Please recommend specialist for potty training 4.5 yo

[Anonymous]

DC has autism and has been withholding stools for 2 years despite laxatives, dietary changes, etc. Also he refuses to even pee in the toilet. Pees in diaper or pull-up and won't ask to be changed, but knows when wet I think b/c if I ask, will tell me. Hates having diaper changed and even more hates having to pass a stool. As soon as there is a sensation of having to go to the bathroom, he will run and hide in a corner of our dining room and gets upset if we follow and ask if he needs to go to the bathroom. So usually I just leave him alone so that he can actually pass the stool - which can take up to half an hour. After emerging from hiding, I say time to be changed and that "poop goes in the potty". Because he holds stool in and hates being wiped, it is a difficult process to clean him. It takes a lot of wipes to fully clean him. We empty the formed poop contents of the diaper into the potty if possible, and he flushes it down. He will even repeat that "poop goes in the potty". I don't see a solution to this problem. Pediatrician and GI just continue to suggest diet, laxatives and say that it is just behavioral, although he seems like he has some physical pain/sensitivity to his anal area as he is very sensitive to being wiped and of course super sensitive to passing a stool - instead of relaxing his anal sphincter, he automatically seems to tighten when stool is trying to pass. ABA has deferred trying to do a potty-training program with him as they want to focus on other things. OT could not address it. I just don't ever see him getting over this. His IQ is ~70 as per psychologist who diagnosed him with ASD and recently saw him again and developmentally is more like 2-2.5yo so maybe because he is delayed by at least 2 years just patience on my part? He will be in private pre K with an aid next year so I guess there's no real reason he has to be potty trained except I worry about all this stool withholding damaging his longterm bowel function...please help, especially anyone who has been through this. Is there a specialist who deals with this? I thought about a psychologist but because of his limited speech/understanding, I don't know how much he can actually work with a psychologist...and it would obviously have to be one that specializes in this area.

[Anonymous]

My kid with ASD did not potty train until age 6.

Are you happy with your ABA provider? Is your child making progress? For me that is the most important thing. I had an informal guideline, that I wouldn't really push potty training until we could have an actual conversation about it. So we needed to advance the language skills first.

Once we could do that, our ABA therapists came up with a plan.
Find out if your ABA therapists think your child is not ready yet, or if it is more an issue of they need more hours of therapy a week to add to this goal.

Hang in there.

[Anonymous]

OP, maybe he is anxious that he may fall inside the potty even with a seat on? Have you tried just sitting him in those baby portable potties and putting a liner on that and then maybe ask him to help empty the liner contents into the real potty and flush?

Summer is best time to potty train..If he agrees, get him off the diaper and there will be plenty of accidents but when they get used to the feeling of not having diaper and wet pants they will start trying to go in potty..Mine got potty trained only at 3 1/2 (first she did the pooping in the potty and only then did the peeing in potty - of course that differs with each kid). At almost 5, she's still in pullups at night..

[Anonymous]

PP here..yeah, so if my kid who may on the spectrum did it only at 3 1/2 and you say your child may be at the maturity of a 2.5 yr old, I would say give him time and focus on other things like speech..