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Help: toilet training a child with special needs

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02/11/15

When it comes to toilet training, typical children as well as children with autism can be difficult to teach. Not all children respond to the same teaching techniques or instructions, so methods that are progressive with one child may not be as successful with the next. However, the best way to communicate with a child through this training process is by analyzing the problem through the child’s perspective and implementing a visual concept or structure for the child to better understand what is expected of him or her.

AutismToilet Training

When it comes to toilet training, typical children as well as children with autism can be difficult to teach. Not all children respond to the same teaching techniques or instructions, so methods that are progressive with one child may not be as successful with the next. However, the best way to communicate with a child through this training process is by analyzing the problem through the child’s perspective and implementing a visual concept or structure for the child to better understand what is expected of him or her.

And just how might the characteristics of autism influence the difficulty of diagnosed children learning how to independently use the toilet when necessary?

1.) A child with autism may not understand what is being expected of him in the bathroom, due to their incapability to understand language or imitating models.

2.) A number of children with autism have trouble organizing and sequencing information, and therefore may struggle in grasping the appropriate sequence of steps and/or focus necessary required in using the toilet.

3.) Child’s difficulty in accepting changes in their routine may also be problematic.

4.) Sensory Issues: Child may not know how to read the body cues that tell him or her that they need to use the bathroom. The child may also be overwhelmed by the sensory environment of the toilet (loud flushing noises, echoes, running water, chair with a giant hole in it hovered over a puddle of water, etc.)

5.) Most two or three year olds will gain a sense of pride and accomplishment from pleasing their parents by using the toilet appropriately. This type of motivation is rare with children with autism.

When attempting to toilet train a child with autism, one of the first things that need to be done is defining a realistic goal. A child’s independent toilet usage may take a little while to establish, but in the meantime, each step towards that independence is a goal in itself. However, in order to choose a starting point for the training, it is necessary to observe and assess the child’s understanding of the toilet process. In the beginning, caretakers should begin by establishing a meaningful routine around toileting and collect data about the child’s readiness for schedule training or for independent toileting. We highly encourage parents to implement a chart similar to the sample chart depicted below and use it to collect data. On a routine basis, the child is taken to the bathroom for a “quick check” every 30 minutes or so, and the data should be recorded on each of the occasions.

The goal of implementing a chart like this is to uncover any kind of pattern that exists in a child’s toilet habits. Over a period or one to two weeks, a pattern of data should emerge, and parents should begin to ask themselves these following questions.

1.) Is my child dry for significant periods of time?
2.) Is there some regularity in my child’s wettings/soiling?
3.) Does my child show any indication that he is aware of being wet or soiled?
4.) Does my child pause while wetting or soiling his or herself?

If the answers to all these questions is no, then the child is probably not ready for independent toileting, but a goal to establish a positive bathroom routine is still appropriate. During the charting phase, parents should also be sure to pay attention to the other aspects that are a part of the toilet training process.

1.) Is my child beginning to pick up on the routine involved?
2.) How are my child’s dressing skills?
3.) Does my child have any fears or interests related to the bathroom (reaction to flushing, water, toilet paper roll, or other bathroom fixtures)?
4.) What is my child’s attention span throughout the training process?

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