Autism Potty Training



For parents of children with autism potty training can be especially challenging. In my years of working with families with young children with autism and other developmental disabilities, we've found the following guidelines for toilet training extremely helpful. Many families have had a lot of success using them, which is why I want to share them with you.

1. When ready to start a potty training program, be prepared to stay home and not make plans, so the full attention is on getting your child potty trained. It could take a few days, a week or two, or even longer, depending on your child and how consistent parents (and whomever is working with the child) is.

2. Child must wear regular underwear. Pull-ups and diapers are only used when child is sleeping.

3. Keep child's bladder full of liquids as much as possible throughout the day, but avoid salty foods, because that makes children thirsty, and you want the child to drink without something to make them want to drink.

4. Every 30 minutes take the child to the bathroom. Have child sit on the potty for 10 to 20 minutes or until child voids. If by 20 minutes child does not void, instruct child to pull up pants with the least amount of help as possible and allow child to leave the bathroom. Boys should sit on the toilet during training. When the child is on the potty, it is not fun or reinforcing until the child voids.

5. If the child voids during this time, reinforce with a tangible item as well as verbal praise right a way. Cue the child to pull pants up and then allow child to leave the bathroom.

6. Using a timer, a child is to have a dry check. Guide child's hand on their pants so they can feel whether they are dry or wet as well as the person doing it with the child can double check. If child is dry, provide reinforcement and verbal praise.

7. If during a "dry check" the child is wet, have them touch the wet pants and tell them where they should void. ( ex. we pee pee in the potty, no pee pee on the floor.) Bring child to the bathroom right away. Prompt them to pull down their wet pants, sit on the potty, and them pull up their wet pants and bring them back to the spot where they urinated in and follow this routine again. Do this positive practice 5 times. Use a full prompt procedure if need be. After the fifth run through in the wet pants, change child, have child clean the wet spot. Do not provide a lot of attention at this time. This practice is not suppose to be fun for the child. If child is crying and or acting out, ignore those behaviors and go on with implementation.

8. Usually when first starting this positive practice, children will have accidents, but don't give up, keep implementing this positive practice procedure.

9. The first time the child self-initiates, stop scheduling the child for potty time. Once this occurs, you do not schedule a potty time again, because if you do so, the child will become dependent on a schedule rather then initiate on their own.

10. Continue to keep child's bladder filled with fluids. At this time more accidents are likely to occur, but continue to use the positive practice procedure when this happens.

11. During potty training you should not require the child to mand (request) the potty and you should not prompt them to ask for it either. That will come once self-initiations are met.

12. Within a short period of time the accidents should go down to a minimal, if any. At this time, the child should begin to self-initiate more often. IF the child only initiates that one time over about a two week period, start scheduling again.

13. After a child has had twenty consecutive initiations, with no accidents you may stop forcing the fluids.

14. When you are ready to venture to a store or other public places, fill your child's bladder right before you go, so as soon as you get to where ever, without saying anything, walk right to the bathroom and to the stall and show them the toilet. See if they will self-initiate. If not, then use minimal prompting.

15.Bowel training. Accidents of this type will continue to occur for many children after voiding in under control. Do not go back to diaper. Do not use positive practice procedure for this, just have the child clean it up. Eventually the child will begin using the toilet for bowel movements as well.

16. Once the child is voiding and having bowel movements in the potty, then it is time to teach boys to stand while urinating.

17. If a child has a regular bowel schedule, you might want might want to have them sit on the potty at that time.

18. After a month or so of self initiations with no accidents, you may want to have the child start manding (requesting) for the potty. A way to do this is stopping the immediate access to the bathroom., while the child is on their way to it, so they have to say something prompted or unprompted to get to it, or if its a nonverbal child, then have them give you a pecs symbol of a potty as their mand. Make sure self-initiations are strong before having a child request to go to the bathroom.

I hope these guide lines are helpful to successful potty training!





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Read one family's story about toilet training for their child with autism