Potty training any child is difficult, but potty training a child on the autism spectrum or a child who has another developmental disability can be particularly trying. Our little ones like their routines and are often resistant to any changes, and they often have sensory issues and ritualized and repetitive behaviors which make it difficult to transition from eliminating in their diapers (which, remember, is all they have known, and with which they’ve gotten very comfortable) to the potty (which is a new, unfamiliar place, with new sights, sounds, and feels to process). Furthermore, little ones with limited expressive language capacity aren’t able to easily tell us when they need to go to the potty, or what they don’t like about going so that we can help them. Here is how we approach potty training:
Start by establishing a consistent schedule to “habit train” your child so that he or she is used to going to the toilet to eliminate. At first, you will need to take your child to the potty every 30 minutes (sometimes more frequently – for younger and lower-functioning children, you may need to start with every 15 minutes). When first starting, try to check for a dry diaper before bringing to the potty so that your child has a chance of success.
At first, just have your child sit on the potty. When they do sit, get super excited and give lots of praise. For really stubborn children, you may have to slow the process down and break it into more incremental steps so there is less change to process all at once; for example start by just going to the bathroom and sitting on the potty fully clothed, then move to sitting while still wearing a diaper, and only then move to sitting on the potty with pants and diaper off.
Gradually increase how long your child sits on the potty. Use a timer to help your child understand how long they need to sit, and to remind you. Better yet, because our kids are such visual learners, use a visual timer for this purpose. You can either buy or borrow a fancy one, or you can just use an old egg timer or hourglass if you have one lying around.
Bring a favorite book, toy or other activity along, so that your child can look at it or play with it while on the potty. You want to make going to the potty a pleasant experience, not an anxiety–producing pressure–filled experience. I personally strongly prefer to avoid food–based rewards, but if that is what motivates your child, use it.
Another visual aid that really helps is a chart that shows your child in pictures each step of the process. For example:
1. pants down
2. sit on potty
3. toilet paper
5. pants up
6. wash hands
You can use the visual aid to prompt your child throughout the process.
Another approach that helps is to create a visual schedule for your child’s day so that he or she can see when it is time to go potty throughout the day (remember, this will be every 30 minutes to start). On the visual schedule, you can put something highly motivating (favorite toy) after potty trips so that your child knows that he or she has something to look forward to after going, and begins to establish a positive association with going to the bathroom.
Once your child successfully goes for the first time on the potty, throw a huge party in the bathroom, and give rewards. Make going to the bathroom so much fun! It is key to reward and reinforce success.
By the same token, try not to be negative or to get frustrated when your child doesn’t go (which will be often, since you’re starting with every 30 minutes). Doing so may create more anxiety in your child, which often leads to withholding elimination and creating bigger issues. Unsuccessful trips are no big deal – you’re just training your child to go, and there’s always next time.
To prime your child before going to the potty and then to reinforce after success, consider using a social story. If your child can read, you can have them read the social story to you.
Make sure everyone in your child’s life (family members, caretakers, therapists) is on board and ready to help you be consistent across environments, which is the key for achieving success.
To get off to a good start, we often recommend devoting an entire weekend when your life is at least slightly less crazy than normal to a potty party for your child. You can increase fluid intake so that your child has more opportunities for success and just devote the entire weekend to spending a lot of time in the bathroom so that you’re really focused on establishing good routines. If you can get someone from your therapy team to help for all or part of this initial period, even better.
Video modeling is another approach you can use that is near and dear to me and to Jenny – click here to check out our complete line of video modeling DVDs. And because our children are such visual learners, you can use a camera to document the process and to record successes, and then later use the video models to prime your child before going to potty and later to reinforce success, similarly to the way you would use a social story. However, we don’t have a Teach2Talk video on potty training, and I’m often asked why. The short answer is that we would love to, but the best video models actually depict the desired behaviors, and we’ve been unable to come up with a way to do this in good taste and that would be legal in all jurisdictions.
Yes, I know that all of this is a lot of work for you (remember, I’ve helped potty train a lot of children on the spectrum – but of course I get to go home at the end of each day, while you won’t). But if this approach is applied consistently for long enough, it will work for almost any child. Of course every child is different and you may need to adapt the approach to your little one, but when doing so please try to remember that consistency and rewarding success are the keys. Also, remember to be realistic about your child’s current capabilities. Some children will pick this up in a few days, many in a few weeks, while others will take longer, and may need to have the experience broken down into smaller, more incremental changes to achieve success. Throughout the long process, please try to remember how much easier it will be for you and how much better your child’s day-to-day life will become when he or she is potty trained. Good luck!