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Toilet Training Your Child With Autism

The wave of unsolicited advice started around my older daughter’s second birthday. At the store, on the playground, walking down the street, over the fence in my backyard, at mommy and me class, grandma (and a few grandpa) types had endless suggestions for how I should get her potty-trained. The “when” I should potty train her was implied: YESTERDAY.

It’s nobody’s business when and how you toilet train your child, but while today people are generally more relaxed about seeing a 3-year-old in diapers, the silent judgement sometimes remains. Children with autism may not master toilet training until they are much older, and it can be a struggle for parents to deal with the public criticism.

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What many people don’t understand is that there are two important components of autism that can slow down the toilet training process. Children with autism frequently have trouble with social cues, so they may not understand why mommy and daddy are jumping around and high-fiving when they pee on the potty. Toilet training is also a major change in daily routine that offers new sensory experiences, which may be a struggle for some children.

Here are some tips for getting your child with autism out of diapers.

Readiness counts. Elimination communication (which I admittedly know little about) aside, most children cannot toilet train until they are ready. When they are ready varies from child to child. Your child might be ready to toilet train if he or she:

  • stays dry for about 1 to 2 hours between diaper changes
  • has predictable and well-formed bowel movements
  • asks to be changed or gets fussy or pulls at diaper when wet/soiled
  • demonstrates awareness of need to eliminate. For instance, goes into a corner or hides while eliminating, or can say or sign “potty” or points to a picture
  • is able to imitate actions of others
  • shows interest in the bathroom habits of others
  • is able to pull down his pants or pullup diaper

Once these skills are mastered, toilet training may still be a challenge, but it will be much easier.

Realize that this is a marathon, not a sprint.

Make a plan. Children with autism thrive on structure and routine. First, pay attention to your child’s elimination habits. How long can he stay dry between diaper changes? When does he have regular bowel movements? Make a chart if it helps you keep track.

Set up your bathroom with everything you will need in easy reach. Think about your child’s sensory needs—will he be bothered by the cold toilet seat? The size of the hole in the toilet seat? Will he need something to prop his feet on? Will he get stuck wanting to play in the splashing water? You may need to adapt the environment to your child’s individual needs. Stock your bathroom with favorite activities to distract your child while he sits—books, hand-held toys, and mobile devices are favorites. Next, develop your bathrooming routine. Performing the same routine each time you head to the toilet will help your child learn what to expect.

Make a picture chart of your routine. Many children with autism process information better visually rather than by listening. If your child is already using PECS you can easily create a visual of your bathroom routine. If your child is not yet using PECS, get out your digital camera or smartphone and take a photo of each step of the routine.

Print them out and laminate them, then use magnets to attach them in order to a small baking tray (easier than Velcro—thank you, Pinterest!).

Leave the bathroom door open. All children learn by imitation, and children with autism may need extra opportunities to observe the process. Allowing your child to see others (who are comfortable with the idea) use the bathroom can help them understand that—like the book says—everybody poops. If you are uncomfortable with this idea, try using a doll instead or watch a video designed for children who are potty training. Likewise, visit your library for lots of books on the topic.

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Finally, get started. Choose a distraction-free period of time, and get going. About 10 minutes before your child typically wets his diaper, give him a visual (your picture), verbal (“go potty”) and physical (take him to the bathroom) cue. Give him all three cues for each step of the process. Over time and as your child is ready, you will decrease the cues to encourage independence.

Celebrate small successes. Reward yourself and your child for every small success and realize that this is a marathon, not a sprint.

Have you toilet trained your child with special needs? Share your own tips with us in comments below.

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