24 Jul Getting started on toilet training with an autistic child

You are bound to run into some challenge when you first start potty training your autistic child.  Parents and teachers will find that delays in communication, delays in learning through imitation, need to sameness and anxieties, fears, sensory profiles, and phobias all come into play during the toilet training period.

When you want to start the process of toilet training make sure you have a few basics in place, which include:

• The child must be dry for at least 2 hours at a time indicating bladder control.
• The child does not have any constipation or diarrhea problems at the time of starting potty training.
• The child is not sick or on a new medication of any sort.
• The child has been sleeping well and is not moody or emotional in any way.
• That potty-training does not coincide with any other change for example a new school, new home, or new routine.
• That everybody working with the child during the potty-training phase is on the same page and ready to dedicate at the least 3 days focused entirely on establishing a new routine for the child. During the initial toilet training time families are encouraged to stay at home and limit outings or routine changes

Once you know that you will be starting potty training with your child you can start preparing for the process.  How to prepare for potty training an autistic child?

• Prepare the bathroom: know if you are going to potty train or toilet train.  If a child struggles with change, we recommend that you skip the potty stage and move straight to putting your child on the toilet.
  • If you go the potty route you will prepare by having a suitable potty ready for use.
  • If you go the toilet route, then you will prepare by buying a training seat and foot stool so your child’s feet can touch the floor when they are sitting on the toilet
• Purchase enough underwear (underpants of panties) for the process and prepare for accidents.
• Preparing for the accidents is a vital step – make sure you have cleaning materials ready and that the process of cleaning will not be distressing for the child. If you make a big deal of this then the child may react negatively to the process.  You want anxiety to be minimal during this stage.
• Ensure you have wet wipes available in the bathroom and that you are not flustered during the training process. If you have all the tools ready, then you don’t need to run around and leave your child sitting on the loo waiting for you.
• Prepare visual toilet schedules for your child. This can help with establishing a toilet routine.

Here is an example of what a PECS card looks like.  You can download these of the internet should you want a copy, or you can purchase the Board maker software and design your own visual support cards for your house.  Many autism schools, autism therapy centers and autism specialists already have the software, and they will be happy to help you with a copy for home use.

• Furthermore, you will need to teach your child a way of letting you know they need to go to the toilet. For verbal children you can implement phases such as “bathroom or toilet” and for the non-verbal child a PECS visual cards, an AAC button or Makaton sign will need to be implemented.
• Prepare to wait – but do not wait for too long because asking an autistic child to remain seated for long periods of time will cause problems. 5 minutes is more than enough.
• Consider clutter and sensory input when your child is new to the world of toilet or potty training. Some families have implemented calming music and dimmed lights which has worked for them, but we have found that this is not necessary.  What we do know is that the calmer mom or dad are during the process the easier the child transitions into the space.
• Be prepared to train little boys twice. The first step is going to be sitting on the toilet.  Only once this skill is mastered would be recommend you start teaching standing positions.  Children with autism often find bowel movement on the toilet very challenging so we suggest starting with this position.

When all this is done, and you are ready remember “POSITIVE REINFORCEMENT” rewards.  These items must be easy to give, not available to the child at any other time other than toilet time and a successful bathroom session must always be rewarded with enthusiastic praise.