Most typically developing children toilet train between three and a half and four and a half years, and by the time they’re 5, most neurotypical children are completely toilet trained. However, research shows that less than half of children with autism are toilet trained by the age of 4 or 5. When a child isn’t toilet trained by this age, it can impact the entire family; including, the financial strain of buying diapers, limited options when it comes to school or daycare programs, and limiting families from doing activities they love, like going out to dinner or vacationing. Researchers in the field of Applied Behavior Analysis have created a body of research that establishes effective practices for toilet training. Lauren Cox, Director of Clinical Operations for the Southern California Region and BCBA, shares expert, research-based tips for toilet training a child with autism and how families can prepare for toilet training success.
Read More: FAQs On Hygiene & Autism
Individualized Toilet Training Plans
Behavior analysts draw on years of research that illustrates how to successfully toilet train individuals with autism. In addition to this research, Trumpet Behavioral Health has an incredible library of skills to pull from depending on the deficits your child is experiencing. To create this library, Trumpet pulls from landmark research as well as research from practitioners within our organization. As a research-focused autism therapy provider, our insight has paved the way for effective toilet training treatment plans for learners from every background. For example, if you’ve toilet trained your child in the past and they’re continuing to experience accidents, your clinical team will use a different approach than they would with a family who is new to toilet training.
Foundations of Successful Toilet Training
Before we begin toilet training, our team will determine if your child has the readiness skills to be independent, which is crucial to toilet training success. As part of this process, our team will explore if your child has an awareness of elimination. Are they aware if their diaper is wet? Do they try to take it off themselves? Depending on your child’s level of readiness, your team will prepare a toilet training framework to meet their needs.
Once we create a plan, we’ll coach your family through every step. Toilet training requires a significant amount of support, and we begin preparing families for this momentous learning experience weeks in advance. Our team will meet with you to set up expectations, outline the toilet training process, define success, and create a plan for when an accident does happen. By the time your family is ready to begin toilet training, you’ll understand how to react to accidents, how to respond to successful attempts to use the toilet, and what to do when your child “self-initiates”, or takes themselves to the bathroom.
How To Toilet Train A Child With Autism – 5 Steps Towards Success
The toilet training process has several important steps, which your autism therapy team will review with you before toilet training begins. Although your child’s plan will be customized to their needs, most toilet training programs for autism include the following steps:
1. Scheduled Sits
We want our learners to have success when they’re sitting on the toilet, so we’ll develop a sit schedule depending on your child’s history. This schedule will outline how much time is spent on and off the toilet during the training process. At the beginning, the schedule may be more intense and call for your child to spend 5 minutes on the toilet, 5 minutes off. As your child has success and begins to learn the basics of toilet training, the plan will gradually become less intense.
2. Celebrate Success
When a learner eliminates while on the toilet, it’s important to offer extremely potent reinforcement right away. As soon as they begin to go, give them their favorite snack, play their favorite video, blow bubbles, or give them something else they love. It’s important that your child receives an extremely powerful reinforcement at the moment elimination begins. You may be tempted to wait until your child flushes and washes their hands first, but that will make it more difficult for your child to link the reinforcement to the act of using the toilet.
3. Allow Them To Move Off The Toilet
After you reward your child for using the toilet, allow them to move off of it right away. Our goal is to train learners that being on the toilet is to eliminate – it’s not a place to sit and hang out. By allowing them off the toilet right away, you’ll reinforce that the toilet is for elimination and that they’ll be able to leave and do other fun activities outside of the bathroom.
4. Prepare For Accidents
As any child becomes toilet trained, accidents are bound to happen. When they do, remain as neutral as possible and refer to the procedure your therapy team created. Instead of providing a big reaction, use this as an opportunity to take your child to the bathroom. Avoid reasoning with your child about why they shouldn’t have an accident – it’s much more effective to teach them where to go and provide positive praise and reinforcement when they do.
5. Generalize The Skill
Research shows that toileting is successful across environments. After a few successful training days, try toilet training in different places, like a relative’s house, a grocery store, or in the community. Be sure to keep on your schedule and keep your reinforcers with you. The principles of toilet training are the same – you’re just in a different bathroom.
Toilet training can seem hard and daunting, but it works. Be patient with yourself and know that the first few days are going to be hard. Remember, if all supports are in place and the procedures are clear, success can and will happen.
Are you curious about toilet training your child with autism? Contact us today to learn more about our individualized approach to autism therapy.
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