Potty training can be a challenge for any child, but it's often even more daunting when a child has autism. Ingrained routines, sensory difficulties, and communication problems can all get in the way of your child accomplishing this important milestone. However, with the right approach and a little patience, you'll soon be able to leave diapers behind.
Know When Your Child Is Ready
For many neurotypical children, potty training happens around the age of three. According to BrightTots, an autism resources website, children on the spectrum often aren't ready for toilet training until quite a bit later, sometimes closer to four or five years old. Since you can't use your child's age as a guideline for when to start potty training, look for the following signs of readiness:
Can Stay Dry for 60 Minutes
Your child may be ready to begin toilet training if he has a dry diaper for an hour or more at a time. If not, your child may not have the necessary control to make it to the bathroom. If your child has low muscle tone, which sometimes accompanies autism, this type of control may take longer than average to come in.
Can Make a Simple Request
Communication challenges can be one of the biggest obstacles to potty training a child with autism. Functional communication problems, such as requesting something, are one of the core aspects of autism spectrum disorders, according to the National Institute of Health. If your child cannot yet ask for more juice or a favorite television program, he may not be developmentally ready to communicate a need to use the bathroom. Working with a speech therapist can help your child improve his functional communication to the point where potty training is a reality. You can learn your child's habits and begin to teach potty training without communication, but it is much more challenging.
Understands and Is Motivated by Rewards
Because potty training is challenging and your child may not be motivated to do it, it helps to have a reward. This can take the form of a piece of candy, a sticker, or a small toy. If possible, relate the reward to your child's special interest for even more motivating power. If your child has been motivated by rewards in the past, he may be ready to begin toilet training.
Tips to Help Potty Train a Child with Autism
As with everything involved with autism, there isn't a set approach that will promise potty training results every time. Each child is different and will require a slightly different process. However, the following tips apply to most children on the spectrum and can help you make this process as simple and successful as possible.
Consistency Is Key
For many kids on the autism spectrum, consistency is incredibly reassuring. Routines and rituals can bring comfort, especially when it's time to learn a new skill. Start by paying attention to your child's behaviors and schedule. When does he have wet or soiled diapers? Is there a schedule? Then form a consistent schedule of visits to the bathroom, based on your child's own habits. Say the same thing each time your child uses the potty. Use the same toilet paper brand, the same potty book, the same order of events. This may be very reassuring for your child.
Offer a Tangible Reward
Toilet training in itself may not be rewarding for your child. In fact, with the noises, sensations, new expectations, and changes, it may even be aversive. Keep a favorite treat or toy in the bathroom where your child can see it. Show your child the reward and immediately present it when your child uses the potty. Use the same reward every time.
Clarify the Process
Because children on the spectrum frequently struggle with imitation and cueing in to others' behavior, you can't rely on modeling bathroom behavior to teach your child the process. Instead, spell out every step. If your child is a visual learner, like many kids with autism, make a pictorial chart of the steps involved in using the potty and post it next to the toilet. Remember, no step is too small to describe in graphic detail; your child needs you to give him this process.
Be Sensitive to Fears
Most parents and teachers who work with children on the autism spectrum are no strangers to irrational fears and meltdowns. Unfortunately, the bathroom and all of the association equipment, noises, and sensations can trigger these reactions in your child. Common concerns include the noise of flushing, fear of a toilet overflowing, and dislike of the echo in the bathroom. Supervise your child in the bathroom and be available to help if he becomes frightened. The child may need to leave the bathroom and then slowly work back up to sitting on or flushing the toilet.
Get Help for Sensory Integration Problems
Similarly, sensory integration problems can prevent some children with ASD from becoming potty trained. Your child may seek out the sensation of a messy diaper or find the water in the toilet irresistible. Whether your child is seeking or avoiding a sensory stimulation, it can help to work with an occupational therapist to decrease and redirect your child's sensory needs and aversions.
Encourage Your Child to Ask for the Potty
In the beginning, you will probably need to take your child to the bathroom before he asks to go. Asking to go requires a certain level of functional communication that may be challenging for your child. However, if you notice any type of bathroom request, even if it doesn't produce the desired result, reward your child right away. To encourage your child to ask, decide on a signal or word that you'll use every time you take your child to the bathroom. Your child may use this word to communicate with you.
Baby Steps Are Okay
Sometimes, the newness of the potty experience and the different environment of the bathroom can overwhelm your child. He may refuse to sit down on the toilet or even begin the potty training routine. Try to take this in stride and use baby steps to get you closer to your goal. You can start by looking at the potty. Then move on to touching it, sitting on the potty with his pants on, and other small steps. Every step closer to your goal is progress.
Expect Dirty Diapers to Continue Longer than Wet Diapers
For many kids with autism, toilet training for a bowel movement can take much longer. Often, dirty diapers may continue for a year or more after your child begins urinating in the toilet. Try to learn your child's schedule to help out. Also, consider offering a more significant reward for this part of training.
Try, Try, and Try Again
If you're anxious to have you child out of diapers, potty training can seem like a long journey. It's not unusual for the process to take a year or more for children with autism. However, in many cases, when the child does become trained, the transition can happen almost overnight. Often, there are very few accidents after the child begins using the toilet. This is one area where ASD can actually work in your favor. No matter how long it takes, keep working and try to be patient. You'll get there.
Tips for Taking Toilet Training on the Road
Once your child uses the toilet at home, it's natural to assume he will use it in public restrooms or at other peoples' homes. Unfortunately, children with autism can have trouble generalizing toilet training, especially right after learning. The lack of consistent routines and a different environment can easily throw them. In time, your child will be able to use other bathrooms. In the meantime, these tips can help:
- If you know you'll be going out, pack a small bag with your child's potty seat, potty books, and maybe even some of your home toilet paper. Keep as much consistency as you can.
- Prepare your child for the change ahead of time. Explain that the bathroom will be different in some ways but that the difference is okay.
- If your child is verbal, make a list together of the similarities and differences between this bathroom and your bathroom at home. Stress how the basic parts of the bathroom are the same.
- Stay with your child in the bathroom so you can offer reassurance throughout the process.
- Use the same reward you use at home, as well as extra praise for this new challenge.
- The sounds of public restrooms can be overwhelming, so consider using earmuffs to help.
Talk to Your Doctor
If your child seems to be struggling more than most, see your doctor to rule out a medical condition, such as an intestinal blockage or infection. Your doctor can also refer you to a professional for behavioral help or further therapy.
A Challenge That Can Be Overcome
For most kids with autism, toilet training is a challenge that can be overcome with lots of patience, consistency, and sensitivity. In time, changing diapers will be only a distant memory.