Autism & Toilet Training: Tips to Help Parents and Caregivers

Your child may be exhibiting signs they are ready to be toilet trained, or maybe you are just very eager to ditch the diapers. Toilet training a child requires the right balance between a child’s readiness to learn to use the toilet, and a parent’s readiness to do the training. When a child has autism, toilet training could come with specific challenges. What we know is that all children are different, so whether your child is diagnosed with autism or neurotypical, it’s a complicated process to sign up for. 

That said, a toilet trained child is quite an accomplishment for themselves and for the parent. Say goodbye to the cost of diapers or pull-ups and improve your child’s confidence in being able to independently use the restroom. It’s worthwhile to begin the process of toilet training once you believe it’s the right time to do so. 

Signs Your Child Can Toilet Train

A child’s toilet training readiness is much more about their developmental progress than their age. While it’s normal for a parent to observe a child’s peers successfully completing toilet training and wanting the same for their own child, toilet training readiness depends greatly on individual circumstances. 

Is Your Child Ready for Toilet Training?

Here are some common signs they could be ready:

• Your child does not like the feeling of a wet diaper, and will take it off on their own to demonstrate their discomfort.
• They show interest when a sibling or adult uses the toilet.
• They will take an adult to the bathroom to get a new diaper. 
• Throughout the day, their diaper remains dry for longer periods of time.
• They can pull their own pants up and dress themselves.
• The child can sit on a toilet or training seat on their own.
• Your child consistently goes to the same spot or hides when they need to void in their diaper

At What Age Can a Child with Autism be Potty Trained

Potty training for a child with autism can vary significantly from one individual to another. Autism is a spectrum disorder, and children with autism can have a wide range of developmental and sensory challenges that may affect their readiness for potty training. Some children with autism may be potty trained at an earlier age, while others may require more time and support.

Here are some general guidelines to consider:

1. Readiness: The most important factor in potty training is the child’s readiness. This readiness includes the child’s ability to communicate their needs, follow simple instructions, and their awareness of bodily sensations related to elimination. Some children with autism may take longer to develop these skills.
2. Sensory sensitivities: Children with autism may have sensory sensitivities that affect their ability to use the toilet. They may be sensitive to the feeling of underwear or the toilet seat, the sound of flushing, or the sensation of going to the bathroom. Addressing sensory issues is important in potty training.
3. Visual supports and routines: Visual supports, schedules, and routines can be especially helpful for children with autism. Using visual schedules and cues can help them understand when it’s time to use the toilet and what to do.
4. Positive reinforcement: Positive reinforcement, such as praise, rewards, or a preferred activity, can be used to motivate and reward a child for successful potty training attempts.
5. Patience and consistency: It’s essential to be patient and consistent throughout the potty training process. Be prepared for setbacks and understand that it may take longer for a child with autism to become fully potty trained.
6. Individualized approach: Every child with autism is unique, and what works for one child may not work for another. It’s important to tailor the potty training approach to the specific needs and challenges of the child.
7. Seek professional guidance: If you’re struggling with potty training your child with autism, consider consulting with a pediatrician, a developmental specialist, or a behavior therapist who has experience working with children on the autism spectrum. They can provide personalized guidance and strategies.

In some cases, children with autism may not become fully potty trained until they are older than their typically developing peers. The key is to be patient, understanding, and supportive, and to work with professionals who can help develop an individualized plan for your child’s needs.

Do Children with Autism Potty Train at the Same Age as Their Peers?

It may initially seem daunting to toilet train your child, especially if they are nonverbal or have communication challenges. That said – you can do it! It is common for children with autism to toilet train later than their peers, possibly related to other developmental delays, but every child is different and not all children with autism potty train later than their peers. Applied behavior analysis (ABA) therapy can help parents and caregivers successfully teach their child to toilet training by providing rewards when success occurs, and de-emphasizing less desired behaviors during the process. 

Common Toilet Training Obstacles

• Because some children have used a diaper for many years, breaking this long-established routine is a challenge all on its own. 
• Sensory overstimulation around a toilet (noises, new environment, water running) makes it a more challenging place for a child to learn a new life skill. 
• Many children with autism do not display common signs they need to use the toilet, such as the “potty dance” or crossing their legs. Accidents are common.

4 Tips to Start Toilet Training

How to Toilet Train a Child with Autism

• Use visual cues to communicate how to use the toilet. A visual schedule that shows to first sit on the toilet, then wipe, then flush, and then wash your hands, can be a powerful tool to communicate with your child what to expect in the process. Some children, especially nonverbal children with autism, may communicate in different ways during the toilet training process, so look for these cues. Some children look at their parents intently right before using the toilet. This is a cue — follow your child’s lead!
• Make potty training fun, and tell your child it’s a potty party day! Show them the rewards you have ready: their new, comfortable potty, their colorful undies and the juice, liquids and other snacks they can enjoy during the time you will be together for potty training. Your enthusiasm will go a long way in getting your child excited about using the potty, too!
• If an accident happens, avoid making it a big deal. They will happen. Instead, clean up quickly and move on. Give your child much more attention and praise when they use the toilet successfully. 
• Rewarding positive behaviors will go a long way when it comes to potty training! Have your child’s favorite treats, toys, or prizes on hand to reward your child when they successfully use the toilet. 
• Use a timer during the days you are toilet training them, and take them to the bathroom every 20 minutes. Provide more liquids and salty foods than normal, since this will help them actually need to use the restroom more often. They will be able to identify the feelings of needing to use the bathroom with the act of going to the bathroom and doing that more often if they take in more liquids than usual. Once your child is catching on to the process (for some, it could be as soon as two days), you can make the increments between the time you are using a timer longer, and decrease the frequency you are giving your child liquids and salty snacks.

Here’s how ABA therapy can teach potty training:

Assessment and Individualized Plans: ABA therapists begin by conducting a thorough assessment of the child’s current skill level, including their understanding of toilet training and any relevant challenges or barriers. Based on this assessment, they create an individualized plan that considers the child’s unique needs, preferences, and abilities.

Breaking Down the Skill: Potty training involves several smaller steps, such as recognizing the urge to go, communicating the need to use the toilet, undressing, using the toilet, wiping, flushing, and washing hands. ABA therapy breaks down the entire process into these manageable steps.

Visual Supports: Visual supports, such as schedules, social stories, and visual cues, are often used to help the child understand the steps involved in potty training. These aids provide clear and structured information about what is expected.

Positive Reinforcement: ABA relies on positive reinforcement to motivate children to engage in desired behaviors. In the context of potty training, therapists and parents use rewards or preferred items to reinforce the child when they successfully complete a step in the process. This can include verbal praise, small treats, or access to a preferred toy or activity.

Prompting and Shaping: Therapists may use prompts and shaping techniques to help the child perform each step correctly. For example, they might physically guide the child through the steps initially and gradually reduce assistance as the child becomes more independent.

Data Collection: ABA therapists are systematic in their approach. They collect data on the child’s progress, recording successful completions and any challenges or regressions. This data allows them to adjust the program as needed.

Generalization: ABA therapy places a strong emphasis on generalizing skills. This means ensuring that the child can perform the potty training steps not only in one setting but in different environments and with different people, making the skill more versatile.

Functional Communication: For children who struggle with communication, ABA therapy can help teach them to express their need to use the toilet effectively. This may involve using signs, gestures, or a communication device to request bathroom breaks.

Consistency: Consistency is crucial in ABA-based potty training. Parents and caregivers are often trained to maintain the same approach, use the same reinforcement strategies, and provide the same expectations across different settings to minimize confusion for the child.

Transition to Independence: ABA therapy works towards the ultimate goal of helping the child become independent in using the toilet. As the child progresses through the steps and demonstrates consistency, therapists gradually fade the use of prompts and external reinforcement.

Potty Training Kids with Autism – Frequently Asked Questions (Q&A)

There are so many aspects to toilet training you may have questions about. At Acorn Health, parents can work alongside a child’s clinical team during potty training to troubleshoot any concerns that come up. Here are some common questions parents have asked our team during toilet training:

How long will it take to toilet train a child?

Toilet training will require planning, consistency and lots of patience. It may take your child a weekend, and it could also take them months of trying the toilet training process over and over again. Establishing a clear reward and reinforcement system will go a long way in getting your child involved and excited about the process.

What if my child has a fear of flushing?

The flushing sound can make a neurotypical child as well as a child who has autism uncomfortable around the toilet. To stop the automatic flusher from occurring if you are in a public restroom, place a sticky note over the sensor so that it flushes after your child walks away.

What if my child plays with toilet paper?

Many children who have autism enjoy playing with toilet paper, this is common. The sensory component of toilet paper is interesting; it’s lightweight, bright and soft. Find other toys or household objects that can fulfill this sensation for your child, such as a favorite blanket to keep nearby during toilet training.

Does autism affect bowel movements?

Some children have lower liquid and fiber intake due to a restricted diet, which can make constipation more likely. Both during potty training and after, add more fiber-rich foods to your child’s diet to make constipation less likely of an issue. Many children with autism have gastrointestinal issues, so make sure your doctor evaluates your child before beginning potty training, as GI issues could make the process more complicated. It’s also common for children to do “fecal smearing.” This occurs for a variety of reasons, but is not uncommon. Your child may have intense discomfort if they are holding their bowel movement, and then choose to release their bowel movement in a place other than a toilet. They may also enjoy the sensory experience of touching fecal matter, or they may want attention. Take note of their behavior before and after fecal smearing occurs, and work to praise instances they do not continue that behavior to prevent it from recurring.

ABA therapy can support your family during the toilet training process, and through other important developmental milestones and life skills. If you have questions about ABA therapy, or would like to request ABA services for your child, call (844) 244-1818.