Image of a girl on a potty

NEWS

The Complete Autism Toileting Guide

June 22, 2022

By ABA Psychological Services

Toilet training for children is a process and it takes every person their own amount of time to learn with the help of an adult. Children who have been diagnosed with Autism Spectrum Disorder (ASD) will likely need additional support, and it’s not uncommon to need to cover toilet training again for an older child with autism or even an adult. Having an accident or needing help is common. It’s also common to have concerns about helping a person with autism use the restroom on their own, as many factors can easily cause conflicts, such as sensory overstimulation or an inability to effectively communicate when verbal skills are limited. While every situation is different, professional guidance can make it easier to accomplish toilet training.

How to Toilet Train a Child with Autism
As the majority of individuals with autism who need toilet training are children, ABA Psychological Services recommends the following tips for those individuals. However, many of the same strategies can be used or slightly altered to assist adults with toileting.

Observe Signs That a Child is Ready for Toilet Training
It’s often asked, “At what age is a child with autism ready for toilet training?” There is truly no correct answer to the question, in that every child will need to learn at their own pace and with methods that resonate with them. However, there are signs that indicate a child with ASD may be ready to learn how to use the toilet on their own:
• They “mimic” adult movements such as sitting on the toilet, flushing, wiping, etc.
• They can pull their pants/clothes up and down with minimal help.
• They have the ability to control their bowel movements and indicate when they need to go.
• They are regularly using the toilet but with adult assistance.

If you are determining when to toilet train an older child with autism, many of these signs may already be prevalent. However, older children with autism (or any children) can experience anxiety or fear with using the restroom on their own. If an accident occurs or a child becomes upset, take immediate steps to reassure and support them. This may include helping, but from a distance so the child becomes confident to go on their own.

Take It Slow
Mastering a new task on the first try is rare for anyone and using the toilet independently is no exception. When teaching a child how to use the restroom, go step-by-step and repeat each step multiple times, explaining what to expect with details that are easy to understand. You should use simple language to describe what to do, even the act of finding the restroom with a single word like “potty.” It’s also important to use teaching strategies that are fun and show the importance of toilet training.

For example:
• The use of storytelling to describe the steps or reading a book with pictures about an animal or fun character using the restroom are great resources.
• Instead of sitting with the child or reading to them, use visual methods like showing a child to add or remove large puzzle pieces or imagery from a “bathroom board” every time a step is accomplished.
• Provide toileting aids to help curb fear or anxiety, such as a child’s seat, a step stool, etc.

It’s possible that a child of any age with autism may progress slowly from one step to another. When this is the case, it’s critical to focus on why the child is having trouble. It’s not uncommon for underlying concerns to hinder progress. It’s also not uncommon for a child with verbal communication limitations to have difficulty expressing their needs. Taking the time to understand verbal and non-verbal cues can help address roadblocks. If you or a loved one has trouble with this recognition, a Board Certified Behavior Analyst (BCBA) or Licensed Behavior Analyst (LBA) can provide guidance.

Use Incentives
When toilet training someone with autism, the use of incentives is key. This includes physical rewards, but also encouragement, such as:

Rewards
• A favorite snack
• A special toy
• Free time to play
• An accolade or prize

Encouragement
• “Yay! You made a potty!”
• “Good job (with the subsequent step) now, what’s next?”
• “What does the (animal, character) do when they are finished?”
• Visual cues that a child has done well like smiling, thumbs-up, or hand clapping.

Always Adapt
Even if a child with ASD makes progress, it is possible they will regress. If this occurs, reaffirm consistency with toilet training and continue to observe your child’s behavior, especially if they exhibit any you haven’t previously seen. Sometimes, regression may actually be a sign of an underlying medical concern, such as an illness or a urological condition, especially if your child exhibits signs of pain or discomfort. Talk to a medical professional whenever these types of concerns arise.

In other cases of regression, especially for older children with autism, they may only respond to toilet training techniques that apply to their interests or desires for an age-specific reward. The ability to adapt during the process is especially important in this case. Continue to work with your child, and a professional, to find techniques that are successful for your situation.

Talk with a Professional About Applied Behavior Analysis (ABA) Therapy
Through consultation with a BCBA, LBA, and with the assistance of an ABA paraprofessional, the professional staff at ABA Psychological Services will work you and your loved one to complete an individualized care plan for toileting and many other needs. Applied Behavior Analysis Therapy (ABA) uses science and behavioral research methodologies to make positive changes for those with autism. Through one-on-one ABA therapy, systematic intervention helps to decrease problem behaviors and increase adaptive behaviors so those living with ASD feel supported and those overseeing their care have tools to address challenges. Talk with us today and book an appointment.

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