How to Potty Train an Autistic Child: Therapist’s Top Tips

While working as a behavior technician in an autism clinic, I mastered the art of the diaper. I could put a diaper on a running child with one hand tied behind my back. During the kids’ time with us doing ABA therapy, we would also potty train them before they entered kindergarten. I’ve cleaned up after more accidents than I can count. I knew all of the spots in the playroom where kids would hide if they had to poop but didn’t want to leave to sit on the toilet. And, of course, the moment all of the children were finally out of diapers, a new class of children would start in the program and need to be potty trained.

All of this to say: I know how tough potty training can be. Potty training a child can be a challenging task, whether it’s your first time or your tenth. Each round has its own challenges and wins, from dealing with accidents to cheering on little successes. It’s an important move toward more independence for kids and their caregivers.

For children with autism spectrum disorder (ASD), potty training can be extra tricky. Learning to use the toilet can be a much longer process for these kids than for neurotypical kids. Sensory issues, communication barriers, and strict routines can all impact the process. Because of these different challenges, a standard ‘one size fits all’ approach to potty training may not be the best solution. Children with autism may need a more unique approach to be the most successful.

Understanding Autism and Potty Training

Understanding autism’s role in learning, especially when it comes to potty training, can make a huge difference in how the journey unfolds. Autism changes the way children pick up new skills, which can make something as routine as using the bathroom a bit trickier if not addressed specifically. For them, it is not just about learning to use the toilet. This process also includes learning how to deal with new sensations and changes in their daily habits that might be tough or strange for them.

Keeping these things in mind can help to determine the best possible types of interventions to try. It can also help parents get a better idea of why it might be hard or scary for their child with autism. It can remind them to stay patient and kind, even when things move slowly or hit a snag. Knowing what the child is up against makes it easier for parents to keep a cool head and a warm heart step by step.

Neurotypical individuals might not even realize how many sensory experiences are involved in a bathroom trip because they process them automatically. Many bathrooms have bright, harsh overhead lights right when you walk in. Toilet seats are cold and unpleasant on the skin, and water splashing up while using the toilet can feel startling and uncomfortable. Flushes can be loud and jarring. Soap can have a weird texture, and washing hands can be unpleasant if the water is too hot or too cold. There may be a whole list of other sensory experiences that a child may experience on top of this, all of which can make toilet trips incredibly stressful.

In addition to the sensory experiences that they may face, beginning toilet training also affects the child’s routine. More than likely, they have been consistently wearing diapers their entire lives up to that moment. They have been going to the bathroom in the same way their entire lives. Changing that very well-established routine can be especially challenging. On top of that, communication barriers make it so that children may not be able to communicate their need to go to the bathroom. This puts extra pressure on the parents to recognize their child’s need to go.

That said, there are many different variables to consider when learning how to potty train an autistic child. It is crucial to be patient and understanding. It is also important to be consistent in training and open to possible toilet training programs that may deviate from traditional methods. Since autistic individuals often learn differently, adopting unconventional or tailored potty training techniques can better align with their learning styles and needs.

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Preparing to Start Potty Training

The first and most important step in potty training is making sure that the child is ready. Any steps taken too early will only cause stress to everyone involved. These signs can vary from child to child, and so it is always important to discuss potty training with your child’s pediatrician before starting the process. They can also help to rule out any medical concerns that may hinder the process.

Some signs that a child is ready to start potty training include seeking out privacy before soiling their diaper, pulling at or showing other signs that they are uncomfortable with a soiled diaper on, being able to go longer periods (2 hours or so) without having a dirty diaper, having more regular/predictable bowel movements, being able to hold in bowel movements overnight, and being able to follow some basic one-step instructions.

Once it is established that they are ready for potty training, creating a conducive environment is key to supporting a child with autism through the potty training process. This usually involves making adjustments to accommodate sensory sensitivities and ensure comfort. Changes can be simple and easy, such as using soft lighting, providing noise-canceling headphones, or having comforting objects readily available near the toilet. Parents know their children best, and so these changes are very much dependent on the individual child being potty trained. These small changes can make a significant difference in easing anxiety during toileting.

Another important adjustment to consider is getting the perfect potty. Using the regular toilet is possible, although other options may work out better, especially for children who have stronger sensory sensitivities. Conventional toilets also might not be ideal for children with smaller bodies and weaker core muscles since it’s possible for them to fall back into the bowl accidentally. For children with autism, certain features can make a huge difference in comfort and better help the learning process.

Look for potties with stable bases, comfortable seats, adjustable heights, and supportive backrests. Parents should also consider getting one with a removable seat for easy cleaning – potty training can be a messy process.

Rewards, such as stickers or preferred treats, are not necessary but may be incredibly helpful since they may serve as positive reinforcement for desired behaviors. Assistive tools like step stools or toilet seat inserts can also provide additional support. 

Developing a Potty Training Plan

How to potty train an autistic child article

For any potty training strategy considered, a firm commitment to routine and consistency is key. Potty training is a marathon, not a sprint. As mentioned earlier, potty training changes a very well-established routine in the child’s life. Consistency is the best way to help establish new routines, even beyond potty training. Consistency is best kept when all caregivers (e.g., babysitters or other family members) are aware of the potty training strategies and when strategies are implemented at all times.

Caregivers should consider the potty training plan when making plans for the day or when going to different places. How long is the car ride from the daycare to home? Are there public bathrooms near the playground? These types of questions should be asked beforehand to make sure that whatever strategy is being used can be consistent throughout. Caregivers may also consider the use of visual aids when starting the process. This can help to better integrate bathroom breaks into the child’s routine through the use of a visual prompt.

Implementation Strategies

Gradual introduction to the potty lets the child familiarize themselves with the process and equipment in a way that is less likely to be overwhelming. Caregivers can start by sitting on it themselves with the seat down to show that it is safe to be around. Let them look at the toilet and maybe show them how to flush while they watch from afar. Parents can even find kid-friendly videos to watch with them about using the toilet. Overall, the goal here is to make it a stress-free environment.

Positive reinforcement is fantastic for making potty training a positive experience. Rewards like stickers, extra playtime, or small treats for successful toilet use can motivate the child and increase compliance when it comes to toilet time. Praise and celebration for each success help build confidence and reinforce good habits.

Throughout the process, accidents are almost certain to happen. Handling accidents with compassion and without punishment is essential. Punishment of any sort can hinder progress significantly. Understandably, parents can get frustrated, but scolding them for an accident can be detrimental and can instill fear. Instead of scolding, gently remind the child of the potty process and encourage them to try again next time. This approach ensures that potty training remains a positive experience.

Troubleshooting Common Challenges

It’s not uncommon for autistic children to experience fear or resistance when it comes to using the toilet. This can stem from any of the issues mentioned earlier or other issues that we may not be aware of that are stressful to the child. This is especially why approaching potty training with patience, empathy, and understanding is crucial. More than anything, it is important that their fear of the toilet is respected. Any use of force to have them sit on the toilet can exacerbate their fear and anxiety, erode trust, and create lasting negative associations with toileting.

Caregivers should understand that potty training progress is not linear. Setbacks or regressions are to be expected, especially for children with autism. When faced with setbacks, caregivers need to remain patient and consistent.

For nonverbal children or those with significant sensory issues, potty training methods may need to be further adapted. Visual schedules, picture-based cues, or sign language may be helpful in these types of situations. Additionally, adjustments to the physical environment, such as those mentioned above, can create a better space for toileting. There is no one-size-fits-all answer when it comes to accommodating strategies since all children are different. Ultimately, it is up to caregivers to work with their child to figure out what strategies may work best and which may be harder to implement.

Advanced Tips and Techniques

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Here are some tips to keep in mind during potty training:

  • Set a timer.

    Setting a timer is crucial for remembering dry checks and bathroom trips. Early in potty training, dry checks and bathroom trips should be frequent. The time between trips should grow over time, but setting a timer can help you stick to the schedule and avoid forgetting.
  • Get a wet stop.

    These alarms are easy to set up and help to make sure that the child is still dry without having to check. When wet, the alarm goes off and lets parents know.
  • Keep track of fluids.

    Knowing when and how much water a child has drank can help to figure out when they may have to use the toilet. It can also help to set them up for success in actually using the toilet and not just going through the motions. An important part of potty training is reinforcement and “catching” the correct behavior.
  • Buy underwear in bulk.

    This process is likely to involve a lot of soiled clothes. It is always a good idea to have a few pairs of clean underwear on hand.

Support for Parents and Caregivers

As mentioned a few times above, caregivers can easily become stressed out during this process. Because of this, self-care and support are essential for parents. There is an incredible number of websites and support groups available for parents to learn more about the process or connect with other parents. In addition, it may be helpful for parents to seek out professional help to assist with the process, such as a Board Certified Behavior Analyst (BCBA).

Conclusion

Potty training is an incredibly stressful but very rewarding process. It is one of the biggest early steps that a child can take towards independence. I have potty-trained boys, girls, toddlers, children, verbal, nonverbal, autistic children, and children with various other developmental disabilities, and all of these victories had two things in common: consistency and patience.

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