Training any youngster to use the potty may be a challenge for both the parent and the child. Children with autism spectrum disorder (ASD) are more likely than their typically developing peers to struggle with this milestone for several reasons, which we will explore below. Children with autism may struggle to participate in essential activities, such as interacting with their peers, if they cannot effectively use the bathroom independently. This will also affect issues with developing health problems and physical discomfort stemming from lack of cleanliness. Please note that below are suggestions and may not be applicable to all children with autism. If your child is experiencing significant difficulty with potty training, they may need an individualized behavior assessment and plan under the direction of a Board Certified Behavior Analyst.
Reasons Why a Child with Autism has Difficulty Potty Training
Communication Complications
ASD children often have trouble comprehending and using verbal language. For some, this includes the inability to request help visiting the toilet when they feel the physical urge. Some children with autism are not as in tune with their bodily functions (e.g., feeling too hot, hungry, or needing to urinate) or are distracted and have trouble identifying when they need to use the restroom. Others may use the toilet if advised to do so, but they are unlikely to do so independently.
Developmental delays
Any developmental delays your child may have can significantly affect the time it takes for them to achieve independent potty skills. Research has discovered that children with ASD, on average, need more than two years of potty training to develop bowel control. Some children have trouble with the executive tasks of putting on or taking off their clothing, which can be an additional barrier.
Routine
Many autistic children have unique ways of using the restroom and are often compelled to stick to their routine. Changing toilet habits can be difficult. Some children with ASD may feel comfortable using the toilet at home or school but struggle in public.
Sensory Issues
Children with ASD may fear toilet seats, flushing, or other sensory triggers. Sensory overload from loud sounds and bright lights can lead to a meltdown. Hyposensitive children may not notice damp or dirty clothes.
Fear
Fear often stems from extreme sensory issues, breaks in routine, or apprehension around the inability to complete specific tasks. It can even result from anxiety surrounding any previously unsuccessful attempts at using the toilet.
Medical Issues
A child’s difficulty with toileting may be due to a medical condition. Children with ASD often have gastrointestinal issues that can hamper toilet training. Be sure to consult with your child’s doctor to rule out medical problems before attempting to initiate a potty plan.
Understanding why a child with ASD would struggle more than a typical toddler helps you manage their unique needs and support their learning process. Incorporate these fundamental strategies when you decide it’s time to jump into potty training!
How to Make Potty Training Easier for a Child with Autism
Use Visual Supports
A picture schedule, series of pictures, or social stories can help children understand potty training. Use pictures for describing or identifying items within your bathroom (toilet paper, stepstool, flush handle, etc.). Use social stories to explain why and how we use the toilet.
A series of pictures can show a child the step-by-step process of removing clothing and sitting on the toilet, how to flush, or washing hands. You can use photos of your bathroom or even the actual items to show your child the next step.
Create a Schedule
Keeping track of how often your child naturally urinates or has a bowel movement will help you create a toileting plan. Check your child’s diaper often to plan bathroom breaks (every 15 minutes). After assessing your child’s elimination schedule, plan a set number of times per day to visit the bathroom (6 – 10, or more if needed). Use a timer to signal it’s time for a toilet break. The intent is to visit the bathroom regardless of if your child “needs” to use the toilet or not.
Create a clear, consecutive visual schedule. You can help teach your child the potty routine with pictures. Show your child the bathroom schedule you’ve created, and each step should be labeled.
Introduce Underwear
Children should wear underwear daily during potty training. Be prepared to go through several pairs of underwear. When a child wears underwear, they are more likely to feel the dampness of an accident than if they are wearing diapers. Your child can wear rubber pants or a pull-up over the underwear. Diapers or pull-ups can be worn at night to keep your child comfortable while sleeping.
Tailor the Plan and Environment
Try to change bathroom features your child doesn’t like or that may trigger sensory overload. Be sure to address any accidents right away, and remind them that it is time to visit the toilet when they are wet. Make sure your bathroom breaks are fun, pleasant, and low-pressure. Use a footstool or smaller toilet seat needed. Sit with your child and sing songs or play games to help the time pass.
It’s essential to consider which particular skills your child may struggle with. Some children have not yet learned to sit on the toilet or request a bathroom break. Take small steps towards goals to keep opportunities in the restroom successful. Pushing them to complete a task they are uncomfortable with or have difficulty doing will result in frustration and often refusal to use the bathroom.
Get them Involved
Give your child as much ownership and responsibility with toileting tasks. Dress your child in easy-to-remove clothing, so they undress independently. Include your child in cleanup, even if this means putting their dirty clothes in the hamper or their diaper in the trash. Encourage your child to help flush bowel movements from diapers when possible. This teaches your child that toilets are for waste. After every diaper change, your child should flush and wash their hands.
Practice Consistency
Be sure that any others who work with your child on potty training (therapists, school staff) utilize the same bathroom terminology, visuals, or signs as you use at home. The bathroom schedule at school, during therapy, or in any other location should also reflect the one chosen at home. Stick with the consistency even if you don’t feel like anything is working. Habits often take three weeks to establish, and for children with ASD, this can look much longer.
Focus on Positive Reinforcement and Make it Fun
Use clear, consistent, fact-based, and positive language when your child is potty training. Using the restroom is a private activity for most people, and your child deserves kindness, dignity, and patience when learning this multi-step skill.
Reward your child for using the toilet by letting them do something a preferred activity afterward, or offer favorite snacks, toys, and videos to reward them when they are successful. Give your child positive reinforcement directly after they complete a task asked of them (reward each step of the way, whether your child is working on removing their clothing or eliminating into the toilet).
Some recent research has shown that behavioral techniques can help children with autism learn to use the bathroom effectively, even if they had previously had trouble with these skills. If you’re still having trouble with potty training your child on the spectrum, the BCBAs at Apollo Behavior can help.
7 Ways to Make Potty Training Easier for a Child with Autism
Training any youngster to use the potty may be a challenge for both the parent and the child. Children with autism spectrum disorder (ASD) are more likely than their typically developing peers to struggle with this milestone for several reasons, which we will explore below. Children with autism may struggle to participate in essential activities, such as interacting with their peers, if they cannot effectively use the bathroom independently. This will also affect issues with developing health problems and physical discomfort stemming from lack of cleanliness. Please note that below are suggestions and may not be applicable to all children with autism. If your child is experiencing significant difficulty with potty training, they may need an individualized behavior assessment and plan under the direction of a Board Certified Behavior Analyst.
Reasons Why a Child with Autism has Difficulty Potty Training
Communication Complications
ASD children often have trouble comprehending and using verbal language. For some, this includes the inability to request help visiting the toilet when they feel the physical urge. Some children with autism are not as in tune with their bodily functions (e.g., feeling too hot, hungry, or needing to urinate) or are distracted and have trouble identifying when they need to use the restroom. Others may use the toilet if advised to do so, but they are unlikely to do so independently.
Developmental delays
Any developmental delays your child may have can significantly affect the time it takes for them to achieve independent potty skills. Research has discovered that children with ASD, on average, need more than two years of potty training to develop bowel control. Some children have trouble with the executive tasks of putting on or taking off their clothing, which can be an additional barrier.
Routine
Many autistic children have unique ways of using the restroom and are often compelled to stick to their routine. Changing toilet habits can be difficult. Some children with ASD may feel comfortable using the toilet at home or school but struggle in public.
Sensory Issues
Children with ASD may fear toilet seats, flushing, or other sensory triggers. Sensory overload from loud sounds and bright lights can lead to a meltdown. Hyposensitive children may not notice damp or dirty clothes.
Fear
Fear often stems from extreme sensory issues, breaks in routine, or apprehension around the inability to complete specific tasks. It can even result from anxiety surrounding any previously unsuccessful attempts at using the toilet.
Medical Issues
A child’s difficulty with toileting may be due to a medical condition. Children with ASD often have gastrointestinal issues that can hamper toilet training. Be sure to consult with your child’s doctor to rule out medical problems before attempting to initiate a potty plan.
Understanding why a child with ASD would struggle more than a typical toddler helps you manage their unique needs and support their learning process. Incorporate these fundamental strategies when you decide it’s time to jump into potty training!
How to Make Potty Training Easier for a Child with Autism
A picture schedule, series of pictures, or social stories can help children understand potty training. Use pictures for describing or identifying items within your bathroom (toilet paper, stepstool, flush handle, etc.). Use social stories to explain why and how we use the toilet.
A series of pictures can show a child the step-by-step process of removing clothing and sitting on the toilet, how to flush, or washing hands. You can use photos of your bathroom or even the actual items to show your child the next step.
Keeping track of how often your child naturally urinates or has a bowel movement will help you create a toileting plan. Check your child’s diaper often to plan bathroom breaks (every 15 minutes). After assessing your child’s elimination schedule, plan a set number of times per day to visit the bathroom (6 – 10, or more if needed). Use a timer to signal it’s time for a toilet break. The intent is to visit the bathroom regardless of if your child “needs” to use the toilet or not.
Create a clear, consecutive visual schedule. You can help teach your child the potty routine with pictures. Show your child the bathroom schedule you’ve created, and each step should be labeled.
Children should wear underwear daily during potty training. Be prepared to go through several pairs of underwear. When a child wears underwear, they are more likely to feel the dampness of an accident than if they are wearing diapers. Your child can wear rubber pants or a pull-up over the underwear. Diapers or pull-ups can be worn at night to keep your child comfortable while sleeping.
Try to change bathroom features your child doesn’t like or that may trigger sensory overload. Be sure to address any accidents right away, and remind them that it is time to visit the toilet when they are wet. Make sure your bathroom breaks are fun, pleasant, and low-pressure. Use a footstool or smaller toilet seat needed. Sit with your child and sing songs or play games to help the time pass.
It’s essential to consider which particular skills your child may struggle with. Some children have not yet learned to sit on the toilet or request a bathroom break. Take small steps towards goals to keep opportunities in the restroom successful. Pushing them to complete a task they are uncomfortable with or have difficulty doing will result in frustration and often refusal to use the bathroom.
Give your child as much ownership and responsibility with toileting tasks. Dress your child in easy-to-remove clothing, so they undress independently. Include your child in cleanup, even if this means putting their dirty clothes in the hamper or their diaper in the trash. Encourage your child to help flush bowel movements from diapers when possible. This teaches your child that toilets are for waste. After every diaper change, your child should flush and wash their hands.
Be sure that any others who work with your child on potty training (therapists, school staff) utilize the same bathroom terminology, visuals, or signs as you use at home. The bathroom schedule at school, during therapy, or in any other location should also reflect the one chosen at home. Stick with the consistency even if you don’t feel like anything is working. Habits often take three weeks to establish, and for children with ASD, this can look much longer.
Use clear, consistent, fact-based, and positive language when your child is potty training. Using the restroom is a private activity for most people, and your child deserves kindness, dignity, and patience when learning this multi-step skill.
Reward your child for using the toilet by letting them do something a preferred activity afterward, or offer favorite snacks, toys, and videos to reward them when they are successful. Give your child positive reinforcement directly after they complete a task asked of them (reward each step of the way, whether your child is working on removing their clothing or eliminating into the toilet).
Some recent research has shown that behavioral techniques can help children with autism learn to use the bathroom effectively, even if they had previously had trouble with these skills. If you’re still having trouble with potty training your child on the spectrum, the BCBAs at Apollo Behavior can help.
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