Help! My child is afraid to flush the toilet (and more toilet-based fears)

“I cannot even tell you how much of a show it becomes getting this child to go to the bathroom,” says Rita, mother to Owen, 7. Owen’s on the spectrum.

It’s another day, another ‘toilet show,’ as Rita affectionately calls it. The small bathroom adjacent to the master bedroom has been designed for Owen’s comfort -- the walls are painted a soft blue, his favorite color, and there is a basket of soft toys between the tub and the toilet that Owen reaches for frequently. There’s also a small box of socks and soft slippers in case his feet get cold on the chilly tile, and there’s a radio perched on top of the toilet in case it happens to be a long session, and Owen needs entertainment.

“We have a few things we have to deal with, like sometimes he’s scared to come in here, or sometimes he just doesn’t want to because he’s anxious about something else,” says Rita. “There are some days it’s just exhausting, definitely, but honestly, I always have to remind myself he’s having a harder time than I am, and how could I be so selfish as to make this about me?

“Consider when you’re afraid of anything, how that just overwhelms you. For Owen, it happens to be going to the bathroom. The best thing I can do is support that and help him figure it out.”

Parents of kids on the spectrum do often report that  toilet time can be challenging. We’ve listed some troubleshooting tips for you here, depending on exactly what seems to be the issue for your child. 

“The bathroom is scary!” You may find that your child covers his ears or his eyes when entering the bathroom, if they want to enter at all. Conner, a non-verbal 8-year-old, sometimes grasps at the door in sheer panic when his mother is encouraging him to use the toilet.

“Sometimes he almost hyperventilates, he’s so nervous going in there. It’s been years of this behavior, and  because he doesn’t speak, it’s very hard to figure out exactly what he’s afraid of at any given time,” says his mother, Roxanne. “It could be that he hates the sound of the flushing toilet. It could be that his feet are cold and he hates the feeling. It could be that he doesn’t like the texture of the bath towel on the floor. I don’t know. I never know.”

Some of the things you may consider include:

• If your child doesn’t like the sound of the flushing, distract him with something he enjoys touching, feeling or looking at while the water is going down. 

• Like Owen, your child may enjoy having certain toys or items in the bathroom. You may want to set up a coloring, reading or writing station so the bathroom becomes a less frightening -- and more welcoming -- environment.

• Purchase a sound machine or small radio to play their favorite music. 

• Celebrate the successes; every time your child successfully enters the bathroom or completes their ‘duties,’ positively reinforce. 

As your child gets more comfortable in the bathroom, you can begin taking away some of these creature comforts. This is called shaping behavior, and it will help your child begin to feel safer in any bathroom, any situation. 

“I don’t want to sit on the toilet!” Your child may have a number of reasons why they don’t want to sit on the toilet. It could be that the seat is cold and uncomfortable. It could be that your child fears falling in. It could be that the water just looks scary, swirling down the hole the way it does. 

If your child seems fearful of sitting on the toilet, don’t force -- it could make the fear worse. Instead, gently show your child there’s nothing to fear.

You may practice sitting on the toilet, either fully clothed or with the lid down. When that becomes easier, have your child remove his or her pants and sit. You might even use equipment that makes it easier or more comfortable, like a potty chair or a padded toilet seat (not only are these easier to sit on, they usually feel more stable and supportive than just a regular seat). Some parents also recommend bringing in a portable tray -- the kind that people use to eat their meals on while watching TV on their couches. You can have your child engage in enjoyable activities so they’re distracted and less focused on being on a toilet seat. 

“The flushing is scary!” While some kids love the idea of flushing a toilet, others find it a terrifying prospect. As enjoyable as it may be for some kids to watch the water noisily circle down into the drain, other kids may be mortified -- where does the water go? What happens to the water? Where did the poop go? Can I get flushed down the toilet too? 

Your child may just need to tolerate these scary sounds and be comforted that no, they can’t be flushed down the toilet too. You can try some of these things:

• Close the lid before flushing; this reduces the sound.

• Flush quickly and happily and head right to the sink to wash up; by making it into a pleasant, joyful, relaxing activity, they’re less likely to be stressed

• Some experts even recommend taping the sound of the flushing for your child to play over and over again, so it becomes less foreign, while others encourage adding “flush” to the visual schedule so it becomes part of a child’s regular routine

“You can’t catch me!” Some kids are so fearful of using the toilet that they hide or run away from you when it’s time to poop. Although some kids don’t feel fearful of urinating, defecating seems to be a bigger challenge. In some instances, kids will poop in their pants; in more severe circumstances, they’ll hold it until it becomes a medical emergency. 

If your child tries to run or hide when pooping, instead of discouraging the behavior,  try actually supporting it. Ask him or her to hide in the bathroom! After the bathroom becomes the safe space, start encouraging them to undress, then to sit on the toilet, then flush, and re-dress. 

Any of the above behaviors can certainly be frustrating and challenging, especially when the parent or guardian has no idea what’s bothering or frightening the child. It’s worthwhile to remember, however, that no matter how exhausting it is for the parent, it’s just that much more confusing for the child, who probably has a difficult time expressing his or her feelings about the bathroom -- and other things. Learn more tips on how to potty training your child.

For more information on fear of flushing, visit us at  www.allianceabatherapy.com. 

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