A Parent's Guide to Toilet Training in Autism

Toilet training is an important milestone in a child's life. The process of toilet training may look different for an autistic child, and anticipating the potential differences can help you feel more prepared so you can set your child up for success.

Understand Your Child’s Readiness

Before you start, it's important to assess your child’s readiness. Readiness for toilet training isn't simply about age, but about a combination of physical, cognitive, and emotional factors [1]. Look for signs like being aware of bodily functions, showing interest in the bathroom, and showing discomfort with wet diapers. If your child isn’t showing these signs yet, patience is key.

Create a Comfortable Environment

Your child may have sensory sensitivities that make toilet training more challenging. Creating a comfortable environment can go a long way in making the transition from diapers smoother. You could try a special toilet seat, soft toilet paper, or even a particular scent of hand soap. Using warm wipes instead of cold ones or allowing your child to have a favorite toy or book with them may also be helpful [2].

A caregiver practicing toilet training with his young son.

Create a Routine

Consistency is important when it comes to toilet training. Developing and sticking to a routine around bathroom times can help make the process easier. You might also use visuals like picture charts or social stories to depict the steps involved in using the toilet, which can provide a sense of predictability and security [3].

Use Communication and Rewards

Communication is an integral part of this journey. If your child is non-vocal or has limited vocal skills, consider alternative communication methods. This could include sign language, an Alternative or Augmentative Communication Device (AAC), or a picture exchange communication system (PECS) to express the need to go to the toilet [4].

Also, remember to celebrate successes, no matter how small. Rewards can be a powerful motivator. Find out what your child loves—stickers, extra playtime, a favorite treat—and consider using it as a reward when they successfully use the toilet.

Handling Setbacks

Setbacks are a normal part of the process. An accident doesn't mean failure—it's just a part of the learning curve. If an accident happens, reassure your child that it's okay and part of learning. Maintaining a positive, supportive attitude can make your child more comfortable and willing to try again.

Seek Professional Guidance

If you're not sure how to proceed, consider seeking professional guidance. Occupational therapists, medical providers, and other specialists, like the ones at Cortica, can offer specific strategies tailored to your child's unique needs [5].

Citations

Schum, T. R., Kolb, T. M., McAuliffe, T. L., Simms, M. D., Underhill, R. L., & Lewis, M. (2002). Sequential acquisition of toilet-training skills: A descriptive study of gender and age differences in normal children. Pediatrics, 109(3), e48-e48. https://doi.org/10.1542/peds.109.3.e48
Reynolds, S., Lane, S. J., & Gennings, C. (2010). The moderating role of sensory over-responsivity in HPA activity: A pilot study with children diagnosed with ADHD. Journal of Attention Disorders, 13(6), 468–478. DOI: 10.1177/1087054708329906
Macias, M. M., Roberts, K. M., Saylor, C. F., & Fussell, J. J. (2006). Toileting concerns, parenting stress, and behavior problems in children with special health care needs. Clinical Pediatrics, 45(5), 415–422. DOI: 10.1177/0009922806289616
Frost, L., & Bondy, A. (2002). The Picture Exchange Communication System training manual (2nd ed.). Pyramid Educational Products.
Cicero, F. R., & Pfadt, A. (2002). Investigation of a reinforcement-based toilet training procedure for children with autism. Research in Developmental Disabilities, 23(5), 319–331. DOI: 10.1016/s0891-4222(02)00136-1