Thursday, August 15, 2013

Potty Training your child with autism

Ok…so, take my advice. DO NOT start this potty training procedure unless you have nothing else to do! And even better…don’t leave the house! I started doing it on a Sunday and made some progress, but then Monday morning…BOOM! I had a TON of work to do…I work from home. I tried…I really did. But, I had to put it off after only one day. As you can imagine, I wasn’t really getting any work done…Having to get up every 5 minutes and whatnot.


This is the only potty training procedure that I have seen that is even close to working for a child who doesn’t really respond well to social interaction (praise) and is nonverbal. The repetitive nature of this potty training procedure is perfect. I know that Alex learns best through repetitive and consistent instruction.


At this point Alex will push “potty” on his communication device when he needs a diaper change and is consistently using the potty when taken to it. Our only hurdle now is to get him to understand that he needs to tell us “potty” before he urinates/has a bowel movement in his diaper….that he should only do this in the potty. But, pretty good progress…eh? J For his reinforcer I was using bubbles and that was really fun, but I think I am going to have to think of something even more motivating. Finding something that your child will just go crazy over is the key…well, that and consistency. If they love the iPad, take it away for a few days or a week and then only give it to them when they use the potty. If they have a favorite candy, food, song, toy, etc…take it away and then only give it to them when they are successful. If the reinforcement is not enough to make them want it really bad then it will take longer.


So, just make sure you are prepared first before starting potty training as it will help a great deal! Don’t just prepare the items that are listed above, but also prepare yourself to follow through! Just keep thinking about the end result and how much you will be helping your child in the long run. We have been turned down for several things all because Alex is not potty trained. You will get discouraged and you will get frustrated. I know. I only did it for one day and was thoroughly frustrated and worn out. Alex did pretty good and was tolerable of me interrupting his play every 5 minutes, but at first he didn’t want to sit on the toilet that long and he can get aggressive. I can never get used to my son trying to hurt me or making him get to the point where he wants to. But, I just prayed and asked others to pray and God helped me through it and I think helped me to see that I can only do so much. That said, don’t beat yourself up if you do need to take a break and regroup.


You’ve got this. Your child CAN be potty trained!




·         Ability to Learn

·         Mobility

·         Physical sensation of the need to eliminate (this is assumed…unless there is a medical condition that prevents it)

·         Ability to control elimination (also assumed)

For More Information…

·         Toilet Training Persons With Disabilities: A Rapid Program For Day and Nighttime Independent Toileting, Richard Foxx

·         Toilet Training in Less Than a Day, Richard Fox & Nathan Azrin


·         Adult toilet or potty chair? (adult seat is suggested so there is no transition needed)

·         Underwear or training pants will be worn during the day. Diaper or pull up may only be worn at night.

·         Training pants

·         Center and side panels made of 100% polyester white batting.

·         2 kitchen timers or stopwatches (on phone) with minutes and seconds.

·         Reading material in bathroom(s) (for the parent to pass time)

·         Chair or stool in bathroom(s) (for parent to sit on)

·         Changes of clothing in bathroom

·         Paper for keeping track of Urinating in Toilet, Accidents, Dry Pants, and if the child WI (walked in the bathroom, WT (walked to toilet), ST (Sat on toilet), FI (fully initiated)

·         Reinforces (things the child enjoys. Ex. Favorite foods, toys, etc…)

·         Plan ahead for a start date

This procedure is very intensive in the first days and possibly weeks. Therefore, preparation for allotment of time for implementing the procedures consistently and correctly is crucial to achieving the desired outcome of toileting at a level of independence that is age-appropriate.



·         Put child in underwear or training pants as soon as child awakes. Diaper/pull-up may only be used at night. No diaper/pull-up during nap or car rides. (can put a liner and towel in car seat)

·         Boys and girls both sit on the toilet. Boys can be taught to stand later, if desired.

·         Encourage child to drink water or other fluids at least every 30 minutes.

·         Put child on toilet every 30 minutes. Child stays on toilet until voiding or 15 minutes, whichever comes first. If child does not void after 15 minutes, allow child to leave bathroom ad restart 30 minute timer. (the speaker suggested having a large bean bag handy if you have a child that is aggressive…it does come in handy, trust me)

·         Limit adult involvement in the toileting process. (have child walk to toilet, pull down own clothes.

·         If child voids, immediately provide tangible reinforcement and praise, have him pull his pants up, and allow to leave bathroom, restart 30 minutes on timer.

·         When restarting the 30 minute timer, encourage the child to drink.

·         Dry pants checks. Every 5 minutes, check to see if child is dry. Put child’s hand on front and back of pants to check self. If child is dry, provide tangible reinforce and praise, and restart 5 minutes on timer. If the child is wet, start positive practice.

·         Praise should emphasize the word “dry” (If your child is nonverbal I would be sure to limit words and just say “dry” happily)


·         Positive Practice: If child is wet, have child touch the wet (say “wet” and sound disappointed) and tell them where they must urinate. Example. “Your pants are wet; You need to go pee pee in the potty”. Then, quickly take the child to the bathroom, pull his/her pants down and sit him/her on the toilet. Immediately have child stand up without allowing the opportunity to urinate in the toilet and pull wet pants up. Take child back to the place where the accident occurred or was discovered.

·         Repeat the sequence 5 times. After the 5th time, clean child and replace wet clothing with dry clothing and reset 30 minutes. Send the child out of the bathroom without allowing the opportunity to urinate. Avoid corrective feedback, lecturing. Maintain neutral affect, and avoid loud or angry voice. However, positive practice should not be fun for the child. The purpose of positive practice is to reduce accidents.


·         As soon as first initiation occurs, stop scheduling potty time. Continued scheduling may result in a dependence on scheduling. Limit adult involvement in the toileting process.

·         At this point there may be an increase in accidents. Continue to implement positive practice and dry pants checks, and accidents should again decrease as initiations increase.

·         If accidents do not decrease within a day or two, go back to scheduled potty time every 30 minutes. When the next initiation occurs, again discontinue scheduled potty time.

·         If the child is not having any accidents, but is not initiating, gradually increase the length of intervals between potty visits until child has only the choice to self initiate the toileting process or wet pants, which should result in positive practice. (30 min»60min.»2hrs.»4hrs., etc…)

·         If the child is a boy, it is appropriate to teach him to stand to urinate, if desired, when he is able to stay dry, with few or no accidents and is independently initiating bathroom visits.

·         It is at this time that the child may also be taught to request the bathroom.


Bowel Movements: At first, do not take any action when BM occurs other than to clean the child and put him in clean clothing, no positive practice. Many children will begin to have BM’s while they are urinating in the toilet.

·         Usually, positive practice for soiled pants will only need to be implemented 1-3 times before BM accidents no longer occur.


Possible Problems

·         Hesitance to implement positive practice.

·         Hesitance to allow accidents.

·         No data collection.

·         Not enough dry pants checks.

·         Limited opportunity to initiate.

·         No initiation.

·         Judging success of the procedures based on emotional responses rather than the targeted behaviors.

·         Continued accidents over a period of time when consistently implementing positive practice.

·         Inconsistency.


·         Definitely have a book or a TV show to watch not only while waiting in the bathroom, but for in between checks and potty times…It’s nice to get away from it all for 4 minutes. J

·         Get up before the family and make meals for the whole day. You won’t have the time or the energy to try to make meals for yourself, much less the family.

·         Take time OFF! Take it from me, trying to do this potty training and do work, housecleaning, make supper, etc…is NOT a good idea.

·         If you can have time with just you and the child to be potty trained it would be optimal…or at least someone to help out at the house. Having a younger sibling who does not understand can be very frustrating.


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