Potty training is tough, and if your child has autism, there can be additional challenges due to sensory or social quirks that make ditching diapers even more difficult. Still, potty training is entirely within most kids capabilities; it just takes figuring out ways around their issues and the right motivation to get them moving.
For expert tips on making toilet training kids with autism easier, read on.
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Drop the diapers (and the pull-ups!). "For many kids, wearing a pull-up while toilet training can be a nice bridge that prevents messes when the child has accidents," says Katherine Walton, assistant professor of psychology at the Nisonger Center at The Ohio State University Wexner Medical Center. "But for children with learning disabilities like autism, continuing to wear a diaper or pull up can get in the way of learning independent toileting skills."
The reason: Some kids with autism are under-responsive to bodily sensations — like the fact that they are wet. So, super-absorbent pull-ups just further muffle the little sensation of wetness they feel … so why run to the bathroom when all feels fine? Instead, switch straight to underwear. "It may be messy at first, but it will help the child to associate the feeling of needing to urinate with the feeling of being wet — and encourage them to use the toilet, since having wet underwear isn’t all that fun," Walton explains. -
Try "sit for six." Most children with autism thrive on routine, so rather than winging it and waiting for your child to tell you he's gotta go, make it easier on him by making scheduled bathroom trips. At first, aim for six trips where they head to the bathroom and sit on the john. At first the trips can be as short as a few seconds, but try to lengthen that over time up to 10 minutes apiece (using a timer can help). If your child urinates or defecates, he can leave — which helps him realize that peeing and popping on the potty are good things!
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Draw up a chart. Since many kids with autism also learn through visual aids, it can help to draw up the schedule with images for each step of toilet training, from pulling down pants and sitting on the toilet to flushing and washing hands (the organization Autism Speaks has a sample visual toilet training schedule you can print out). Then, "go through ALL of these steps each time to help the child understand the routine, even if the child doesn’t need to do them all, like defecate in the toilet," says Walton. "This can also help parents to identify trouble spots in the routine that are hard for the child and might require extra practice."
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Pinpoint problem areas. "Some children with autism may have unusual fears or anxieties related to toileting," says Walton. This is because in addition to under-responding, kids with autism also over-respond to sensations — for instance, the flushing toilet may seem too loud, or perching on a toilet set may feel too precarious. If so, try your best to alleviate these problems by getting a footstool or at least closing the toilet seat when you flush to dampen the noise.
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Establish the right reward. If you're open to using rewards to toilet train, they can be a powerful motivational tool — only kids with autism may not respond to the same kinds of carrots as their peers. For instance, since they often don't respond to social interactions the same way, encouragements like, "don't you want to be a big boy" or "don't you want to be like your big sister?" may not work as well as with other kids. Generally more tangible rewards like treats or time with a coveted toy may be more motivating, but try experimenting to see what works.
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When in doubt, consult a professional. If you've tried all of the above to no avail, you may want to consult your pediatrician or other professional. "They can also help screen for any problems that could be contributing to toilet training difficulties, such as constipation or other gastrointestinal difficulties," says Walton. "If your child is getting older and typical strategies haven’t worked, these professionals can also help you put together a more individualized plan that will work for you child."
What's been your biggest potty training challenge? How have you gotten around it?
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