Lorraine MacAlister, Autism Training Consultant, The National Autistic Society gave some good advice on this…
Why might children with autism find toilet training tricky?
There are various aspects of autism that might make toilet training tricky, but not impossible. Some of the communication and interaction around toilet training can be difficult to understand; the amount of verbal language used, phrases like “let’s spend a penny”, learning what to do by copying others, not liking change or being put off by the idea of wearing ‘big boy/girl pants’. Many children also have sensory differences, therefore they may find it difficult to register the need to use the toilet or may find the bathroom a very overloading room to be in – or they may love it and be more interested in posting things down the toilet or flushing it!
What things are important to think about?
When thinking about toilet training a child with autism, there might be some other things to think about when planning for this.
- Think about the bathroom – remove unnecessary distractions and try to start changing nappies in the bathroom
- Language – think about the words you’re going to use, make sure everyone uses the same words, e.g. “wee and poo”
- Supplies – do they need a toilet seat, foot stool, rails to hold on to, wet wipes, a ‘toilet toy’ to encourage them to sit on the toilet
- Developing a toileting routine – using visual supports
- Are they ready – it can be useful to monitior their nappies for a 2/3 days to get a picture of when they normally have a wee and this will also let you know if they are staying dry for about 1½ hours in the day which is an indicator that they are ready, they may need help with learning how to sit on the toilet and with understanding that wee and poo need to go in the toilet (Rewards and Social StoriesTM can help with this).
- When you are ready – remove the nappy and using your visual routine to support your child, try sitting them on the toilet around the time where they were usually having a wee or around break or mealtimes – but not too often as to put them off or to encourage them to wee too often.
For more information, visit the NAS website.
Here is a technique recommended by June Rogers MBE, Team director at Promocon…
‘’This is a very common problem with toddlers – so much so we have written a leaflet about it! Basically you allow ‘poo nappies’ which are left in the bathroom – you can tell the child that the ‘The poo fairy’ has left them as it sometimes make negations easier. The child is told that when he/she wants to do a poo he/she can have their ‘poo nappy’ on – the nappy is put on in the bathroom and the child stays there until the have done their poo – the nappy is then taken off and the poo put in the toilet and the child is then involved with flushing it away etc. It is important that the nappy is put on/taken off with the child standing so that way they can help with pulling pants up and down and also start to learn about wiping bottoms etc
It has to be to the child’s advantage to do it this way rather than in his/her pants so you can say things like the poo fairy has left some special stickers and every time he/she does a poo in the nappy in the bathroom he/she can have one of the stickers. Once he/she is happily going into the bathroom to do a poo in the nappy then you move the goal posts and say that the poo fairy said he/she can still have a nappy on but he/she must also now sit on the toilet /potty – once he/she is doing this you are almost there and just need to work on removing the nappy completely. Some mums progress by just putting the nappy on the potty/toilet and sitting the child on the nappy on the potty/toilet then one day they just ‘forget’ to put the nappy there and sit the child straight on the potty/toilet. Others cut a bigger and bigger hole in the nappy …one determined little chap said he was going to poo in the toilet ‘when I am big’ so his enterprising mum bought smaller and smaller nappies until they were too small to fit him and then told him he was now ‘big’ so had to use the toilet!’’
Read the leaflet >
Early Elimination Toilet Training Method
At one year old, child is expected to control elimination, walk, and verbalize simple needs.
Bowel and bladder training begin simultaneously at 2 to 3 weeks of age.Initially, the mother assumes all responsibility by placing child in a special training position outside the house when she senses the child needs to eliminate (e.g., after feeding and waking).
For voiding, mother sits with legs extended straight out, places the child in a sitting position between them facing away from her and supported by her body. She then makes a “shuus” sound so child learns to associate it with voiding. This is done many times over 24 hours. If successful, the child is rewarded with feeding, close contact or other pleasurable activity.
The child is expected to gain competence in communicating his or her need to void and climb into the assumed position and urinate by 4 to 5 months.
For bowel movements, mother sits on the floor with knees bent, infant facing her, supported by her lower legs. Child’s legs are placed over hers. The mother’s feet provide a kind of potty. No sound is made. If elimination occurs, the child is rewarded by pleasurable activity; if not, the child is returned matter-of-factly back to previous activity.
During elimination, social activity carries on; elimination is not regarded as private or unclean.
The mothers claim to learn to read infants’ movements, skin and muscle tension, and also distinguish a language of grimaces, grunts and cries to signal need. When specific pushes and shoves are detected while carrying a child on her back she may occasionally stimulate a sphincter reflex with a gentle pat to the rear.
At 3 to 5 months, young girls 5 to 12 years old also learn the child’s signals and participate in further training by assuming elimination positions at appropriate times. Helpers are scolded or punished if they are not responsive or sensitive to infant’s needs.
Occasional accidents are expected and handled casually; caregiver cleans up immediately.
At one year, when infant begins walking, he or she is expected to eliminate away from the living area of the house. Accidents in the living area or courtyard first attract warnings and later physical punishment.
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