GO POTTY....GO POTTY NOW!

Many autistic children have difficulty initially getting potty trained, and even if they do get potty trained, many times there are accidents that follow for a long time afterward.  This has been true for Michael.

Michael is a twin, and I think that is a good thing.  He has a sibling, a very bossy sibling, who is the same age.  Mikayla was trained by the age of two without any problems at all.  She got to go to the private pre-school early because she was potty trained.  Not so for Michael.  If I remember right, he got potty trained by the time he was four.  I think this is a pretty good age for #1 being  a boy and #2  being a boy with autism.

Chris with the twins when they were 3.
 Mikayla trained, Michael not so much.

Even though he was mostly potty trained we continue to pack a "just in case" bag in his backpack for school. This "just in case bag" usually has a pair of underwear and pants, just in case of an accident.  He used it a few times during this last school year (first grade), and the one time I had cleaned out his bag and didn't put a "just in case" bag in his backpack, was the one time that he had a really big accident and there weren't any extra clothes for him.  That was the day that I had to run home very quickly, and missed co-teaching my 3rd grade math class.  *sigh  Luckily I work at the same school as the twins, so everyone was extremely forgiving.

So what is happening in Michael's head when he has an accident.  I believe it is called, "I am too busy doing what I am doing, and I don't have time for any interruptions, even if it is myself that is interrupting."  Many times he is building with his blocks, watching a TV show, or is on the computer playing a fun computer game.  I watch him clutching his crotch and practically dancing around the room.  I say to him, "Go potty, GO POTTY NOW!"  Sometimes he will run off and go to the bathroom just making it by the skin of his teeth.  Other time he will refuse, "I don't have to go to the bathroom," he replies, his eyes fixed on the computer screen and his dancing getting worse and worse.

Lately we have had many accidents in a row.  One was caused in the kitchen (thank goodness...easy to clean floor), in his swim suit.  He was trying to get a cup of water for himself and was stuck there.  His dilemma was to either finish getting the glass of water, or hurry off to the bathroom.  He chose the first option and peed on the floor.  The next day we had an accident up in his bedroom, he was playing with blocks and had to go, he stood there screaming from his bedroom holding himself.  He was stuck and couldn't "go anywhere",  he was holding handfuls of pee and was afraid to move.  I couldn't help him, as I am stuck on the couch with a broken foot (long story) and he was having a melt down because no one was coming to help him.  He then had two more accidents that day, so there was 4 in a matter of 2 days.  What in the

Having a broken foot that has 5 fusions is not easy
when you have an autistic kid.

world?

It doesn't help to get mad or upset at him.  I think when we do that, it kind of gets worse.  We talk to him and tell him he needs to be more aware of this situation.  Michael says, "I will try mommy."  This cannot be any good for his self esteem.  This isn't any good for his social image.  Right now first and second graders don't catch on as quickly, but in third and fourth grade?  He is going to be the "baby" who wets his pants and has to have him mommy pack him extra underwear.




Well, I blame the onslaught of accidents on summer vacation.  There isn't a real routine this last week before we go back to school.  There is no camp, no swim team.  The twins are sleeping in later.  There isn't a real schedule.  Michael thrives on schedule.  There is also too many "fun" things going on.  It is very hard for my "normal" kid, much less my autistic kid to break away from such fun.

I also believe that all of these accidents might be a sensory issue.  I do not think that Michael realizes he has to go half of the time until it is way too late.  Maybe he thinks he can get to the bathroom on time.  Does he actually feel the sensation to have to urinate?  Maybe the sensation is muted.

I also say in the back of my mind, maybe this is an attention deficit thing.  Many autistic children are also diagnosed ADD or ADHD.  Sometimes I think, "Maybe we should try ADD medicine, then he would pay attention to his body and go to the bathroom on time."  I am not one for medicine, but I slowly find Michael paying less and less attention.  I'll wait tho and see what his second grade teacher says.  If it is starting to affect academics in school, then we might have to seriously look at this.

We are looking forward to starting school again.  We will be on a more predictable routine, and hopefully we will have less accidents.  I will be packing a "just in case" bag again for second grade.  I will probably be packing this bag for a long time, because Michael will always be "Somewhere Over the Spectrum."

Internally and Externally Distracted

When we brought Michael up to the CHAD center at Dartmouth Hitchcock, Lebanon, one comment stood out in my mind about Michael.  The doctors there said that he was, "Internally and Externally Distracted."  I thought about that phrase again today as I picked up the twins from a Math Play Date.  (This is a play date in which my friend, who was a former teacher, gives the children an hour or so of more challenging math, then the kids have a fun play date).

Mikayla, Ethan and Michael playing with an IPAD

My friend, Tammy, who has these play dates for about eight first graders, emailed me the other day and said, "Michael never wants to eat snack while he is here.  He says he isn't hungry, and will continue to play a game, work on the computer, or solve problems.  Is there a food he really likes to eat?"  I told her that he liked blueberries a lot, but not to worry if he doesn't break away from what he is doing.  He gets totally engrossed in something, and it is hard to break him away from that, even to go to the bathroom.

So today I go to pick them up, and Michael is at the computer totally immersed in a new computer math game.  All of the other children are in the play room, playing or outside in the snow.  I go over to Michael and tell him that I'm there and it is time to go home now.  He looks up from the computer and says, "I'm really hungry and thirsty!"  Tammy had given the kids snacks hours before.  Michael said he didn't want any and continued to play the math games on the computer.  Tammy said, "Oh no Michael, I had bought blueberries for you....."  Michael smiles happily, "Blueberries!  Yum Blueberries!  I want some Blueberries!"  Then Tammy had to tell him that they were all gone because all of the other kids ate them all up.  Michael did not break away from what he was doing to eat his favorite snack.  So Michael settled for a banana.

As Michael was eating his banana, he started to hold his crotch and dance around.  Again he was so hyper-focused in what he was doing, he had forgotten to go to the bathroom.  This is a daily occurrence at our house and I know the signs as sure as I know the back of my hand.  I always have to say to him, "Michael, go potty, go potty NOW!"  He will always dance around like that then tell me he doesn't have to go.  He doesn't want to leave whatever he is doing.  It seems to be worse with computer time.
When he is not internally distracted, he can be externally distracted and not seem to pay attention to verbal directions.  Sometimes I think, "Could he be ADD or ADHD?  Could this just be his autism?  Is there a relationship between autism and ADD/ADHD?  Could Michael be misdiagnosed?"  These questions often come up in my head.

Michael and "Sissy" Amora at Christmas

I was talking with my step daughter Amora, the other day.  Amora is 24 and living on her own.  I became her "mom" about 10 years ago when she was starting high school.  She isn't a "step daughter" to me, she is just as much as my own as Mikayla is.  Anyway, she was saying to me, "Mom, I think I might be on the spectrum.  You know the whole time I was in grade school, middle school and high school I thought I was just ADD.  I've been reading your blogs about Michael, and I have a lot of the same characteristics as he does.  Maybe I was misdiagnosed and I have some form of autism.  I thought about that for a while, and it could very well be.  It runs in the family.  Her two brothers have it, and I think her father has it as well.  Chris's Uncle had it, but they didn't really know what to call it back then.  She really didn't have any friends, or any close friends.  She wasn't the kind of kid to want to go to the prom, football games or any social events.  She was on some medicine to help her concentrate, because we thought she was ADD.  Could we have been wrong?

Can autism look like ADD or ADHD and vice versa?  How do you weed it out?  How do you separate it?  Could Michael very well have both?  I'd like to know if anybody out there has figured this one out!