and sent him to school. We did warn his teachers, and they were very supportive.  There were A LOT of accidents, but he did get a bit more practice in. During this time he also became used to using the potty at school. This attempt lasted about 30 days.  I don't want to discount all the progress we made during this time, but in hindsight I think the problem was that I was waiting for him to 'get it'. Everyone kept telling me one day he'd just get it and he'd train himself overnight. I kept trying different things to motivate him, and tried different strategies geared towards making that magic moment happen. I kept waiting and waiting for it to click and for him to wake up potty trained one day. This attitude of mine was stressing us both out. Instead of improving, he started to get worse and have more accidents. Ultimately we had to stop because G began holding in his BM's in until school and then would make a big mess for his teachers right as they were getting started. They put up with this for a full week before asking us to go back to sending him in pull-ups. I don't blame them! But, then we had no potty training support from his teachers.  He began to PANIC when wetting himself, and in general his anxiety was getting worse. We decided to stop.  This was a painful decision.

Have you ever had to quit potty training? If so, you'll be the only other mom in the world besides me. Maybe I'm being slightly over dramatic, but this time between quitting in February and starting again after school ended in June was tough. It was bad. I had breastfed, made all his baby food, taken him to library story times, and taught him letters, shapes, and numbers.  As a stay at home mom, mothering was pretty much my only job and I like to think I was pretty good at it. But I had failed at potty training.  I tried to hold back tears and share my frustrations with the other moms, but they would always respond by telling me to have him aim at cheerios or give him M&M's when he goes.  No one understood what we had been through. In my heart I knew he wouldn't be going to High School in pull-ups, but I was sure he'd start preK in them. I wasn't very hopeful about kindergarten, either.

This is what went up on the Bathroom door at first, but I added things later
How I Did It

First, I changed my attitude.  There wasn't going to be a magic moment where he just suddenly got it and trained himself.  I stopped googleing potty training methods because they were all for younger kids and we'd tried everything anyways. I also stopped posting about my struggle on facebook. The terrible advice I was getting and the condolences from mom's of little toddlers was...not helping. 

Second, I made a sticker chart. If this was going to take months then we needed to set up a simple, consistent system of rewards and expectations that were easy for he and I to follow.  My sticker chart was epic. It had over 100 spaces and had rewards about every 10 spaces.  In the beginning I had to draw in rewards more frequently because things were going so slowly.  I left it pretty blank in the beginning so I could add more presents and candy squares depending on how quickly he acquired stickers.

Almost to the top!
The day after 3yr old preschool ended, I put up the sticker chart and tried to be positive and excited about it.  I explained that he didn't have to use the potty if he didn't want to, but if he did he would get a sticker on the next available space. If that space had a lollipop or popsicle then he would get that treat. If the space had a present on it then he would get a wrapped present.  Usually the presents were between $3 and $5, but occasionally we'd spring for something he'd been asking for.  Whenever we were at home he would have a naked bottom, and he'd wear pull-ups when we went out. We had all summer, so there was no rush, and I admit I had lost all hope so there was no sense of urgency with this. I expected to be doing this for the next year, so why push him and stress us out? When we went on vacation I brought his potty seat, but he usually would wear pullups the entire time.  Everything was about keeping things low pressure and stress free.

The first 20 stickers took him 45 days to earn.  I cleaned up a lot of horrible poop messes off the carpet, the couch, and my child.  He urinated on the floor so often I stopped bothering to get out the carpet cleaner just for that.  But, he made slight progress all the time, and he was starting to show pride every time he earned a sticker. Looking back, I wish I'd put more presents on it in the beginning because I think it was getting close to that second present that started really motivating him to get stickers. By the end of July he was starting to get one sticker every day, sometimes two! I reserved August just for potty training. No vacations, and at least 4hrs of having a naked bottom at home every day.  I did send him to 3 weeks of morning summer camp at his preschool in August, but he wore pull-ups. I told him he didn't have to, but to tell me if he pee'd at school and it would still count for a sticker. On the 3rd day of camp he ran out to tell me, "I pee'd at school!!" From then on, he still wore pullups to camp, but came home dry because he was using the potty there.  We soon figured out the tightness of briefs was confusing for him, but he could wear knit boxers at home during potty training time and still be successful.

The Last Sticker! We were clapping and cheering.


He slowly got the hang of it as we approached the end of the chart, and I promised him that when he got to the end he could have a potty party with CAKE AND PRESENTS! This was highly motivating and he began having little to no accidents and earning 4 or 5 stickers a day. I hate to say it, but...one day he just got it.  After two nights waking up dry and asking to use the potty rather than his diaper in the mornings I decided to let him wear underwear at night. It's now November and he's only wet the bed 3 times since we switched.  After everything we'd been through on this journey I really wanted his potty party to be special so I admit I splurged on a nice pile of about 10 presents.  He got a pile of presents at his party and got a 'cake mountain with blue frosting' as requested. He ended up using the potty right before the party and earning the final sticker at the party (I admit to 'forgetting' to give stickers towards the end so it would work out just right).  He started Pre K in underwear and has only had a few accidents at school.

Potty training my son was a nightmare and the worst thing about parenting I've experienced thus far. But seeing him ultimately overcome and be victorious was amazing.  So, that's how we did it. I can't promise it will work for everyone, but patience and a giant sticker chart is what ultimately worked for us. Good luck!

Disclaimer: I'm not a doctor or a psychologist, just an inexperienced mom. Consult with a medical professional before making any changes to your routine. 

 

Sunday, November 9, 2014

The 'We Sort of got a Diagnosis' Update

Long time, no posts! My netbook died.  That's really no excuse because we have a desktop, but after that happened I stopped blogging and enjoyed the summer. A lot has happened with my 4yr old 'G.' We got the diagnosis of 'Other Specified Neurodevelopmental Disorder' for him which I was happy with at the time. At least it was something. The psychologist didn't give me any tips for potty training, but he did support my efforts. He agreed that there was not going to be a magic potty training method for him. It was going to take months of hard work. He said that G's diagnosis will probably change as he gets older.  He thought G definitely was not on the spectrum, but might develop generalized anxiety disorder or ADHD in the future (those disorders are not diagnosed at such a young age).

At first I was really happy with this because we could start occupational therapy and get health insurance to pay for pullups.
Those were two things that I really needed to happen, so any kind of a diagnosis was a victory. But, after we got into therapy it became apparent that G's sensory processing issues were more severe than I had previously considered. They seem to really contribute to how he handles situations that generally cause him anxiety. For example, trick or treating is something I wasn't sure he was going to be able to do this year, but with sensory therapy he did awesome.

The evaluation center I chose simply didn't seem to have the capability of diagnosing G. I still feel very strongly that he has hypotonia and so many professionals have agreed.  The evaluation center and the psychologist there agreed he probably had it, but that has to be diagnosed by an MD and they only had nurse practitioners and psychologists at the evaluation so it couldn't be diagnosed. They also couldn't diagnose sensory processing disorder because they only diagnose disorders classified in the DSM. So, while I know he has sensory issues, I don't know if he has Sensory Processing Disorder or not. They claimed that since he only completely bombed 2 out of the 5 tests for autism that he doesn't have it. It's great he totally passed 3 of the categories, but he totally failed the other 2. This didn't really mean a lot to me until I saw the pediatrician after the final report came out and the Ped said he was still very suspicious of autism and didn't think we should rule it out at all. Really, I just chose the wrong evaluation center. I was hoping to get a quicker result by avoiding our University Hospital with really long wait times and that was the wrong choice.

Our pediatrician really wants us to start over and get re-evaluated at the university, but I'm not sure what we have to gain by that.  We have decided not to send G to kindergarten in the public school system next year. It would be nearly impossible to get him an IEP without a more specific diagnosis, and his small private church school goes up to 2nd grade. We've decided he will stay there as long as we can afford it. It's expensive, but you just can't beat the class size of less than 10 kids in a class. This year the kindergarten and 1st grade have less than 10 kids combined!

He is doing occupational therapy and absolutely loves it! Our current diagnosis is good enough for insurance to pay for therapy so we don't need an evaluation to get that.  Other special needs moms have really pushed me to get the evaluation because knowledge is power and I could help him more if I know what he has, but the process is so stressful for us. I already have a great OT to ask questions and a multitude of facebook groups for special needs parents. I'm just not ready to drag us through another eval when it's not necessary. So we're happily watching his improvements and waiting to see if our situation changes.  I'm open to getting another evaluation done, just not right now.

G is doing really doing great. He's now fully potty trained. HOORAY! That definitely will be getting it's own post soon. He had a rough start to preK, but now he loves it and he has no accommodations at school this year. We started occupational therapy in September and it boosted his confidence immediately. He has really blossomed and life has gotten so much easier in the past few months. Perfect time to start trying for another baby ;)

Tuesday, May 27, 2014

A Look Ahead. A new look, Homeschool, TTC

Hooray! I finally changed my blog title. Thank goodness! I really had long felt that the old title no longer fit my season of life. I will always consider myself an 'infertile.' My life is changed by that journey of infertility, miscarriage, and longing for pregnancy, but I'm now a mother and that dominates my daily life. We plan to begin trying to conceive a third child in December (I'll begin preparing in September), but even then my life will be primarily concerned with mothering the two boys I already have.

In other news, I will be getting the results of Gabriel's developmental clinic evaluation on June 5th. Not that far away! I really tried to glean some information from the psychologist who called me to make the appointment, but he wasn't falling for it. I did ask how long the appointment would take and he said they usually take about an hour. If there's nothing 'wrong' and he's completely neurotypical then it wouldn't take an hour to tell me that, right? right?! It's not that I want something to be wrong, it's just that I really want help. I don't want his behavior to be a result of my parenting. Not because I don't want the guilt, but because I don't really know how to parent any differently. We need help. We need services.  At this point, the best thing would be for him to be diagnosed with something so we could get help.

On a positive note, Friday was the last day of preschool. YAY! I'm looking forward to G attending pre-k next year, but right now he needs the break. I became convinced we just would not be able to potty train while he was in school, and even without PT school was becoming very stressful for him. On Sunday each week he'd finally be his wonderful self.  That would last until about Wednesday and then behavior problems would start again. I'm glad we're done with that for a while.  Our first few summer days of homeschooling and potty training have been going very well. Right now with schoolwork we are just working on writing.  I purchased a complete curriculum workbook designed for a 3yr old preschooler knowing it would be a bit below his level to boost his confidence and so we could just focus on writing.  These last two months of 'I don't want to go to school' have really done some damage and while I don't think Gabriel thinks he's stupid, I'm not sure he realizes how smart he is. I presume it's hard when everyone else in the class can write and hold a pencil and you can't. I got a variety of pencil grips off ebay and we've been doing great with the grotto grip. He's only done a few days of work with me and I've already seen a lot of improvement. We only do 12-15minutes a day. I know that's not much, but he's really not interested in school work and I'd rather work every day for a small amount of time than work a lot in the beginning and then he soon refuses to do anything. I've also noticed that his fingers get tired even in that small amount of time. I feel even more convinced that he has hypotonia like we initially thought and it's the reason for his poor fine motor skills. 


Potty Training Sticker Chart!
I feel like I've written a novel already, but I have to share a bit of my baby fever. I'm enjoying working out and my body feeling so small and strong, but I really do want another child. I'm sure I'll love being pregnant when it happens, but it will be more about the miracle that will soon be with me rather than the miracle growing inside me. I've started seeing the number 111 all around.  I made a motivational potty training sticker chart for Gabriel and it had 111 squares for stickers.  Then I ordered some TMNT stickers for it and when they arrived I saw they totalled exactly 111 stickers. From then on, I started noticing that number on the clock, price tags, and page numbers. I haven't stopped seeing it. While I was preparing to write this post I saw I'd already written 111 posts on the blog. It's really everywhere! I decided to go on the internet and find some kind of interpretation of those numbers. At first I was scared by it because I saw the number one often symbolized new beginnings, being alone, single parenthood or starting your own business. My DH drives so much I always have a fear of losing him in a car accident. I was afraid this was a terrible omen that I'd soon be starting over as a single mother, but after thinking about it more I realized it didn't really fit. I'm seeing three 1's. Why do I see 111? The number three symbolizes laughter, amusement, new friends, attracting love, sexual expression and creativity. I know it's all just a coincidence and probably doesn't mean anything, but I think this number means I will conceive a third son. Another strong, beautiful, independent boy. Three ones.  I'm hoping it also means I'll conceive in the first month of the year, but I think I've read into this irrelevant frivolity enough. LOL.

That's all for now! We will receive Gabriel's diagnosis or lack thereof in a few days and I'll at least be reporting the results to twitter if not on here.

Wednesday, April 30, 2014

Development Clinic Evaluation Update

I only have a few hours left to keep up with my new years resolution of posting one blog post every month for all of 2014, but I think I'm going to make it! I never shared my March post on twitter, but it was a simple post displaying my 4yr old's photography. I may be biased, but I thought his perspective was so interesting! If you're into that sort of thing, you should check it out.

Earlier this month we finally had our evaluation at the child development clinic to get Gabriel diagnosed with whatever behavioral issue he might have.  In case you haven't been following, we know he has low muscle tone that is affecting his performance at school, but insurance will not pay for therapy because hypotonia is generally a symptom of a larger problem.  He needs to be diagnosed with whatever other issues he has in order to receive therapy for the immediate problem.  The evaluation was intense. It started off with Gabriel in the adjacent room with the psychologist while I was interviewed by a series of medical professionals. I heard Gabriel laughing in the other room and was even able to spy on him a bit in between interviews. He thoroughly enjoyed that portion of the evaluation.

My interviews were exhausting. They really pushed for every piece of relevant or irrelevant information about his birth, medical history, and family medical history. They asked the same questions a variety of different ways to make sure they got everything.  I definitely felt grilled. I wasn't resentful though, because I didn't want to leave anything out that might help them. Next I met with the psychologist after he'd finished with G. He was sort of difficult to talk to and now I kind of regret I didn't push past my own discomfort and share more about the issues we face. I did give him the scoop, but I don't know if I shared enough details or went as in depth as I could have.

After that last interview we'd been there for over two hours. I was taken to Gabriel who was getting a hearing test and I could immediately tell he needed a break. At home, after school, he usually needs 30minutes to an hour of 'zone out' time in front of the TV. During this time he doesn't want to interact with anyone. He prefers that no one else is in the room with him. Even in the summer he often needs these breaks after a busy morning and now that he's four, he is sometimes able to tell me that he 'needs a rest'.  I could tell he needed one of these breaks, but I knew we were at least 30 minutes away from being done.

Earlier, the psychologist had asked me what would happen if Gabriel didn't get one of these breaks. I said he would have a meltdown, but that rarely happened because I was pretty good at responding to his needs.  And if it did happen I was pretty good at mitigating it. Well, that wasn't to happen on that day! After the hearing test he met with another medical person to test reflexes and to rule out possible other causes for the low muscle tone. We pushed him beyond his limit and he had one of the biggest meltdowns I've ever seen. Certainly the biggest one he's had in the last six months. He screamed, kicked, and completely flipped out. I was able to calm him down enough to leave, but everyone agreed that the evaluation was over.

So, I guess they saw everything there was to see. Now we have to wait EIGHT WEEKS for the results! Eight weeks! UGH. I'm disappointed, but there's really nothing I can do about it. I'm sad that after all his preschool teacher has done to help us out in this process she won't know the diagnosis until after he moves out of her class. But, I'm glad his next teacher will have all the information she needs. Hopefully we can start some kind of therapy this summer and it won't be so much of a problem next year. 

Though the evaluation wasn't a great experience, I feel like they were very thorough.  I'm hoping this leads them to the correct diagnosis and we can move on to treatment. We made the decision to seek help for Gabriel on January 17th, and now I'm not sure we'll have help by June. I hope we'll have a diagnosis by then, but after that we'll have to choose a therapy program and get enrolled.  Not sure what my next post will be about. This time next month we still won't have any news!

Thursday, March 27, 2014

My 4 year old's Photography

Still no more developments on our search for a diagnosis for Gabriel, but I recently gained an interesting new perspective into his world when I downloaded 200 pictures off his toy camera.  They were fascinating!  Since I don't have much to report on this month, I decided to share his best photos.  We have an evaluation next month at a child development clinic so hopefully I'll have more to report in my next post.
 
He got the camera at Christmas, better test it on little bro first!
 
 
And then mommy!
 
Took me a while, but this is toilet paper
 
 
 
 
 
Close up of a row of Arizona Green Tea at the Supermarket
 
Self checkout scanner
 
Grandma's interesting rug
 
I love his perspective! What a great shot of Daddy and brother
 
 
"Mommy! Say CHEEESE!"
 
 
 
 
 
 
Taking a picture of me, taking a picture of a record.
 
 
Our front steps
 
Headlights on the car! Took me forever to figure out this one.
 
 
 
My camera lense
 
 
 
Microwave buttons
 
 
 
 
Peering over the double stroller, waiting for mommy.
 
There I am!
 
 
 
 
Unintentional selfie
 
 
 


 
 
Are they not fascinating? Such a unique perspective. I love my little photographer!