Toilet Training Children with Autism or Other Development Disabilities

Toilet Training Children with Autism or Other Development Disabilities

Over the years I have overseen the successful toilet training of many children. In fact, on a number of occasions I have received an e-mail from parents who successfully toilet trained their child after attending one of my presentations, but without my direct involvement. I never lose my enthusiasm for helping parents to toilet train their child with special needs, and while I always enjoy the satisfaction of watching a child gain independent skills, the satisfaction increases exponentially when I am able to help one more child to become completely toilet trained.

When I use the phrase “toilet trained”, I am referring to the ability to stay clean and dry when not wearing a diaper or pull-up, and when feeling the need to eliminate, the child will go to the toilet and eliminate independently, or when the toilet is not readily available (at a restaurant, someone else’s home, etc.) the child will appropriately communicate the need to eliminate. This is different from a child who is “schedule trained”, meaning that the child will stay dry and clean only if taken to the bathroom by someone else, on a regular schedule. A child who is schedule trained may have toileting accidents, occasionally or often, when there is a change in schedule, routine or when someone forgets to take the child to the bathroom. While a child is probably in a better situation when schedule trained, as opposed to having to wear a diaper or pull-up, that child is likely to be far better off when completely toilet trained.

Toilet training is something we all just tend to take for granted. First-time parents may deal with some anxiety and may worry about getting their child toilet trained, particularly if it affects placement in a preferred pre-school or day care class, but the worries generally fade away as the child matures and responds to traditional toilet training strategies. Sometimes, parents of a child with special needs will assume that their child will eventually mature and respond to traditional strategies rather than taking a more proactive approach to toilet training, or worse they may give up, thinking that their child cannot be toilet trained when the child does not respond to traditional strategies. This is often the case with children on the autism spectrum, as they often do not respond favorably to traditional teaching strategies in general.

The truth is that most children with developmental disabilities and delays, including children on the autism spectrum, can be toilet trained. However, the process may involve much more effort and time than with typically developing children. Toilet training should begin between 3 and 4 years of age for most children but no later than 5 years old. If a child with a developmental disability is 5 or older, toilet training should be at the top of the list for learning objectives. Of course, these are general recommendations and each child’s individual needs and abilities should be evaluated.

Aside from aesthetic and sanitary reasons, toilet training should be given priority because lack of independent toileting skills will likely result in reduced options for education, community activities, social interactions, and perhaps even living arrangements. Additionally, the need for diaper changing becomes more problematic as a child matures toward and into adulthood. In the case of a child with special needs, toilet training strategies will likely become more difficult to implement, if not impossible, by the time the child becomes a teenager, particularly if the child also engages in problem behaviors.

Therefore, toilet training should be considered a necessity, not a luxury, and if the first attempt at toilet training doesn’t work, parents should not assume that their child cannot be toilet trained, but instead should continue to seek strategies that may work for their child.

gail_waymanGail Wayman, M.Ed., BCBA is the Owner and Executive Director of The Wayman Center in Plano, Texas, which provides early intensive behavioral intervention to children with special needs. She is a Board Certified Behavior Analyst (BCBA) and a certified Special Education Teacher who has worked with children with special needs, including those with Autism Spectrum Disorders, for more than 15 years. She has worked in public schools as a Special Education Teacher, Behavior Specialist, and In-Home Trainer. She has also provided consultation services for school districts, private and public service providers, and families implementing in-home ABA programs. Ms. Wayman has presented workshops and training for various organizations such as the North Texas Autism Education Center, Autism Treatment Center, FEAT North Texas Autism Conference, Texas State Autism Conference and the Association for Behavior Analysis International (ABAI).

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