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Are you experiencing difficulty in toilet training your child who is diagnosed with an Autism Spectrum Disorder (ASD)?
Before you begin training, it is important to understand the desired outcomes and target behaviors for toilet training.
Priming is a teaching method that involves providing information that will help someone perform a task or activity.
Because toilet training is a difficult task for most children, it is important to recognize and praise your child for their achievements. Once a reward has been established, it is important to have specific target behaviors for your child to achieve. Positive practice, also known as overcorrection, and restitution, are considered “aversive procedures” because they are used after an accident occurs with the goal of preventing such mishaps from occurring in the future. Scheduled sittings is a practice that involves designing a schedule of specific times during which your child will sit on the toilet. The above-mentioned interventions have been shown to be effective in clinical studies of children with autism. About this site Philosophy Why use this website?
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The idea is to present information before completion of the task in order to allow the person to become familiar with what is expected.
Reinforcement-based training involves rewarding your child when they successfully learn and complete a toilet training behavior 3 .The first step in this intervention is choosing a reward to use as reinforcement.
For example, your first goal may be for your child to effectively flush the toilet after each toileting attempt. Although reinforcement procedures are generally preferred, these practices are shown to be successful and have fast rates of learning proper toileting behaviors 3. You can create this schedule in one of two ways: (1) observe your child’s bathroom behaviors for a period of 1-2 weeks, paying attention to the times in which they urinate or defecate in their diaper or (2) identify regularly scheduled times, such as every 60 minutes. It is important to note that these interventions are typically provided by or in conjunction with a behavioral psychologist.
Research shows that while typically developing children are usually toilet trained between ages 2–3, toilet training is often delayed and at times never achieved in children with ASD 4.
These behaviors include: waiting until on the toilet to urinate, undressing, sitting on the toilet, correctly using toilet paper, flushing, re-dressing, and washing hands 4.
This consequently increases the likelihood that they will complete the behavior appropriately 1. The first step of this intervention involves “environmental restitution”, which means that the child helps to clean up the site of an accident. Increasing fluid intake will increase the likelihood that your child will urinate during the scheduled times and continue to engage in the positive behavior.
As such, we strongly recommend that parents consult with a professional prior to implementing some of the above interventions. The use of priming to introduce toilet training to a child with autism. Focus On Autism And Other Developmental Disabilities, 14(2), 106-109.
The potty journey: Guide to toilet training children with special needs, including autism and related disorders.
Given these findings, it is not surprising that the state of Michigan, through Medicaid and the Family Support Subsidy (FSS) Program, provides financial assistance to families with a child with severe developmental disabilities to aid in the cost of special care expenses, including diapers when deemed appropriate.
Given that children with ASD may require more time to learn a new task 1, video priming is suggested as a toilet training method because some children with ASD have keen visuo-spatial abilities 4.
If your child asks for the reward at other times during the day, remind him or her specifically what they need to do to receive the treat.

After restitution, the child is made to sit on the toilet a number of times, walking from the site of the accident to the toilet. It is important to keep in mind, however, that risks such as electrolyte imbalance are possible, so be sure to seek the advice of a doctor before initiating this practice 3. Sunfield Center psychologists are available to help address toilet training challenges and other issues faced by families of children with autism.
Teaching toilet skills in a public school setting to a child with pervasive developmental disorder. Journal Of Behavior Therapy And Experimental Psychiatry, 28(2), 163-168. Incontinence in children with ASD can further exacerbate challenges with the child’s hygiene, self-confidence, and acceptance4.
One study tested the use of an animated toilet training video before the onset of training, finding that it increased the speed at which a child acquired toileting skills 3.
Lastly, be sure to provide behavior-specific praise and a lot of attention, including hugs, high-fives, and cheering throughout the entire process 2. The main goal here is to teach the child the proper toileting behaviors that are desired in place of having accidents 3.
If the child successfully urinates in the toilet, make sure to provide the appropriate reward and then allow the child to leave the toilet area 3. Various toilet training interventions have been developed specifically for children with developmental disabilities including ASD. A video also minimizes the need for oral instruction, which is especially helpful for children who are non-verbal 4 . When rewarding your child, be sure to do so in small amounts and limit access to the reward outside of successful toileting behaviors. This will help ensure that your child stays motivated and interested in earning the reward2. Even if the child does not go on the potty you can praise her for making partial progress.How does a potty chart work?Potty charts basically remind you to praise your child’s effort during potty training and recognize small achievements along the way. Our printable potty charts list the milestones that need to be reached until your child can be potty trained.
Complement her and let her know what a good job she is doing even if she doesn’t make it to the potty on time.For some kids getting stickers on their potty chart will be all they need to keep them motivated. Some kids will want a prize when they complete their chart or each time they are successful. We call this a “potty prize” and if you are going to give one then you might find it helpful to keep a jar of small prizes handy during potty training.
See what works for your child.Isn’t giving my child a “potty prize” a form of bribery?A reward is given AFTER your child successfully uses the potty.
A “potty prize” should be given soon after your child successfully uses the potty in order to make a firm association between the “potty prize” and the success on the potty.

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