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Many children with autism spectrum disorder (ASD) struggle with potty training, or do so at a later age compared to children without ASD. This can be multifactorial in nature, and attributed to several factors they may experience — including but not limited to:
- General development delays
- Intellectual disabilities
- Challenges with communication and language
- Sensory delays
- Physical or structural abnormalities
- Stress and/or anxiety
- Dietary intake
- Constipation
Below are a few tips for potty training a child with ASD:
Prepare, set realistic expectations, and be patient
Support systems, standardization, and schedules
- Have a support system in place. All of the child’s caregivers should be on the same page for this journey. They should be aware of expectations and adhere to the same routine.
- Many children with ASD benefit from strict routines and schedules. This can be advantageous with toilet training.
Keep instructions simple and consistent
- Most children with ASD benefit from simplicity and redundancy. When explaining the toilet training process and enacting the plan, be clear, succinct, and consistent.
- Practice timed toileting: Have the child sit on the toilet every hour or so to start so they get used to sitting, and hopefully peeing, on the toilet. Slowly increase the interval if the child can stay dry in between.
- Consider utilizing external reminders, such as toilet training watches, which can provide auditory/vibratory reminders to use the bathroom. These can help children feel more independent and in control.
Positive reinforcement only
- Always provide ample positive feedback and consider enacting positive rewards. Celebrate success too. Sticker charts can be helpful if the child can conceptualize and work toward a goal or prize. External motivation is helpful.
Pause if necessary
- If the child is resistant and/or not motivated, consider pausing the effort and retrying in a few weeks or months. Child initiation to toilet train can be a positive predictor of success.
If no progress is being made, seek help
- If there has been no success in toilet training after ~6 months, seek help from the child’s healthcare provider. Never be afraid or hesitate to engage them in this process, as early intervention is best. They may identify a physical reason impeding toilet training, such as constipation, a medication side effect, or a physical abnormality that needs addressing, and they can involve other specialists as needed.
