Toilet Training for Your Autistic Tots: What Methods are Best?

Potty Training Autistic Children
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If your child has been diagnosed with autism, chances are that you are having problems with their toilet etiquette and potty training as well. From refusing to enter the bathroom to smearing feces on the walls, wet beds and money spent on diapers, this is one issue that can frustrate parents and even siblings to no end. It is no fun having to clean up after a child who will defecate anywhere but where he or she should.

Autism in the household could mean more than just bathroom problems. Those issues can be coupled with explosive meltdowns that parents needs to figure out how to control, sleepless nights trying to get that little one into bed and getting a better night's sleep, months or years spent trying to get a single sound or word out of that child in order to communicate, and siblings who have no idea how to deal with the autistic brother or sister in their home.

Factors that might be causing problems according to Occupational Therapists include:

  • Fear of flushing
  • Fear of the hand dryer
  • Fear of the noise bowel movements make when hitting the water

Building on the tips offered by a fellow reporter in 2012, 2013 offered new research in the field and new methods by which to help potty train your child adamant about not going to the bathroom to do his business or simply not understanding what he should be doing and why.

What can you do to help you children go to the bathroom?

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According to a study of late, the combination of ensuring they are in their underwear, giving them a specific schedule about when to sit on the toilet and using differential reinforcement had massive improvements in the bathroom behavior for 5 out of 6 children looked at. Using the underwear tactic alone had improvements shown for 2 out of 4 children. The study doesn't use a large enough sample but presents a rather interesting combination that could come in handy.

The May issue of the Journal of Developmental and Physical Disabilities highlighted a rather interesting technique that one can use to potty train autistic children. It is through the use of a film sequencing the different points necessary to properly go to the bathroom. These include:

  1. Walking to the toilet
  2. Pulling down pants/undressing
  3. Sitting on the toilet
  4. Eliminating in the toilet
  5. Redressing
  6. Flushing
  7. Washing hands

The film can then be replayed multiple times over. The child can be watching you or another child follow this sequence. It will allow for the visual sensory, give them an idea about what to do and let them mimic the actions seen on the film shown.

Another study conducted in the Netherlands found that the use of response restriction toilet training protocol, where children are trained in a single natural environment and the time allowed on the toilet is lessened over a period, was quite beneficial. 5 participants had less than 2 accidents per day while going to the bathroom in the correct fashion up to 6 times daily. In two others, accidents were decreased and correct bathroom etiquette increased. Three of the participants maintained the positive results even up to 18 months after the initial training.

Bedwetting is a huge problem for autistic children, even up to adolescence. One study used a single case to try out a behavioral therapeutic method. Studies looking at proper potty training techniques are few and far between, making each single case study as valuable as a representative whole-population sample. For this particular therapy, the 12-year-old girl had a urine alarm put on as she slept and a dry piece of underwear in the morning rewarded with praise and preferred tangible gifts.

The Vanderbilt Kennedy Center offers some great pointers to help with toilet training your autistic child. These include:

  • Increasing liquid intake and high-fiber foods
  • Making the bathroom a positively peaceful place with soft music, colors the child enjoys, soft lighting, scents that won't trigger meltdowns, etc.
  • Making sure a footrest is placed in front of the toilet to ensure the child feels safe and stable
  • Ensuring your child wears clothing easily unzipped or taken off
  • Possibly keeping a set of toys the child can only play with while going to the bathroom
  • Having a reward ready if your child does it all correctly
  • Keeping visuals of what do do after each step on the wall for easy reference
  • Using a story format to help child understand the process of going to the bathroom
  • Giving child picture cards that they can use to communicate the need to go to the bathroom if they are not verbal yet

All in all, try to make the experience pleasant for all parties involved. Ensure that those around you who also care for your child now and then are in on the plan and follow the same routines you do. Most importantly, make sure that both you and your child with autism are just about ready to start learning how to go to the bathroom and potty train before you take on the project, as it requires much time and effort.

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Comments

I have a 15yr old autistic daughter she is semi verbal. It took years to get her 80% potty trained. Right now I have a problem with her. She does not wipe herself and me and behavioral services not the best. and the school has made an effort to teach her.. but she does not get it down. Is there any suggestions how to address this or a video to demonstrate to her with how to wipe front and back?
Have you tried pictures on the wall in front of her? and demonstrating for her on the side as she is in the bathroom? It would be up to you how you want to demonstrate, but I would suggest a hefty amount of modeling. Why do you think she has learned everything else but wiping? Most children hate wiping themselves until they have to. If she knows you will always wipe for her, that might be causing the problem.
My 8 years old boy, uses the toilet to urinate but not success with BM's. I would appreciate your kind help. God bless you. Ana
I couldn't refrain from commenting. Very well written!