Toilet Training Among Young Children with Autism, continued from Page 11
Domain of
Toilet Training
Setting up the
Routine
Strategies
• Have the child sit for very short periods of time, building up to 5 minutes of sitting on the toilet at
a time.
• Sit the child on the potty at the same times every day so it becomes part of the everyday routine.
• Go through each step of the process each time the child sits, including dressing, tearing toilet paper,
wiping, redressing, and washing hands.
• Reward the child for sitting, even if it is for 15 seconds at first, to make the routine fun.
Creating
• Select a potty chair or toilet seat that allows the child to sit with stability and comfort.
an optimal
• If using the toilet, make sure the child’s feet are stable and the child appears comfortable when
environment
sitting.
• Select a bathroom that is closest to the child’s play area.
• If using a potty chair, place the potty chair in a location that is near your child’s play area.
• Have preferred items (e.g., toys, books) in the bathroom to create a fun and comfortable space for
toilet training.
Awareness
• Understand if the child is aware of when he/she urinates or has a bowel movement in the diaper: Is
there any indication that he/she notices when wet or dirty?
• If the child is not aware, try underwear and point out when the child is wet or dirty. Sometimes
diapers are so absorbent, children do not feel the wetness.
• If the underwear becomes too messy, try underwear under the pull up. This may provide the child
with a little more awareness of what it feels like to be wet or dirty.
• If the child pees in the bath or shower, point it out and make sure the child is aware (e.g., “You are
peeing!”).
Sensory
• If the child is afraid of the toilet flushing, let the child practice flushing. Give the child control; this
Processing
may mean not using bathrooms with automatic flushing. Or let the child wear headphones in the
bathroom.
• Explore different bathrooms at home, school, or in the community. Some bathrooms may be more
acceptable to children than others – be observant of these and figure out why (e.g., lights, size of
space).
Motor Skills
• Set up the environment so the child is completely stable on the toilet. Many children will not relax
enough to void if they feel unstable; this means having a child-sized toilet, a foot stool or even handle
bars on the sides of the toilet. Many child-sized toilets and modifications are available for purchase
online.
Communication • Use simple language (e.g., “potty time,” “pee,” “poop”, “you’re wet”).
• Use pictures and words to reduce the amount of language needed.
• Watch for nonverbal signs that your child needs to use the bathroom (e.g., a potty dance, grabbing
their diaper, squatting, universal potty posture with knees squeezed together).
Dressing
• Select clothes that are easier to take on/off (e.g., elastic waist bands).
• Add stickers to your child’s clothes to help them distinguish back/front.
• Consider how the child would dress more effectively: sitting down or standing up.
• Practice dressing during every trip to the bathroom.
Wiping
• Practice tearing sheets of toilet paper. Figuring out how many sheets is a skill that needs practice.
• Practicing wiping in other daily activities to help provide an understanding of “clean” (e.g., tearing
off a paper towel, wiping the table after dinner, wiping their face).
Continued on Page 13
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