Almost two years ago during his last year at his home school it was mentioned in the communication book that Matthew had spent 20 minutes on the toilet. Since there was no mention of toileting in that current IEP at the time, I was not pleased and quite surprised at reading this note.
1. Is a sentence strip being used?
2. How often and what times is he being brought to the restroom?
3. When he has a bowel movement in diapers how is it determined to have him then sit on toilet for twenty minutes?
4. What verbal and visual cues are used while he is on the toilet?
5. What are the steps involved upon entering the bathroom?
6. How is he cleaned, with wipes or toilet paper?
7. Is a toilet seat cover being used? How does he react to sitting on this? Where are his hands while he is on toilet? Is this a sensory issue being on the seat?
8. How is baby powder applied when in bathroom, in an upright position or while on toilet?
9. How involved is Matthew in this process? Does he throw diaper in garbage? Does he pull diaper on and pants and then shoes while sitting on toilet? Is he sitting on toilet with just his socks on his feet? Is the dirty diaper in the stall with him or has it been disposed of before he sits on toilet? Is a new diaper on him while he is sitting on the toilet?
10. How does Matthew react to the flushing noise? Is he facing the toilet and does he stim on the water going down the toilet? What type of reaction is on his face? Does he get prompted to flush the toilet? Is this done via verbal or visual cue? Does he touch the toilet with his hands to flush? Is he in his sneakers at this point or in socks only?
11. How sanitary is the bathroom? Does he use hot and cold water to wash hands upon leaving and entering bathroom? What does he do once he returns to classroom, does he look at schedule to see what happens next?
12. When others enter bathroom how is that handled? Is the stall door closed with just Matthew behind the door? Does Matthew get bothered when other children enter the bathroom? How does he react when other flushing is going on?
13. Are other children from his class in the bathroom at the same time or do they all have different schedules? Is the same stall being used each visit for consistency or not part of the training?
14. Are the new foods and drinks being introduced on a daily basis being recorded in a log book? Are ingredients being noted and observations relating to allergic reactions? What is the time frame from trying new foods to using the bathroom?
15. When Matthew was on the toilet for 20 minutes what type of reinforcers were being used and what type of communication was made to him? Was his back being rubbed at the time, where were his hands? What was he doing with his feet, were they on the dirty floor with only socks? Does he have one of his sensory fidgets with him to hold in his hand?
16. The common side effects associated with Geodon that Matthew takes includes the following = itching, constipation, inability to remain in a sitting position, upset stomach, diarrhea, weakness and rapid heartbeat. Less common include rash, dry mouth, runny nose, coughing, abnormal vision and abnormal muscle tone, appetite loss, muscle aches and fungus infection of the skin.
17. It is also mentioned that grapefruit juice may interfere with the breakdown of Geodon. Please refrain from trying this liquid with Matthew since he takes his first dose before each morning.
I should also note that at the time Matthew was being taken into the girl's room with his aide. The restroom was two doors away from the classroom. I made spaces between the questions for answering directly on the paper and printed out three copies. I gave one to the teacher, one for the Assistant Principal and I kept one.
I recommend teachers, aides and parents read the book Toilet Training for Individuals with Autism and Related Disorders
Another useful book to consider is Activity Schedules for Children with Autism: Teaching Independent Behavior
One other book in the Topics Of Autism series is A Picture's Worth: PECS and Other Visual Communication Strategies in Autism
What happens Before the Bell Rings. Consider Classroom Modifications for the Autistic Student Some students need a Behavior Support Plan
Preparing for A Field Trip