Each and every child will encounter challenges as they grow older, whether that's learning to speak, walk, or even potty train. However, children with an autism diagnosis can sometimes face an even more unique set of challenges. Specifically, one of those unique challenges may be mastering incontinence.
Typically, children with autism spectrum disorder (ASD) who struggle with incontinence will grow out of or see significant improvement in it as they age. Sometimes, however, it may take longer to establish effective toilet training practices. Autism, with the addition of incontinence, may seem overwhelming at first, but there are proven ways to manage incontinence in both younger and older children with autism without having to make drastic changes to your daily routine.
What Is Incontinence?
Incontinence is defined as the lack of voluntary control of urination or defecation. Incontinence is often prevalent in children with autism due to common delays in potty training. Some nonverbal children with autism may also not be able to communicate the need to use the restroom, resulting in unwanted accidents.
In some cases, individuals with autism may experience urge incontinence, where they don’t realize the need to urinate until they feel a sudden, unexpected urge, and the bladder contracts when it shouldn’t. Children can also become distracted by video games or other stimulating activities, in which they may not recognize the urge to urinate.
We recognize that children with autism have unique, special needs that are specific to the individual. Essentially, there is no one clear answer or route to addressing said needs in full. It can take some trial and error before you establish what is best for your child and their unique needs.
In other cases, incontinence can only be managed, but incontinence treatment can help some children successfully use the restroom on their own without the need for youth diapers or training pants (pull-ups).
How to Help Your Child With Incontinence
There are many ways you can help support your child while helping manage and treat their incontinence. Read our top eight tips below to set your child up for success.
1. Be Supportive
The first key to success in helping your child manage their incontinence is to be supportive and understanding.
This may be a given, but it is important to assure your child that their incontinence is not their fault and they are not alone. It does not have to be a "bad" thing, nor is it something that will necessarily last forever. You may need a lot of patience and persistence to help your child manage (or overcome) their incontinence, but there are ways to make it easier on both you and your child.
2. Speak With Your Healthcare Provider
If your child starts to experience symptoms of incontinence, such as delayed toilet training, nocturnal enuresis (bedwetting), or bladder leakage, it is important to seek help from a healthcare provider.
A trip to your child's pediatrician will allow you to decipher if the incontinence symptoms are due to the effects of your child's autism, another underlying medical diagnosis or issue, or a combination of the two. Other medical diagnoses will have varying treatment plans, but if your child is clear of any other medical diagnosis that could be causing the symptoms, their incontinence treatment may involve a more hands-on approach.
3. Use Incontinence Products
Symptoms of autism can include resistance to change, so it may take a little extra work with your child to take steps towards using diapers or pull-ups less. As your child's primary caregiver, remember that you know them best.
When trying a new method of toilet training or removal of diapers, we recommend taking 2 weeks to ensure that your child has enough time to truly adjust to the changes. Using interval continence care products such as training pants or pull-ups can also be beneficial in the training process from diapers to regular underwear. Also, if your child exhibits signs of an incontinence schedule, such as only passing stool in their pull-up after they eat lunch, you may have an opportunity to anticipate the event and intervene.
4. Set & Stick to a Toileting Routine
Another method of helping your child manage their incontinence symptoms is to keep track of your child’s normal bathroom routine. Knowing roughly when and how often your child uses the restroom will enable you to be able to remind them that it may be time to use the restroom before an accident occurs.
It can be good practice to have your child use the restroom every 2 hours, depending on the usual schedule. A bladder diary can be a great tool to track accidents, as well as other contributing factors.
If your child doesn’t want to stop engaging in an activity for a bathroom break, pause and remind them that it will still be there when they get back.
We recognize that this can potentially cause meltdowns to occur, but it is important to try different methods of working with your child to ensure their success.
Using a positive reward system- such as a sticker chart- for adherence to timed toileting can be very motivating and successful as well.
5. Carry Incontinence Supplies With You
It is also beneficial to plan ahead and always be prepared for activities outside of the home. This can be achieved by ensuring your child has enough incontinence products to last through the event. Keeping a bag with extra pull-ups and a change of clothes can be a great way to combat and triage potential incontinence episodes. Underpads (or chux) can also help mattresses stay clean and dry during your child's sleepovers.
6. Involve Your Child's Teachers
It is vital to involve your child's caregivers in their incontinence treatment to maintain consistency and support. It would be very beneficial to inform your child’s teachers about their incontinence so they can set your child up for success by:
- Allowing your child to sit close to the restroom.
- Allowing your child to go to the restroom without permission.
- Developing a private codeword for accidents.
- Assisting with changing and clean-ups if accidents happen.
- Ensuring that extra pull-ups or other incontinence products are readily available if needed.
7. Understand Your Child's Specific Triggers
When potty training, children with autism can encounter sensory triggers in the restroom. Whether the flushing of the toilet is too loud or the toilet seat is uncomfortable, it is important to be aware of what might be discouraging your child from using the restroom. Flushing the toilet once they leave the bathroom and special toilet seats are good ways to help your child with these sensory triggers.
8. Feed Your Child Healthy Foods
Another way to set your child up for success is by equipping them with a healthy diet with plenty of fluids. Oftentimes, young children don’t drink enough water which can contribute to constipation which can worsen incontinence. Incomplete stool emptying can dilate the bowels/rectum, putting pressure on the bladder and thus cause urinary accidents. Fruits and vegetables that are rich in fiber may help with battling constipation, as well. It is important to contact your doctor if your child’s stomach is distended, they complain of abdominal pain, or their bowel movements are small, hard, painful, large in diameter, or infrequent: the goal is for your child to poop at least once per day.
How to Receive Incontinence Supplies Through Insurance
Managing incontinence can be overwhelming at times. However, Aeroflow Urology can assist in supplying incontinence supplies through your Medicaid (and some private insurance) plans. Not only will this service be beneficial financially, but it can also alleviate stressful store trips. Instead of running out to the store for youth diapers and pull-ups last minute, fill out our quick qualification form to get started.
If approved, your child's incontinence supplies will be shipped directly to your home in discreet packaging on a monthly basis - ensuring privacy and ease of use.
One of our Continence Care Specialists will be matched with your child to ensure they have correctly fitting products. Our Specialists will also check in on a monthly basis to see if any changes need to be made, such as switching sizes as your child grows, or switching to a product with more or less absorbency.
Dr. Samantha Eaker
Samantha Eaker, DNP, CPNP-PC is a board-certified pediatric nurse practitioner specializing in pediatric urology. She is a Medical Advisor and Author for Aeroflow Urology. Dr. Eaker received her Bachelor of Science in Nursing from Georgetown University and her Doctor of Nursing Practice from The University of North Carolina at Chapel Hill. She currently practices in North Carolina, serving children and adults with congenital and acquired urologic problems. She is passionate about providing personalized care to and advocating for her patients. Primary care trained, Dr. Eaker enjoys the continuity of care that pediatric urology provides. When not in the clinic, she is most likely to be found traveling with her husband, playing with their Great Dane, or staying active on the Peloton and throughout local state parks.
Information provided on the Aeroflow Urology blog is not intended as a substitute for medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.
