From learning new routines, to knowing when it’s time to use the toilet, to being able to manipulate clothing, the potty training process can take many years for some children with autism to become experts. Keep in mind that children with autism are all very different and master skills at different times.
Some children have developmental delays and may not realize he/she has to go potty or maybe the child has communication challenges and is not able to tell someone when the bathroom is needed. And children with severe autism may not have the cognitive and motor skills to use a toilet—making the task more of a challenge. Patience is definitely key.
But parents and carers of ASD kids shouldn’t stress too much over potty challenges because, as they say, for every problem, there is always an answer. In this article, we offer possible solutions to help facilitate the training of children with autism to use the toilet.
Toilet Training Issues Confronted by Autistic Children and Ways to Help
To better understand the challenges of children with autism, here are some issues kids may encounter while toilet training, as well as some recommendations on ways to resolve them:
Child has an excessive interest in repeated flushing or fear of flushing the toilet
Encourage your child to play with swirling water under supervision in a different area in your house. Ensure your child knows when you are going to flush the toilet when he/she is inside the bathroom as the roar of the toilet can be terrifying to some. Slowly bring your child closer to the toilet by allowing him/her to stand nearby while you are flushing. You should also teach your child that you only flush once each time. When you think that he/she is already ready, you let him/her do the flushing while you watch.
Child does not want to sit and relax long enough in the potty chair or toilet
When you potty train or toilet train your child, ensure that the seat of the potty chair or the toilet is comfortable. You might want to first encourage the child to sit with his/her clothes on to create a familiarity. You can experiment on the various features of the toilet or the potty chair in order to find a comfortable fit for your kid. Try offering him/her a special reward for sitting and relieving himself/herself in the chair or toilet. You can use models like stuffed animals or dolls to practice sitting, or you can utilize a visual or auditory cue on how long your child will sit on the chair or toilet.
Child only wants to play in the water or with the toilet paper
To resolve this, teach your child to play only with water in a specific area in your house. You should also take the toilet paper off the roll and put it up only when your child is finished and teach him/her how to use it. You can also buy tissues that are pre-measured or folded, as well as a box of flushable wipes for your child to use.
Child does not want to be cleaned or is afraid of being dirtied
When your child tries to clean himself/herself and makes a mess, you should always stay calm and try to create a routine that is very comfortable. When he/she gets some feces on the hand and panics, you should help him/her immediately to show that it can be cleaned easily. You should also teach your child to wash hands clean with soap and water.
Child is afraid of bowel movements or has constipation
Help your child to recognize that the squatting and grunting that he/she may be doing is helpful in making a bowel movement. If you child hides in a corner when he/she relieves himself/herself, gradually teach that the bathroom is the right place to poop by placing a mat on the spot where you want the child to relieve himself/herself. You can also install a diaper-lined chair potty or toilet so that your child can recognize it as a place to relieve himself/herself. However, if your child suffers constipation on a regular basis, you may need to consult your doctor on how to appropriately resolve his/her situation.
A boy who has difficulty in standing while urinating
If your son is used to sitting while urinating, you can teach him how to urinate while standing by providing a visual chart on how boys use the bathroom. If he is afraid or does not want to touch his penis, you can ask a male family member to demonstrate how to aim it in the toilet bowl. You may also use some target objects such as a colored toilet paper or a paper boat to encourage him to urinate in the bowl.
Signs Indicating Your Child is Ready to Be Toilet-Trained
To increase the success of toilet-training your child with autism, you should be aware of the signs showing that he/she is already prepared for it. Among the possible signs are:
- Showing awareness that he/she is wet or soiled by pulling at or trying to take off a wet or soiled diaper, and/or trying to vocalize the displeasure of feeling wet or soiled.
- When he/she tries to take you to the bathroom or gets a clean diaper.
- When he/she stays dry and clean most nights.
- When he/she responds positively to some kind of positive reinforcement or reward.
- When he/she can imitate your actions like sitting in the toilet.
How to Prepare for a Successful Toilet-Training Process
To increase the prospect of a successful toilet-training process, you should make sure that your child doesn’t have any medical issues that could affect his/her condition during training. A visit to the family doctor for a physical exam may be a good idea. You should also contact your physician if you observe unusual signs such as painful urination, too much or too little urination, and the inability to hold urine.
Here are other tips for preparing to toilet-train your child:
- Experts say you should monitor and make a chart on the condition of your child every 20 to 30 minutes. You should observe whether the child is wet, dry, or dirty. You should continue monitoring his/her condition for at least once a day per week after you already started his/her training to keep track of progress.
- Based on the condition you monitored, plan a schedule for toileting. You should also prepare your bathroom and other areas in your house where the training will be conducted by removing the distractions and installing the necessary accessories and equipment.
- Schedule a toilet training routine that you should tell your child to follow. You could create a picture or visual chart, as well as verbal cues of the routine so that your child can fully understand it. As the child progresses, you can gradually eliminate the cues.
- Always give positive feedback on each accomplishment of your child. You may also use reinforcements, incentives, or rewards. Exercise extreme patience with your child and give him/her time to practice the scheduled routines.
Steps in the Potty or Toilet Training Process with Autism
Here are some steps you can follow in toilet training your child:
1. Use Social Stories
Use social stories or books with your child’s favorite characters to introduce him/her to the process of using the toilet or the potty chair. Many applications (app) featuring social stories and books are already available on the market such as the potty training apps from 1tucan: Super-Intelligent Kids. You should choose the app that works best with your child.
2. Read to Your Child
Read the stories to your child while you are in the bathroom together every day. You should tell the stories in a fun and engaging way through actual demonstrations. An explanation of each step is necessary so the child can fully visualize and comprehend the chronological order of the things needed when using the potty chair or the toilet.
3. Encourage Independence
Encourage the child to do the steps himself/herself when you think that he/she is already familiar with the process. Do not push your child too much by doing only the steps he/she is already very familiar or most comfortable with. This way, he/she will not become stressed and his/her interest in the story and activity will be maintained.
4. Use Positive Reinforcement
Introduce positive reinforcement and reward for his/her accomplishments to sustain interest. You should design the potty chair or toilet with your child’s favorite things as an added attraction or motivation for him/her to imitate your story. You can also give rewards for each successfully completed step as a way to increase interest and self-confidence. You should always exercise patience in training your child as this process could last for months or even years.
5. Teach Your Child How to Ask for Potty
Teach your child some terms to use when he/she wants or needs to use the toilet or potty. Among the possible terms you can use are “Potty now” and “Toilet now.” Using these terms will enable the child to start the process and reinforce his/her confidence in completing the act. This will also inform you about the need, allowing you to make the necessary move to assist him/her.
Additional Tips in Potty or Toilet Training a Child With ASD
Here are some additional tips for potty/toilet training a child with autism:
- Refrain from using childlike terms when training the child how to use the potty or toilet. You may teach the right terms while he/she is still young to make it easier later in life.
- Have your child drink water 10-15 minutes before the expected time he/she will go to the toilet to increase the chance of relieving himself/herself successfully. However, you should ensure that he/she only drinks the right amount of water as giving too much can create an unnatural routine.
- You may use wet wipes in the training of your child as toilet papers could create rashes in their sensitive skin. You can also teach your child that the wipes should be placed in the trash bin for disposal rather than flushed down the toilet. Flushable wipes are available as well.
- When you are travelling and your journey is expected to take hours, you should avoid giving too many drinks to your child. You can also put a protector on your child’s car seat to prevent it from being soiled by accident.
- You can also teach your child how to use the toilet when you go out to places such as malls and parks when he/she is already toilet-trained at home. You may use the same routine you do at home when training your child how to use the toilets in said places.
- You should use minimal alternative clean-up methods such as baby wipes and a tepid shower during the training period.
Training an autistic child to use the toilet or potty chair can be a very long and challenging process, but it can be done. You just have to be very patient, well-prepared, and very determined to do the job. You should also be proactive in finding new ways and tools, as well as some additional tips to help you in the process. Your success in this endeavor marks the first step toward your ultimate goal of training your child how to take care of himself alone and/or live on his own.
Keep in mind, toilet training can be a lengthy process and some children on the spectrum may be slower to reach this milestone than others. In the meantime, if it’s necessary to wear diapers, pull-ups, or youth pants for an extended number of years, there are options available.