She Told Me, I Listened

She pulled down her pants this afternoon, in the middle of the living room.

I took her to the bathroom, where she promptly peed on the pot.

She told me.  I listened.

So small.  And yet, I can't help but think that the earth moved on its axis just a little bit!

Priceless.

The Potty Journey: Guide to Toilet Training Children with Special Needs, Including Autism and Related Disorders, by Judith A. Coucouvanis:
$14.90 at barnesandnoble.com

Bag of Twizzler Bites, for incentives: $1.99

Seven pees out of nine toilet sits at home today (plus another at clinic):

PRICELESS.

Bladder of Iron, Will of Steel

Joy and I started the day with one hour and eight minutes in the bathroom.

One hour and eight minutes, before she finally gave in and let the first morning pee loose on the toilet.

She woke up dry, so she had to be holding something.  In fact, she woke up with dry jammie-pants but without a diaper!  (I thought I might have somehow forgotten to put one on her last night, but turns out she'd taken it off in the bed-tent.  Definitely dry, though.)

As we camped out in the bathroom, she drank three glasses of water, sat and sat, played game after game on her iPad. Occasionally she'd get up and jump around a little bit.  On one of those jump-arounds, at about the 45 minute mark, she peed just a little on the floor.  I quick swooped her onto the pot, and mopped up the little puddle, and expected the rest of the release any second.

That little bit of release was enough to enable her to hold the rest for another 23 minutes.

She gets a much-desired candy reward when the pee goes in the toilet.  I can't have the candy in-view-but-out-of-reach, though.  Tried that, it only makes her mad, and puts Mama at risk of getting swatted in the face.  Which never feels good, and is even dicier when Mama is balancing on the edge of the tub.  There aren't a lot of seats in the bathroom, and Joy gets the prime one...

Other than avoiding the candy fight, it was a relatively peaceable hour-plus as far as Joy's response was concerned.  Mama, though, gets antsy with all that cooped-up time.  After all, I don't get to play with an iPad while I perch on the bathtub edge.  And perch, and perch.

I've decided that I can only try these marathon wait-outs at times when I don't have any deadline at all on the other side.  Otherwise it comes across as "caving" when I call a halt, and I can't have Joy holding out with the expectation that I "cave."   (Pigeons pecking forever at the lever that once provided food, etc.)  So I can't do this on my work-mornings.

We're trying all the tricks.  Running water.  Dipping hands in water -- though she finds it puzzling that I'd let her dip in a basin but not the toilet.  Playing with the Pocket Pond app on the iPad to make splashy-water noises. Squirting water at her privates while on the pot -- apparently some kids respond to warm water, others to cool water.  Joy doesn't respond to either in the desired fashion.

It's quite clear that we've got contest-of-wills on pee-holding here. I'm also pretty sure that she's deliberately using the diapers instead holding in between toilet visits.  Before we started this training push, we used to find dry diapers during the day at least occasionally.  Now, not so much.

At the clinic they've got a higher tolerance for dribble, so they're working with her in underpants and just dealing with the soaked shorts.  At home, we really aren't ready to deal with pee-stink all over everything.  Hence the long bathroom sessions.

I was really hoping that after a couple of successes, Joy would "get it."  She'd understand what we were asking, realize how it felt, start working for the candy.

Alas, this has not yet come to pass.

Think good thoughts for us in our bathroom vigils!  The summer is waning, and I would purely love to be able to send Joy off to second grade with toilet training well underway.

---

Evening update -- All day we had the baseline 3-minute sits, the minimum that I'm requiring on our schedule. Then at a 7pm sitting, she'd filled her diaper both wet & mess, I was just having her go through the sitting motions after getting cleaned up, and lo & behold she PEED after just 1 minute!!! Maybe there's hope after all...

There Was A Little Girl

The other night, JoyDad and I got to spend some quality time with Joy. Rose was off with friends for the whole evening, and Joy was delightfully happy, and playful, and interactive. At one point JoyDad sighed and turned to me and said, "When she's being sweet, she's just so sweet!"

Which was funny, because I'd already been plotting a post around a rhyme I'd remembered from my childhood:

There was a little girl,
Who had a little curl,
Right in the middle of her forehead.
When she was good,
She was very good indeed,
But when she was bad she was horrid.
-- Henry Wadsworth Longfellow

Masterful use of slant-rhyme (forehead/horrid) -- I guess it makes sense that it comes from a master, though I hadn't known it was Longfellow's work until I went looking it up for this post!

Not that the concept of being good doesn't set my teeth on edge. Sweet behavior and core "goodness" are very different things, and we conflate them at our peril. It's even worse to assign good and horrid intention to a child whose behavior is surely coming from causes we don't fully understand...

I gotta say, though, Longfellow's little ditty captures something of the contrasts we've been living with Joy lately.

When we're having our good moments, she lets us record her singing, and then sings along again and again as we play it back! She smiles, she giggles, she initiates interactions, she's truly a joy to be with.

The bad moments lately, as I mentioned in my transition post, are rather scary things to have happening as we head toward kindergarten: head-banging, and hitting and hair-pulling.

Take Saturday, for example. Saturday afternoon Joy got up happy from her rest, and we went to a gallery opening. (Elites that we are.) Actually, it was a home-grown art show, engineered by an enterprising mama who'd been doing a home-based art camp for her daughters and then displayed the results on the walls of their home and made an event of it. The girls are in the same grades as Rose & Joy; the older one is on Rose's soccer team, and the younger will be in Joy's kindergarten class. So far, Joy is the only classmate that younger-daughter knows, and the family has been capitalizing on the fact that there'll be at least one familiar face!

Joy was willing to let me lead her around as her classmate-to-be proudly showed off work. Then we found some Joy-appropriate toys in the play room where she happily settled, despite rather a crunch of other kids romping and making noise. She loved the snacks: crackers! blueberries! grape tomatoes! We ended up staying for almost two hours, with nary an outburst or protest in sight. (OK, she did make one break out of the yard to try & play with a sprinkler on the other side of the cul-de-sac. But other than that.)

This was a different girl entirely from the one her morning autism-therapist encountered. Joy gave him one of the roughest sessions she's ever thrown at him -- he's usually a favorite for her. He could hardly make the slightest request of her without getting an over-the-top frustration reaction. Several of these involved Joy getting down on her hands and knees and trying to pile-driver her head into the floor.

The head-banging. Oh my, the head-banging.

We have a whole bag of calming tricks, which we shared at a meeting with her school team yesterday. These include:

• singing
  
• soft calm talking
  
• slip a pillow or thick quilt under her head
  
• change of activity / distraction
  
• silly/fun people games
  
• glider rocker
  
• Baby Einstein MP3s/CD
  
• change of venue
  
• sit in highchair
  
• chewies
  
• pillow squishes
  
• bouncing on therapy ball
  
• back off / alone time
  
• pressure to the head / body-sock on the head

We've been trying very hard to take a thoughtful approach to this, trying not to panic, working to figure out the behavior and keep things from escalating, praying that the switches will slide sooner rather than later. From a behavioral perspective, the headbanging does seem to be a frustration reaction, even though sometimes it doesn't take much to set it off. ("Okay, Joy, let's go potty now"... BANG.) We also suspect there's a big sensory component. Some pressure -- quite a bit of head pressure -- feels good. We'd like to get her to choose other forms of expressing frustration, such as pressing her own hands to her head, or stomping her feet.

Of course the question of a helmet has come up in our thoughts. How could it not? There's almost an easy-fix feel to the idea of wearing a helmet... at least keep the wearer physically safe, then we can figure out what to do about the behavior itself!

Alas, this is one of those truly not-simple things. My thinking on the helmet-question has been profoundly influenced by Kristina Chew, who has written a lot about her son Charlie and self-injurious behaviors. Their experience with head-banging in the past couple of years has taken them through full-time helmet wearing at one school, to a much better experience and very-occasional helmet wearing at his current school.

I'm going to quote a particularly relevant paragraph here, from a post of hers that's well worth reading in its entirety:

One thing I have learned from all this is that often the most obvious solutions just treat the problem people see, without addressing the deeper causes. Thus did the school district (and their lawyers) insist that Charlie wear a helmet. But that blue plastic apparatus has been the equivalent of a putting a band-aid on something serious that requires much more examination. The "protection" offered by the helmet was limited at best. As Jim and I predicted, Charlie banged his head harder while wearing the helmet (which makes for really big holes in the walls). He probably started banging more while wearing the helmet (in part due to the discomfort of the thing?)

Joy hates having things on her head. Won't wear hats, won't wear headphones, no earmuffs, no sunglasses. We're lucky that she is willing to accept a hood on her parka, because winters can be brutal around here.

Imagine the frustration level that could be caused/escalated by forcing Joy to wear an apparatus on her head -- when she's frustrated!

No easy answers. Fortunately the good times far outweigh the horrid, even if we spend a disproportionate time agonizing about the rough stuff.

Onward to kindergarten. Our little girl has her first day tomorrow, at a public school with a fine reputation. We like what we know of her team so far. Ready or not, here she comes. Keep thinking those good thoughts for us!

Transition

I've got a whole list of posts swirling in my head to write -- I guess I ought to at least get something written, and maybe the rest will fall into line in the coming days.

It's interesting -- in the world of developmental disabilities and special education, the word transition has come to have a specific meaning: it's the big Transition from school out into the adult world. There are transition-planning manuals, and transition-planning conferences, and transition-planning laws (in Wisconsin, for example, transition planning has to start in the IEP team at age 14, and at that age the student must be invited to participate as a member of the IEP team.)

Heh.

We've got a huge transition going here, folks, but it's into school instead of out of it.

Transition-into-kindergarten planning for Joy started a couple of years back, when we made the decision to wait an extra year, so that with her early-summer birthday she'd be one of the oldest kids in the class instead of one of the youngest. Back in February, I described the steps we took to get Joy some formal kindergarten practice, spending several hours of each Tuesday afternoon at the school with her early-education therapists.

In April, we had a big summit at the elementary school to put together Joy's IEP, the Individualized Education Program that spells out goals for the upcoming school year, and what services she'll receive that will help her work toward those goals. Looking back now, I guess I never did blog about that meeting. It was a huge meeting -- Joy is going to have a LOT of staff working with her. She's going to have one-on-one attention all the time, safety reasons being paramount but also because that's what it's going to take to work with her in a classroom -- and the school district seems to have quite the commitment to working with kids in the regular classrooms, as much as ever possible.

So far, things seem to be falling into place pretty neatly. Joy was assigned to the teacher whose classroom she got to know in the spring, a fellow with a gentle demeanor who has been assigned clusters of kids with IEPs for the past couple of years. One of her (typically-developing) classmates will be from a family we're in good contact and on good terms with, so that's a fine development. Her special-education lead teacher has had the chance to visit her at daycare for a couple of hours, and will be visiting at home the day before school starts to get acquainted. Joy has had a couple of visits to school, seems comfortable in the classroom (at least when there aren't any other kids there, heh), got to meet the new principal, and got to try potty-routine in the hall-bathroom.

We've got another summit with school staff coming up Monday, not an IEP meeting but a chance to share a home-grown document full of details about the amazing progress Joy has made over the summer, and tips for lunch, and a list of the songs she knows and can fill in words for.

And a list of the new challenges. There are some big ones, and it's more than a little scary.

The top two are: head-banging, and hitting/hair-pulling/pinching of peers and adults.

Just what you want your kid to develop in the months before kindergarten, no?

I think I'll just leave that there. These are switches that we desperately want to flip the other way, as soon as possible. A new environment and routine might do just that -- or it might escalate these behaviors to whole new heights.

Meanwhile, this is all quite a major transition for me. I wrapped up my summer-job yesterday, so I will truly be going back down to half-time again, as opposed to the 75% time that I've been squeezing in for close to a year. All those work hours will now take place during school hours, so I can do drop-offs and pick-ups for both girls at school, and eliminate the need for after-school paid care. A very different routine for me.

Think good thoughts for us. This transition may not be THE big one, but it's pretty much the biggest one so far.

Random Tuesday Thoughts

On toilet-training:
You can lead a girl to potty, but you cannot make her tinkle. (sigh)

On gardening:
Beans, beans, good for your heart! We got green beans. We got dragon tongue beans. I need to process some beans tonight for freezing.

On growth:
Joy can now reach the mantel in the living room. We used to put things up there to be out of her reach. Must create new strategies.

More on growth:
Rose started soccer practice last night for the upcoming season. When we tried on her cleats (which she was able to wear through the end of the season in May), it was like the stepsisters trying on the glass slipper. We went up two and a half sizes to get her comfy with room to grow for the fall.

Still more on growth:
When it rains a lot (and it has), the weeds in the garden go crazy! But at least it's easier to pull weeds from damp soil than from hard-baked soil.

On peek-a-boo:
Joy has created a delightful new twist on an old game. When you put a blanket up to your face for peek, she doesn't yank it down -- she lifts the other side and burrows under to join you. And then says "peek"!

On switch-flipping:
Guess what has faded back into Joy's communication repertoire. Self-biting (and to some extent, chomping others). She's doing some swatting & hair-grabbing too, and not excluding her daycare buddies. Just in time for kindergarten. Would like this to fade back the other way very quickly.

On school administration:
A new principal has been hired for Joy & Rose's elementary school. Must get him introduced to Joy. I hope he's easy to work with. Joy needs allies, especially if we're in a mode where she tips easily into intense protest...

On summer:
How did it get half over already?!

Joy's All-Natural, Super-Power, No-Fail Laxative

OK, since we've been talking toilet-training...

I don't think I've blogged about it, but one issue that we've had on and off with Joy has been a problem with constipation. You wouldn't expect it with her, because she eats a lot of fruits and vegetables, but there it was. We had her on a low dose of Miralax for something like a year, which helped. And then at some point earlier this year, the situation had gone TOO far in the opposite direction, and Joy was objecting strenuously to the ensuing messy clean-ups, and so we stopped the Miralax.

Things have gradually crept toward constipation again, skipping days and such, if you know what I mean.

But since spring brought warmer weather, we have discovered the absolute fool-proof, totally natural, works-every-time way to induce the desired effect.

Go out and play in the water.

I'm serious. Every single time Joy goes out to splash in puddles in the street, or cavort in the inflatable pool, or run through the sprinkler, or even (as this morning) dance in the rain on the deck -- shstuff happens.

With the backyard play, I've gotten so that I just take the diaper bag out with me and change her right there in the (nice private fenced) yard. Because of course the water play is so much fun, Joy totally hates to have it interrupted to go inside and change.

It's almost too bad that this super constipation-problem-solver is so extremely natural. Something that works this well could make millions if it were an ingestible substance or a purchase-able device...

As it is, we'll just continue to use it strategically and count our blessings.

An Idea Whose Time Has Come

A quote from one of Joy's daycare reports:

Potty: Sat on the potty after AM snack. Diaper was damp, so didn't think she would be able to go. But she sat. After a few minutes I asked her if she was all done. She looked away from me and within 30 seconds she was peeing. When she was done, she reached for the TP. Cool!

This quote was from April 2007. Joy was not yet three years old.

At age 6, she's still in diapers around the clock.

When it comes to toileting, the sliders and switches on Joy's mixer board (my favorite metaphor for her developmental pattern) have turned on, and then turned off again. As her words have repeatedly come and gone, so has her willingness to make beginning steps toward potty training.

It's been very hard to decide about making an all-out effort to get the toileting truly underway. I'd really been dreading any approach that involved panties and letting the accidents happen. I'd been rocked on my heels by the experience of datri over at Opposite Kids, whose Kayla was unswayed by an all-out four-day diaper-free marathon over the winter holidays.

One complicating factor for us is that most of the advice about toileting readiness for neurotypical kids has not been consistent with Joy's trajectory. Consider this list at BabyCenter.com:

• Can sit down quietly in one position for two to five minutes. [In our dreams!]
  
• Can pull his pants up and down. [With support - this one we've got]
  
• Dislikes the feeling of wearing a wet or dirty diaper. [Our sensory-seeker doesn't mind at all, might even like it]
  
• Shows interest in others' bathroom habits [Nope.]
  
• Gives a physical or verbal sign when he's having a bowel movement such as grunting, squatting, or telling you. [Oh, come on... you can tell when infants poop!]
  
• Demonstrates a desire for independence. [Hmmm... a little, maybe]
  
• Takes pride in his accomplishments. [Yes, but maybe not how they think]
  
• Isn't resistant to learning to use the toilet. [Totally off-and-on]
  
• Is in a generally cooperative stage, not a negative or contrary one. [Again, off and on. Those switches flip very fast.]
  
• Can follow simple instructions, such as "go get the toy." [Can, yes. Does? Maybe.]
  
• Understands the value of putting things where they belong. [In a few limited situations]
  
• Has words for urine and stool. [Not even.]
  
• Understands the physical signals that mean he has to go and can tell you before it happens or even hold it until he has time to get to the potty. [Only the one "kee" incident.]
  

The bits about being resistant/cooperative have been a big part of what's standing in the way about making a commitment to do anything more than sit potty in the evening before bath. For quite a while Joy was willing to sit on the pot and happily flip through a board-book or two. But then a few months ago she started physically resisting as soon as I would ask her to potty-sit -- and this kid can put up some powerful resistance, let me tell you!

Fortunately, Joy's intensive-therapy folks, Agency 2 (serving up their own House Blend of therapy combining behavioral and relationship principles), have a nicely flexible approach to toilet training.

What has come together in the past weeks has been a combination of readiness on the part of both Joy and her parents, and the willingness of Agency 2 and Joy's awesome-daycare-lady Lynda.

• Joy is often dry overnight.
  
• She's willing to drink a lot of water when we push it.
  
• She understands "first/then" and is willing to work for a relatively immediate promised reinforcer.
  
• Kindergarten is coming up and we want her to have this learning underway.
  
• Agency Two's training guidelines have the flexibility and willingness to "schedule train" without making the frustrating commitment to do a diaper-free boot camp approach.
  
• Lynda is happy to combine our goals for Joy with her daycare's standard potty-schedule routine

Following the Agency 2 recommendations (which are proprietary so I can't post the helpful document online, sorry!), we first did some thinking about desirable rewards that could be reserved for potty encounters, in a hierarchy of desirability. Then we spent several days after we got home from the lake trying to record the state of Joy's diaper every half hour. One important switch here was moving from having Joy in a onesie round the clock to wearing just T-shirts and elastic-waist pants. Onesies are delightful for preventing diaper-digging, but not so fine for moving toward toileting independence. The schedule-recording didn't actually reveal a lot in the way of pattern, but it did get us into a toileting schedule mindset, and pre-shadow for Joy that there was going to be more attention to diaper-related activities soon to come.

Then we sat down with our senior Agency 2 therapist and talked about initial goals, to get us and therapists and Lynda all on the same page. We decided on a schedule of a potty-run every 1.5 to 2 hours, in which Joy would help pull her pants down, clamber up on a footstool to sit on the toilet (with insert), sit for a nice slow count of ten, and then get a reward! Then she has to cooperate with re-diapering (generally standing up, at home anyway), pull up her pants, and work through a hand-washing routine.

We started on Saturday. So far, we have succeeded in getting through all the steps, including the ten-second-sit, every single time. As a side benefit, Joy is learning to count to ten, and is especially eager to fill in the "teh" when we get as far as nine. Sometimes she's in a mood to sit quite a while longer, though, if she's excited to play with her ribbon-reward or mylar-balloon-play reward.

And yesterday morning she woke up dry, was willing to play an interactive people game for a while after the count of ten -- and did a most excellent potty-pee.

I don't imagine this will be either quick or easy, and surely we'll be dealing with sliding switches for years to come. But finally it does feel like we're on our way.

Unexpected, Times Four

More so than usual, we're having to expect the unexpected around here.

Last night we had FOUR verbal "unexpecteds" from Joy, just between supper and bed.

First was during the meal, when I was coaxing her to eat some sweet red pepper. "Peh-puh!" she imitated me, unasked. And then gave a great big grin, apparently loving the way the word felt, exploding through her lips. Lots of "peh-puh"s and giggles for the rest of the meal, and ate the whole helping!

Then a little ways into her evening therapy session, she led her barista-dude over to the gate by the basement stairs and signed "open". "Oh, do you want to go downstairs?" he asked. I don't know as how I can properly represent the version of "downstairs" that she echoed, but it was definitely an unsolicited imitation.

Then after the session was over and she & I were hanging out on the living room couch, she reached for the buttons on the fleece cardigan that I wear around the house. She's fascinated with those buttons, but had never named them for me. I said nothing, she said "buh-buh"!

And last but not least, we had a spectacular unexpected while getting ready for the bath. Joy has been on an anti-potty kick lately, preferring to throw herself to the ground or anything else but sitting on the seat -- and here we'd been planning a big potty-training push over the summer. So I did a little experiment. Brought in a candy treat, and when she threw herself to the floor I caught her eyes and told her, "First potty, then candy." And she let herself be led to the toilet to sit. Then I told her, "We'll count to ten!" And I counted out slowly, "One, two, three..." and when I hit "nine," she finished up for me with a great big "TEH!"

This is even more amazing in that we almost NEVER count all the way to ten with her. Most often we'll go to three, in a one-two-three-GO context.

What else does Joy know, that I don't know she knows? (Or should I say, what Elvis does she know?)

Some Things To Say

On Monday I mentioned that we've been hearing many vocalizations from Joy. I thought you might like to hear about some of the things she's had to say lately.

JoyDad told me about an interaction at snacktime earlier this week. Joy was drinking juice (from an open cup, yeah!) using both hands to lift the cup. JoyDad was doling out the pretzel sticks a few at a time. At one point he offered sticks while she had the cup in the air with both hands. "Joy, do you want more?" He said you could just see the wheels turning as she thought about making the "more" sign but realized both hands were already occupied. And then she looked right at him and spoke.

Mo!

Another lovely vocalization that has come and gone over the years has been "ma-ma". Last time I posted about it was about a year ago. Well, it's back, and it's the two-syllable word, not even the babbly "ma-ma-ma" that was coming out last time. At least for today, even if it's just for today, we're getting "ma-ma"!

By the way, that "just for today" post I just linked to? It focused on the signing of the word "more" -- which was an occasional, some-time thing back in February 09. These days, it's the most solid sign in her repertoire, over-generalized to mean "I want" as well as "more." How very far she has come!

Then there was the imitation last night, when our church fellowship group met for a cookout. Joy was exploring and rolling around in the lovely large yard, I was talking to a couple of other moms, and Rose was playing with a group of older kids halfway across the yard. Suddenly from one of the older boys in the faraway group comes an audible, "Aw, CRAP!" And what do we hear from Joy? A sweet little echo, "caa"! That was the one and only thing she chose to imitate from the other kids all evening.

And finally last night, late home from the cookout and getting ready for bed. Joy sat on the toilet a little bit, without success, and then after bath we went to her room to get her into diapers and jammies. As I was assembling the materials, she loudly announced,

Kee!

What in the world was "kee," I wondered, looking around. It was a new sound, an unfamiliar vocalization. I couldn't find anything to attach it to.

And then she "kee"-ed all over the carpet. Must have been holding it in for a while, it was a major stream.

Oh, yes. This girl's got things to tell us.

Leaked!

You heard it here first! :-)

I haven't talked about potty issues much lately because there's been nothing to report. (Unlike various fellow-bloggers who seem to be on a gas-passing roll lately...)

At age five-and-a-half, Joy's still in MA-funded diapers, and though she's had several little strings of potty-pee successes over the past few years, basically there's been little movement on the whole toilet-training issue here (heh, heh -- "movement"!) For what seems like forever, I've been sitting Joy on the toilet, with a seat-insert so she can balance more easily, before evening bath. She's been fairly willing to sit on the pot and play with a board book together for a couple of minutes, but rarely produces.

Something interesting has been happening lately, though. In the past week or so, she's been waking up dry in the morning, more often than not. We've also been seeing some incredible diaper-leaks during the day, veritable waterfalls.

I think she's learning to "hold it." I think she probably also likes the sensation of "holding it," little sensory-seeker that she is.

Tuesday morning she woke dry, I tried a toilet attempt but she let loose between diaper-removal and actually getting onto the pot. Wednesday morning she woke dry, we tried the potty thing, she sat for a while without producing and we put the diaper back on (still hadn't peed by the time we got to daycare). This morning she woke dry, sat on the pot for a while, and then let the waterfall commence appropriately!! Woohoo!!!

So now what?

I've been rather avoiding the whole toilet-training issue, seeing as how life has been plenty full on its own. The Google results on autism & toilet training are pretty depressing, all sorts of stuff about spending hours and hours in the bathroom (like Joy would be willing, let alone me having that time to spend in the first place), or ABA incrementalism regarding "first you get your child to be willing to go through the bathroom door, then s/he needs to be able to remain in the bathroom for five seconds..." etc., which is obviously not where we are.

There have been several obstacles to toilet training as far as Joy is concerned. First is that she's not much of an imitator, so having a potty-competent big sister isn't all that helpful. Second is that she doesn't seem particularly aware of having a full diaper, either wet or messy (probably likes the sensation, if anything.) A big third thing is her communication delays.

Is there any chance that if we view this pee-holding as a new threshold of maturity, and push fluids and take her to toilet-sit fairly often to increase chance of success... that we'd actually end up with a potty-training trajectory? Or should we just add the morning potty-sit to the bathtime potty-sit rather than making a big push right now (heh, heh -- "push!")? Or do we need to plan for some fancy autism-specific training regimen?

Thoughts, dear been-there-done-that readers?