Rub-a-dub-dub, I’m afraid of the tub

It was the evening of November 13, 2006, only 5 days after SB’s devastating autism diagnosis.  I placed him in the bathtub for his bath, just like I did every night.  He had never complained about baths before.  In fact, he usually seemed to enjoy them, and liked to spend a little time splashing around in the tub after being washed.  On this night, however, he began screaming as soon as I sat him in the tub.  He immediately stood up, and screamed and cried as though in terror.  I checked the water temperature, which seemed fine.  What on earth was going on?  At 20 months old, he had no words to tell me what was wrong.  Even more frustrating, he had very little receptive language, which means that he really didn’t understand what other people were saying to him.  My attempts to soothe him were pointless.   “Don’t cry.  It’s ok.  It’s just a bath.  See?  It doesn’t hurt.  It’s just water.  There, there.  It’s ok.”  He just stood there, screaming as though in pain.  Finally, I used a washcloth to splash him off a little bit, and quickly took him out and dried him off.  I guess he didn’t really need a bath that badly, anyway. 

The same thing happened for the next 9 days.  Ok, I may have skipped the bath a few nights in there, not wanting to deal with the screaming and crying.  But after a while, I couldn’t keep skipping his bath over and over, because he was starting to get stinky.  I realized that I had to deal with this problem, because it wasn’t going away on its own.  My husband and I were baffled, and I was distraught.  I had just learned that my child had autism, and I was already overwhelmed by all of the things he needed to work on.  Now, all of the sudden, here was a new one to add to the list.  Where did he get this fear of baths?

The first thing I did was to ask the pediatrician what to do.  Her suggestion was to tell him 15-20 minutes in advance that he was going to take a bath soon, and then talk about what I was doing during every step of the bath in a calm, soothing voice.  I wrinkled my brow looked at her like she was nuts.  Did she forget that he was just diagnosed with autism?!?!?  “HE DOESN’T UNDERSTAND ANYTHING I SAY TO HIM!” I rudely replied.  “Oh,” was all she said after that.  You start to feel pretty hopeless when you realize that you have stumped your doctor.  If we had a problem like this now, the first person I would go to would be our ABA therapist.  But since this happened in the first 2 weeks after his diagnosis, we hadn’t started ABA yet.

So where did I go next on my quest for help with this problem?  Google, of course!  I learned from searching the internet is that this is actually a common problem among toddlers in general, not just children with autism.  This was comforting for me to read.  In fact, for the last 5 years I have wrestled with this question every time I see an unwanted behavior in either of my children, which is almost daily: Is that an autism behavior, or just a normal child thing?  Most of the time, it’s impossible to know for sure.  For some reason, learning that it was a normal child thing made me feel a little bit better.  There were a lot of articles on the internet about how to help your child get over a fear of baths.  And many of these articles also contained comments from parents who listed strategies that they had used successfully.  But since most of these parents did not have children with autism, many of the suggestions seemed somewhat irrelevant and useless to me. 

The first piece of advice that I read on several different websites was to never drain the tub while your child is in it, because some kids develop a fear that they will get sucked down the drain.  I had never drained the tub while SB was still in it, and so I was pretty sure that this was not the issue.  There were also lots of stories of children who had pooped in the tub, and then became scared to get into the bath after that.  Again, I knew that this was not the issue I was dealing with.  Another suggestion was to get into the bath with your child.  I tried this, but it didn’t help at all.  It actually made him even more upset.  I’m not sure why, but I’m guessing that since I had never done it before, it was confusing to him.  I also read that it might help to buy him a new bath toy to get excited about, but if you have read my post “I’m not an ABA Therapist…but I play one on TV,” you will remember that SB didn’t really play with toys yet.  He had no toys that he liked or connected with, so I knew that this suggestion was also no help. 

Then I finally read a piece of advice that I thought might be relevant: bubbles.  SB loved to watch us blow bubbles.  Here was something I could work with!

So on the first night of “Operation Calm Bath,” Charlie and I got to work setting up our bathroom in advance.  We filled the tub with warm water and lots of bubble bath.  To double the bubble fun, I also brought a bottle of bubbles for me to blow.  I put a CD player in the bathroom to play his favorite CD at the time, which was the Fisher Price Little People “Sing-a-Long Favorites.”  We turned the lights down to add to the calming ambience.  Then we went to get our little boy.

Charlie put SB in the tub, and let him stand instead of sit.  Of course, he screamed bloody murder, like always.  But then I started blowing bubbles, and he got distracted.  I blew bubbles, I sang, I reached in and splashed around in the bubble bath.  His crying was intermittent while Charlie washed him off with the washcloth as quickly as possible.  I would say he cried for about 60-75% of the bath, which, sadly, was a huge improvement over the 100% of the previous 9 days.  We called it a success.

We did the same thing the next night.  And it got a little bit better.  He cried for less than half of the time he was in the bath that night.  And the most important milestone on this second night was that in the moment Charlie finished washing him off, he wasn’t crying.  So we were able to take him out of the tub happy, and praise him for doing a good job.  Each night he seemed to get a little more comfortable, and cry a little bit less.  On the fifth day, we were actually able to coax him to sit down in the tub without a lot of crying.  After 2 weeks of “Operation Calm Bath,” he finally seemed to forget his fear and enjoy bathtime again.

The only thing that my husband and I could come up with as a possible reason for the sudden fear of baths was that SB had a bit of a diaper rash on that first night he got upset in the tub.  It’s possible that when he sat down in the water, it stung a little bit.  And since he was not very rational at the time, (actually, he’s STILL not very rational, and there may be a post about that someday soon!) maybe he was afraid that sitting in the water would hurt again every night, even after the rash cleared up, because he didn’t connect that the rash was the reason for the pain.  He just knew that one time, the bath caused him pain, so he was afraid to get in it again.  We’ll never know for sure, because he didn’t have the language to tell us at the time, and he doesn’t remember the incident now.

In retrospect, I think that the most important lesson I learned here is to NOT PANIC when a new behavioral issue arises.  When SB started having these bath terrors, he was newly diagnosed with autism, I was pregnant, and life just seemed so damn overwhelming that I didn’t think I could handle one more thing.  So when this one more thing did occur, I felt so depressed and full of despair.  I thought things like, “How will we ever get past this?  Will he always act like this when I try to bathe him?  How are we going to find the time to work on ALL of his issues?”  Looking back on all that we’ve learned in the past 5 years, I now know that when a new behavior occurs that needs to be addressed, it’s important not to panic.  I’ve learned to:  1. Take a deep breath.  2. Consult my ABA therapist, doctor, the internet, other parents, etc. until I find a strategy (or several) to try.  Be patient, and keep trying.  Something will work.  3. Remind myself that it will NOT always be like this.  Some behaviors can be fixed or controlled in a few weeks, like this one.  Others may take years, like SB’s weird rocking habit in bed.  (That is another interesting post for the future.)  No, I don’t have time to work on ALL of his issues.  Not at once.  But I CAN work on one thing at a time.