Tips and Tricks for Potty Training Autistic Children
Potty training is never easy, whether it be an Autistic child or a neurotypical child. A lot of parents find themselves at a complete loss. When it comes to Autistic children it is a whole new ballgame.
I was lost when I was faced with it the first time with my oldest son. He didn’t potty train until he was almost 7 years old. He was nonverbal and on the severe end of the spectrum at the time. The thing that I learned and that you will learn if you do a little research online is that the primary difference between potty training an Autistic child and a neurotypical child is that in an Autistic child’s stress levels shoot up “two or three times above the norm during the process.” The next biggest difference is that age limits don’t apply like they do with neurotypical children. Where you would start a neurotypical child potty training at around 18 months to 2 years old, with an Autistic child it all depends on their cognitive/developmental level.
Is Your child Ready?
So, how do you know if your child is at the correct cognitive/developmental level to start potty training? Per Special Learning, Inc., the rule of thumb is that you will be able to tell by “observing if your child can already observe and somehow focus, imitate others and have somehow established a communication system with you.” If your child cannot do these things then they are not ready to be potty trained, regardless of their age. Also keep in mind that “children on the spectrum may have less sensitivity when it comes to cold, wet, or sticky sensations. They may also have muscle tone issues that make it harder for them to pull pants up or down.” Let’s say that your child is developmentally ready to potty train, where do you begin?
Starting Potty Training
You start with patience and perseverance first and foremost because you are going to need it!
Honestly though, it all comes back to routine and schedules… Per Generation Rescue, to successfully potty train your Autistic child you want to “start by establishing a consistent schedule to ‘habit train’ your child so that he or she is used to going to the toilet to eliminate.” As children with Autism are reliant on routine and schedule “habit training” them is simply getting them used to a new step in their schedule. It’s getting them ready for a change in their environment.
It is with careful and meticulous planning that you will teach your child to pee and poop in the right place. Since Autism renders your child’s communication and cognitive skills altered, it will take extra effort and patience to achieve a positive outcome. Generation Rescue also suggests that you take your child to the potty every 30 minutes (sometimes more frequently – for younger and lower-functioning children, you may need to start with every 15 minutes). This is what I did with my son once we started medication with him and I could tell he was finally developmentally ready to be potty trained.
When you first start the process don’t be completely focused on if your child successfully uses the bathroom or not, just have your child sit on the potty. When they do sit, get super excited and give lots of praise. It is suggested that for stubborn children, you may have to “slow the process down and break it into more incremental steps so there is less change to process all at once; for example, start by just going to the bathroom and sitting on the potty fully clothed, then move to sitting while still wearing a diaper, and only then move to sitting on the potty with pants and diaper off.”
Once you get your child used to being on the toilet gradually increase how long your child sits there. As visual aids are key, use a timer to help your child understand how long they need to sit. If need be, bring a favorite book, toy or other activity along. Giving them something to do increases the chances that they are going to sit there. Remember your goal at first is to simply get them used to sitting on the toilet with their pants down and in position to use the restroom. You want to make going to the potty a pleasant experience, not an anxiety–producing pressure–filled experience.
Another thing I did was made a visual aid with the toileting steps on it and hung it where he could see it. I used PECS cards I purchased to make my aid; but honestly you could just draw pictures or nowadays you can print out PECS cards online that will help.
Picture Steps to Include on your Visual Aid:
-sit on potty
Now the Real Work Begins
Now you are ready to start potty training. Continue your schedule of taking them every 15 to 30 mins and start explaining each time what they are supposed to do in the bathroom. You may even implement a reward system if they do go. It is suggested that you could check with your pediatrician to find out how much liquid your child can safely drink in a day. Then, push the fluids for a few days. If possible, mix juice with water, or alternate between milk, juice, and water. The more fluids your child drinks, the more likely he/she is to urinate often - and be successfully in urinating into the toilet.
Don’t feel frustrated if your child picks up on urinating on the toilet but will not poop. Many children will have relatively little problem with urination but seem reluctant to poop in the toilet. Many reasons can explain this, says Dr. Kimberly Kroeger, Psy.D., a clinical psychologist and assistant professor of pediatrics at the Cincinnati Children's Hospital Medical Center. She continues to say, "If there is a problem, we look at why. It may be constipation, or it may be that the child doesn't like the splash that occurs when a bowel movement hits the water. If that's the problem, we work slowly to desensitize."
Per VeryWell.com, Dr. Kroeger also “offers tips for managing toilet teaching when your child wants to poop only in a diaper. The key to success, she explains, is taking the process step by step.”
Her very useful steps are to:
“-First figure out when your child is going to poop and have him/her poop in the diaper - in the bathroom.
-Slowly, fade to having him/her poop into the diaper - on the toilet.
-Next, have him pull his/her pants down before sitting on the toilet.
-Last of all, have him/her sit on the toilet with diaper off.”
She explains that these steps may take a long time, and you may need to break them down further. The key to success, however, is making it possible for your child to succeed. She brings up one more important point that a lot of us face when potty training our children- the elusive smearing they love to do!
One minute they are sitting there clean as can be and the next they have smeared their poop everywhere. Or you put them to bed and wake up to it all over the walls… What can you do?
First, it is not unusual for children with Autism to smear their feces on themselves, on the walls, or on their clothes. Per Verywell.com, Dr. Kroeger has some specific advice for parents finding themselves in this unpleasant situation. "Children do what they do for one of only four reasons," she explains: to get attention, to get something they want, to escape from something unpleasant, or to have or avoid a particular sensory experience.
So, she asks you to ask yourself, “why are they smearing feces? What happens when they do it? Are they getting attention? Are they being allowed to escape a situation they don't like? Are they getting something they want?” She warns that if they're not getting any of these outcomes, they're probably enjoying the sensory input they're getting. Once you know why your child is smearing feces, you can fill their need in another way.
Hopefully by this point you have a good grasp on what you need to do to start potty training your Autistic child. I wish you all the luck in the world. It is one of the hardest ventures that some of you will ever take on.