How Can I Toilet Train My Autistic Child?

Embarking on the journey of potty training is an adventure for any parent, but when it comes to children with autism, it can present unique challenges. Understanding the individual needs and sensitivities of a child with autism is crucial for successful toilet training. In this guide, we'll explore specific tips tailored to make the process smoother for both parents and kids.

1. Toilet Training Visual Supports 

Children with autism often benefit from visuals to help explain things. In toilet training visual supports are especially important, because the idea of beginning toilet training can be a pretty foreign concept for many children who resist any change to their routine.

Visual supports can be a first then board with pictures that help a child understand that if they poop or pee in the toilet or sit on the toilet they will get a reward or a sequence of pictures that show them the expected steps of using the toilet.

Try to include details that will be meaningful for your child, for instance a picture of the actual reward your child will earn. To make a visual support you can take photos if your your child responds best to realistic pictures, download pictures from online or even draw your own pictures. Visual cues provide clarity and help make the process of toilet training more understandable and less daunting for children.

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2. Decide on the Method

Potty training methods tend to fall into 2 categories, slow and steady or intensive. They both have pros and cons. If you are not in a hurry and you have a child that you are concerned about anxiety you can choose the slower method.

For this you can just consistently set your child on the toilet at a consistent time each day, such as after child wakes up or after eating lunch each day. If you are doing this you can either have your child wear absorbent underwear or keep them in a pull-up.

Another way is to begin with a short time each day with underwear on or no clothes on, gradually increasing the time each day. Some people choose the 15 minutes before bedtime or right after waking and then after 2 or 3 days of success move to 20 minutes, etc.

You can also consider an intensive potty training method that is only last 3-5 days but is completely absorbing during this time period. Most children with autism are able to be urine trained after the 3-5 days when taken but may still have to work on initiating using the toilet.

This approach can be particularly successful for children who may not exhibit all the readiness signs. Intensive methods involve picking a day when diapers or underwear will not be worn anymore (except overnight), staying close to the bathroom (not leaving the house if at all possible), and following a sit schedule.

In this method, urinating in the toilet usually accidentally happens initially and this is rewarded, leading the child to make the connection between urinating and holding urine in when not seated on the toilet.

I have had the most success with this method for children that may not show the traditional readiness signs for toilet training.

If you want step by step instructions on toilet training a child with this method you can purchase this toilet training manual

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3. Beyond Sticker Charts

Understanding what motivates your child is absolutely essential for any method. Identify what motivates your child and use it as a driving force during potty training.

While a typical child may respond to just receiving a cute sticker to put on a chart, many children with autism will not be motivated unless you consider items that are unique and can only be had for sitting or for peeing on the toilet.

It is important to have a wide variety of reinforcers or motivators and plenty of them!

Whether it's a favorite toy, special food or drink treats, or magnet letters, incorporating motivation into the process encourages active participation and a positive atmosphere.

4. Toilet Training Social Stories 

A short story with pictures that explains the process that the child will be undertaking is very effective if you are toilet training a child who does not know what to expect or is showing any signs of anxiety.

If you are doing the slow and steady method you can write a story about how each day when they awake they will sit briefly on the toilet and get to look at a special show on Mom's tablet and how happy they may feel to be growing bigger and doing new things.

You can also craft social stories that address any fears or anxieties your child may have about the toilet. Social stories help demystify the process, providing a clear narrative that alleviates fears and builds confidence. Common fears that may be addressed in a social story might be pooping in the toilet, using new or different bathroom, falling in the toilet, or the sound of the flush.

Make sure to introduce the story at a time when your child is in a good mood and not while the issues is occurring. Allow your child autonomy to decide if they want the story read to them, if they want to do something else while you read the story in the background, or if they just want to look at the pictures. Leave the story in a location where they can access it if if they have any interest. It is important to never force them to look at the story.

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5. Focus on One Skill at a Time

Avoid overwhelming your child by trying to focus on more than one skill at a time. It is not uncommon for just the act of having to pull down pants to feel overwhelming for a child with autism. If you are really intent on getting the child to remain seated on the toilet and this is difficult for them, do not also insist they pull down their own pants. Obviously eventually they will need to complete more than one step but if you are conscientious about adding skills on slowly you are less likely to encounter resistance from your child. When your child has mastered one skill you can expect them to add on a new step. This approach promotes gradual progress, reducing stress and ensuring a more successful learning experience.

6. Consider Sensory Differences and Accommodations

Acknowledge sensory differences and make accommodations in the bathroom environment. Most children with autism have sensory differences and this is one of the things that can make toilet training difficult. In my own household, I wanted to forego the potty seat and move directly to the adult toilet, however, 3 of my children had insecurities about being up high and it was definitely worth it to begin on a small low toilet where they were more comfortable. I'm happy to report they now all use an adult size toilet :)

Some of the sensory adjustments that can be made for a child with autism include:

• Turning off the light or making it lower if possible

• Adding a toilet insert to an adult size toilet or using a smaller child size potty

• Using a space heater to make the area warmer

• Allowing a child to hold a fidget or item while on the toilet

• putting a weighted stuffed animal on childs legs while they are on the toilet

• Adjust lighting, introduce comfortable seating, or incorporate sensory-friendly elements to create a calming space.

• Playing a child's favorite song or music while in the bathroom

• Turning off the bathroom fan or running the bathroom fan if your child likes white noise

• Allowing child to wear noise cancelling headphones

• Letting the child choose what clothing they want to wear

Accommodations catered to your child's sensory needs contribute to a positive and supportive potty training environment.

7. Using Strong Interests as Motivators 

What some people call a perseveration, I like to think of as an amazing motivator. Another characteristic that most autistic children have is intense fascinations with specific topics. This is a unique advantage to potty training a child with autism. The caveat to this is if you give them something, for instance a special new number puzzle, then you will need to make sure they only have access to it during the toileting time. Don't forget many children are thrilled just to have an enthusiastic conversational partner to talk about their interest while in the bathroom, whether it's trains, dinosaurs, Roblox, or letters. Integrating their interests into the process ensures sustained motivation and engagement.

8. Beyond Dolls for Modelling

Transform your child's favorite character from TV or video games into a potty training ally. Traditionally books recommend letting the child see and play with a doll or stuffed animal and a small toilet to model the toileting process. I have had much more success using small figurines of the child's favorite TV show or video game and a small toilet to model. Pro tip, check out thrift stores for Barbie size toilets figurines and Amazon if the thrift stores don't have what you need.

9. Consistency is Key

No matter what method you choose, consistency will be key. Children with autism thrive on knowing what and when things will happen in their lives. This consistency allows anxiety to subside so they can focus on the skills they need to work on.

Ways You May Want to Incorporate Consistency in Potty Training

• Schedule regular potty times

• Do not back track on using diapers or pull-ups

• Use the same steps when taking a child to the bathroom and while child is in the bathroom

• Continue to keep the visual schedule in sight even when the child does not appear to reference it

• Be consistent in how you decrease your level of prompting for things like pants up and down and handwashing.

9. Gradually Adjust Expectations

When toilet training a child with autism, it's crucial to approach the process of decreasing prompts with patience and consistency. Slowly and thoughtfully reducing prompts ensures that the child continually improves, ultimately working towards independence in their toileting routine.

Some people are hesistant to use reinforcement for toilet training but my experience has been that when prompts and reinforcers are gradually and carefully decreased, they are very effective and are easily faded. The goal is not to rely on reinforcers indefinitely but to empower the child to internalize the necessary steps for toileting independently. By fostering a gradual transition and acknowledging small achievements along the way, we pave the path toward greater autonomy, allowing the child to reach a level of independence that aligns with their abilities and needs.

Potty training a child with autism requires a thoughtful and personalized approach. By implementing these tips, including visual supports, intensive methods, motivation-driven strategies, social stories, skill-focused learning, sensory accommodations, leveraging perseverations, and using favorite characters as models, parents can navigate this adventure with confidence. Remember, every small step forward is a significant triumph on the potty training journey.