Can a with autism spectrum disorder become toilet trained? Or, even more important, can a non-verbal, older child with ASD become toilet trained?
Of course they can!
Going potty – or using the toilet – can be very exciting for any child. It can also be very intimidating. It’s the same case for children who aren’t on the spectrum; the main difference is that sometimes it just takes a little longer for the autistic child to learn how. There is no standard potty training age for autistic children.
If you feel your child is delayed, here are some reasons:
General development delay is present in many kids on the spectrum, meaning that they don’t necessarily grasp new skills as quickly as other children.
Your child may have limited communication abilities, so it may be hard for him or her to let you know they need to go.
If your child has been using a diaper for a long time, it may be hard to break from that comfort and routine.
Many children with ASD thrive on routine, but it’s hard to make a routine of going to the toilet at very specific times of day, which adds to the challenge.
Many children, typical or otherwise, develop anxiety around the idea of going potty.
Some parents say that one of the biggest challenges to potty training is the child’s inability to communicate that he or she has to go. Some kids do the “I have to pee!” bounce, while others just say it. Kids with autism don’t necessarily do this – some of them just, well, go.
Where do I even start?
It’s generally a good idea to figure out if your child is ready to be potty-trained. If your child is able to show you or tell you that they’ve soiled their clothes or filled a diaper, or if they are forming regular bowel movements, have enough bladder control to stay dry for at least an hour at a time, or can pull their pants up and down when they get the urge, these are all signs your child may be ready for the toilet.
Next step? You’ll need to come up with some kind of communication strategy that works for you and your child.
What are some strategies for potty training a child with a developmental delay?
Many experts suggest looking at toilet training as a series of baby steps, as opposed to one big, intimidating task. Think of it as teaching someone to make a peanut butter sandwich – you don’t just direct them to go make a sandwich. You’d have to show them where the bread is, where the butter knife is, how much peanut butter to take out, and how to smooth it over the bread. Toilet training for a child on the spectrum has to be taught step by step.
There are three main strategies for toilet training your child on the spectrum.
The first are encouragement and rewards. Positive reinforcement goes a really long way when potty training! You can either reward your child with non-verbal gestures, like a high-five, clapping or other signs, like a thumbs up (sometimes a really big smile is good enough, too!) You can reward your child with a sticker on a big chart in their bedroom, a favorite food, or even an enjoyable activity, like a board game or painting. There’s no need to be stingy with descriptive praise, either – hearing “Way to go!” is wonderful to hear.
Like in typical children, some rewards work, while some won’t. Don’t always use food or toys are rewards, but always using verbal and non-verbal praise to encourage your child to keep going toward the next step.
The second strategy is using visual supports. Many parents have had great success using visual supports because many kids on the spectrum are visual learnings. You can search Google images for printing out a visual “schedule” – this system shows your child how to pull his or her pants down, to sit on the toilet, to use toilet paper, to pull their pants up, and finally, to wash their hands. You can laminate these images and stick them on your bathroom wall where your child can easily see them, and you can go over these images a few times a day so they can get really familiar.
The third strategy is what experts call Social Stories. Social Stories are designed to help kids on the spectrum develop appropriate responses and behaviors.
Social Stories should be simple, accompanied by clear pictures that make the story even easier to understand. The Social Story should be written from the perspective of the child. In the case of toilet training, you can describe the potty experience in a positive way, providing details and making suggestions as to how your child may react to the situation. Your Social Story should also explain why your child should respond in a specific way.
If you need assistance developing Social Stories, many early intervention specialists and specialized therapists will be able to help.
I don’t know if this harder for me or for my child!
Be patient – potty training a child on the spectrum can often be more challenging than potty training a typical child. It could be that your child just doesn’t like change (many autistic kids don’t), or it could be that they’re just going to take a bit longer to adapt to this new skill.
Some tips that may assist you in potty training your child include the following:
If your child is nonverbal, practice a signal your child can share when he or she needs to go. You may provide a picture they can hold up and show you.
Use language that is very specific. Instead of just saying, “Sit on the toilet,” you can say, “Sit on the toilet so you can pee.”
Some parents choose to potty-train on a plastic practice toilet, then on to the real toilet. You may want to head straight for the toilet so that your child doesn’t have to go through as many changes and steps.
Try transitioning from diapers to clothing with liners or washable, reusable training pants. These may teach your child to be aware of being wet, and will learn to ask to go instead of soiling themselves.
Stay calm, positive and joyful.
Why does my child seem nervous to use the toilet?
Sensory overload is common for kids with ASD, and the idea of sitting on the toilet (especially for longer than five minutes), hearing the water go down and watching it flush may all just be too much. Do what you can to help make your child more comfortable. You might want to throw down a plush, comfortable rug under the toilet seat, or give your child warm socks to combat what might be a freezing bathroom floor. You may also want to explain the flushing to your child – where the water goes, why it makes that sound, and ensure him or her that the hole isn’t a scary place.
Sometimes, when kids are afraid of the toilet, it could lead to other problems. They may get constipated. They may decide to go pee or poo in other places other than the toilet. They may flush toys and other objects.
If the above problems persist, and toilet training is draining both you and your child, there’s no harm in taking a break. You can take a breather and start training again in three months. Don’t consider the break a failure – it just means your child is not quite yet ready.
For more information about potty training your nonverbal, older autistic child, visit us at www.allianceabatherapy.com. If you’re in the Fredericksburg or Fairfax, VA area, stop by and visit or give us a call.
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