Depending on where your child falls on the autism spectrum, there may be developmental delays in areas such as potty training. However, when your child is ready, there are simple steps for toilet training with autism that the whole family can take to get proper toileting techniques down.
The first key to success with children with autism spectrum disorder (ASD) is determining when to start potty training. The toilet training age for most children is between 18 months and 3 years of age, but every child is different.
Signs that a child with autism is ready for toilet training may include awareness of being wet or messy, the ability to pull their pants up and down, and comfortably sit on the toilet. But if your child is less sensitive to wet sensations or struggles with muscle control, you may want to look for the capacity to get pants up and down.
Other signs that your child is ready include:
- Finding a quiet place to go
- Asking to be changed when their diaper is soiled
- Remaining dry during the night
Where to Start
1. Associate All Bowel Movements with the Bathroom
Make sure your child learns to associate using the toilet with the urge to use the restroom. Lead them into the bathroom every time they mention needing to go or have an accident. Changing them in the bathroom and having them help with the clean up can help them familiarize themselves with being in the restroom and make for an easier transition. You can also allow your child to flush their accident down the toilet to reinforce that is where it should go.
2. Develop Communication that Works
If your child has a communication delay or doesn’t want to use the word bathroom or poop, use signs or pictures of bathrooms to let them know when and where it’s time to go. You can also develop code words for needing to pee, poop, or accidents that your child is comfortable with. Use the same words consistently and make sure your whole family is in on the plan.
Don’t wait for your child to tell you they need to go or have an accident. Tell them when it’s time for a trip to the bathroom. Sometimes children can get distracted by other activities and forget they experienced the urge to go, so they need a reminder.
3. Create a Bladder Diary
Try to pay attention to your child’s urination schedule in order to create a pattern for them to follow. Take note of when they need to use the restroom during their normal routine. Use a bladder diary to write down what they eat and drink to see if there’s a connection with their diet and how often they need to use the restroom. Eliminating certain triggers such as carbonated drinks can be helpful when potty training.
Once you've established what your child's toileting pattern is, you can create a visual potty schedule based on your findings. It can be beneficial to take your child to the bathroom to void at least six times a day with two longer trips for solid waste. Using a timer for how long your child needs to remain on the toilet can be helpful, as well, to getting used to the feeling of the toilet seat.
4. Recognize Sensory Issues & Triggers
If your child is resisting using the toilet for certain reasons such as not wanting to see their reflection or fearing the loud flush of the toilet, take care of these issues to make the bathroom a comfortable space. Figure out if the door needs to be open or closed, if the fan is too loud, if they need dim lighting, and more.
Taking an item into the bathroom such as a book or game to help your child relax can help them become more comfortable. Over time introduce your child to new bathrooms to help them get used to going in different or new places.
5. Get Your Child Out of Diapers
When potty training a child with autism, it can be difficult to resist using diapers and other incontinence supplies to catch accidents. However, children can feel more comfortable going in diapers than in the toilet. They may hold their waste all day until you place them in a diaper at night. Unless your child can’t hold their urges, save diapers for when they’re away from home. Using a transitional toilet training product such as pull-ups or training pants can also help your child transition from diapers to underwear.
6. Consider Your Child's Diet
Make sure your child has plenty of fluids such as water, milk, and juice, as well as a healthy amount of fiber to help them notice the urge to go. A lack of fiber can lead to constipation, which can make the child uncomfortable. Keeping hydrated is also crucial for helping stool remain soft and easy to pass.
7. Set Goals with Rewards
Let your child and family members know what goals you’re trying to work for and grow them over time. Goals can include making it through 3 days without an accident, then you can increase the duration to 5 days.
Provide rewards for success such as a delicious snack, their favorite toys, or favorite activities. A small reward should be provided for every successful movement on the toilet. Bigger rewards should be provided for meeting goals.