Having trouble with or feeling timid about transitioning your client with autism from diapers to the toilet? Fret not! Follow the steps below – it’s the approach we’ve used for many years to successfully toilet train our clients. Remember: Be patient, be consistent and be your kiddos biggest cheerleader as she learns to use the washroom like a big girl.
Start and stick to a toilet training schedule
The first thing to do is to ditch the diaper. The child should be in underwear all day. At night, he can sleep in a diaper or pull-up.
Step 1: Put the child on the toilet at regular intervals.
At the beginning, take her every 10 minutes. Set a timer so you both know when it’s time to go. When it chimes, show the child a small picture of a toilet and say: “Pee pee” or “I want the potty.” Encourage her to point to the picture and say the words, so she’ll know how to, eventually, ask for the toilet by herself. Then sit her on the toilet for 1 minute. If she pees on the potty, give her over-the-top verbal praise and a favourite treat, such as a preferred cracker or cookie (the only time she should get these nibbles is when she goes to the bathroom appropriately). If she doesn’t pee, simply pull up her pants and resume what you were previously doing, resetting the timer for 10 minutes.
NOTE: If, like some kids, your kiddo refuses to sit on the toilet or go anywhere near it, then hold off on Step 1 until she thinks the bathroom is a cool place. To help her come around, make the bathroom fun: Play her fave music and, on the floor, colour or watch funny YouTube clips together. Once she tolerates the floor, incrementally move your play closer to the toilet until she hops on the porcelain throne to listen to her favourite tunes. *Keep her in diapers until she is no longer scared of the bathroom.*
For more on when a child is ready for toilet training and a program for teaching “Tolerates Toilet”, see When is a Child Ready for Toilet Training?
Step 2: Increase time intervals.
Once the child is accident-free for two consecutive days, take him to the potty every 15 minutes. Then, after two more dry-pants days, systematically increase the time interval by 5 minutes until he is on a 45 minute to 1 hour schedule, or until he is initiating regularly.
Step 3: Dry pants checks.
A child will toilet train faster and more successfully when you praise her for having dry underwear. Halfway through intervals, ask her if her pants are dry; teach her how to feel her pants with her hand. Give her lots of verbal praise – “Your pants dry, I’m so proud of you!” or “Yes, fantastic!”– and, if hoorays aren’t motivating enough, a small edible treat. Then, to reinforce the toilet training procedure, say, “You go pee in the toilet.”
Step 4: Implement an accident procedure.
If the child is progressing well with positive reinforcement, then move onto Step 5. If, however, he isn’t learning by positive rewards alone, it’s a good time to draw attention to accidents. When he has an oopsy, stay neutral and say: “You wet your pants.” Sit him on the toilet for a few seconds, pull up his trousers – keep the wet clothes on for now – and walk back to where he urinated. Repeat this sequence a few times, being careful not to praise if he pees a little on the potty during the process. Remember to keep your tone and reactions neutral. Thereafter, prompt (show him what to do the first few times, then encourage independence) him to get dry clothes, wipe himself in the bathroom and put the wet clothes in the laundry hamper. Finally, have him clean up the accident with a paper towel (with your hands-on help the first few times). The goal of this natural consequence is that the child will learn that it’s far easier to urinate on the toilet than in his pants.
Step 5: Initiation.
When the child is able to stay dry for up to 1 hour, stop bringing her to the potty. At this point, she should learn to use the words you taught her to ask for the toilet when her bladder is full. If she doesn’t initiate independently, stop reinforcing for peeing on the potty and, instead, give her a small reward when she requests the bathroom. Here’s how the sequence should play out: Macy has to go and you can tell by her pee-pee dance. You bring her to a picture of the toilet – have several posted on door frames throughout your home so there is always at least one in reach – and then, after seeing the imagine, she says, “I need to pee.” You say, “Wow, Macy, great telling me that you need to pee!” Immediately provide her with something small that she likes, such as a sticker, Goldfish cracker or gummy bear. Thereafter, quickly bring her to the bathroom to complete the process.
Bonus tips for toilet training success:
- Be consistent! Stick to the potty schedule like glue to ensure quicker success. Wax and wane and it’ll take longer to toilet train, because the child may be confused about where it’s okay to eliminate and, as such, have more accidents.
- Make sure the child is drinking a lot of fluids. A full bladder will give him more opportunities to pee on the potty.
- Track where and when the child urinates on a simple chart. It’s easiest to use a simple data sheet to keep track of what’s happening and how often. If you’re creating your own, be sure to include the date, time, accidents, successful pees on the potty and initiations. This visual will help you see/know when to increase the time between potty intervals.
4. We said it before and it’s worth saying again: KEEP YOUR KIDDO IN UNDIES during daytime hours! It’s vital to ensure that the child does not get confused about when and where he can empty his bladder.
Need more help toilet training your client? Join The Bx Resource and you can watch our recent training video on Toilet Training AND download more of our data sheets and programs on toilet training: www.howtoaba.com/joinbxresource
Image by arztsamui at FreeDigitalPhotos.net
Reference: Azrin N., Foxx R. Toilet training in less than a day. New York: Simon and Schuster; 1974.