Potty Training Readiness In Children With Special Needs
However, this is not always the case for children with developmental delays or disabilities, such as autism, Down syndrome, mental retardation, cerebral palsy, etc. Children with special needs can be more difficult to potty train.
Most children show signs of physical readiness to begin using the toilet as toddlers, usually between 18 months and 3 years of age, but not all children have the intellectual and/or psychological readiness to be potty trained at this age.
It is more important to keep your child’s developmental level, and not his chronological age in mind when you are considering starting potty training.
Signs of intellectual and psychological readiness includes being able to follow simple instructions and being cooperative, being uncomfortable with dirty diapers and wanting them to be changed, recognizing when he has a full bladder or needs to have a bowel movement, being able to tell you when he needs to urinate or have a bowel movement, asking to use the potty chair or asking to wear regular underwear.
Signs of physical readiness can include your being able to tell when your child is about to urinate or have a bowel movement by his facial expressions, posture or by what he says, staying dry for at least 2 hours at a time, and having regular bowel movements. It is also helpful if he can at least partially dress and undress himself.
Difference Of Autism Signs In Boys And Girls
The symptoms of ASD may range from mild to extreme, and there is no definitive list of symptoms that are sure to be shown by each and every child. On top of that, since boys are diagnosed with autism spectrum disorder four times more than girls , classic symptoms may be described in a way to refer more to the boys.
The symptoms are generally the same for the both. But, an autistic girl may be:
- hide their feelings better
- good at imitating social behaviors.
This can make the impairs seem much less noticeable compared to the case of boys. Also, the autism traits in girls are reported less by their teachers.
It is important to note that not all children with autism show all of the signs. In addition, many children who actually dont have autism may show a few of the symptoms and signs. That is why professional evaluation is of utmost importance.
There are certain developmental milestones children reach in terms of their language and social abilities. Caregivers should take notice of these milestones. They should observe children closely during the first few years of their lives. These are crucial times in terms of early diagnosis and intervention. Although not reaching a milestone at a specified time or achieving it late does not necessarily mean that the child has autism, it may be a sign of a developmental delay.
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Tips For Potty Training Kids With Autism
Potty training is an activity of daily living, a developmental milestone, and a rite of passage. It often signifies the transition from being a toddler to becoming a preschooler. It is a real measure of independence.
Being toilet trained is often a requirement for school, summer camp and any child-centered drop-off program. Some children begin to show signs of being ready to toilet train between 18 and 24 months, but many children arent developmentally ready until the age of 3.
Parents and caregivers typically know that a child is showing some readiness when they have the physical skills to dress/undress and climb up to sit on a toilet, when they can stay dry for a few hours, or are interested in the potty or in peers that are toilet trained. For some neurotypical children, potty training can be a challenge, but it can be especially difficult for children with autism.
At the toddler and early preschool age, some children on the spectrum may not yet have a diagnosis of autism. They may be receiving Birth To Three or Early Intervention services for language delays or behavioral difficulties, but may not have been identified as a child with ASD, Autism Spectrum Disorder.
Many of the following tips and tricks in this article can benefit any family with a child struggling with potty training, not just those with autism diagnoses.
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Be Sensitive To Fears
Most parents and teachers who work with children on the autism spectrum are no strangers to irrational fears and meltdowns. Unfortunately, the bathroom and all of the association equipment, noises, and sensations can trigger these reactions in your child. Common concerns include the noise of flushing, fear of a toilet overflowing, and dislike of the echo in the bathroom. Supervise your child in the bathroom and be available to help if he becomes frightened. The child may need to leave the bathroom and then slowly work back up to sitting on or flushing the toilet.
What If My Child Is Afraid To Have A Bowel Movement In The Toilet And Becomes Constipated
It is very common for children with autism to hold in bowel movements while being potty trained. Often times, children will wait until they get their diaper or pull-up at night so they can poop in that. If this happens, do not get discouraged, as peeing and pooping are two different parts of toilet training. The first step is getting your child to successfully pee in the toilet. Once your child on the autism spectrum is peeing in the toilet 90 percent of the time, then you can start on poop training. Use the same potty training procedure, however, identify what time of day that your child is having a bowel movement and start taking your child to the bathroom during that time. Encourage your child to sit on the toilet and poop in the toilet. Also, have your child drink a lot of liquids and feed him/her foods with lots of fiber. You want your childs stools to be soft so they can come out easily. When your child with autism successfully poops in the toilet, highly reinforce him/her with an extra special prize. If your child suffers from constipation regularly, you may need to consult a doctor on how to resolve the situation appropriately.
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Speech And Language Difficulties May Present Themselves During Early Stages Of Language Development
Children with ASD may have a hard time speaking and communicating at the expected level for their age.
Even during infancy, you might notice that your child does not babble or coo in response when you talk and attempt to interact. By their first birthday, most toddlers can speak a word or two, but children on the spectrum often dont learn to speak until much later.
Sometimes, children with ASD babble and coo in the first few months of life, and then cease to communicate altogether. In these cases, all forms of verbal communication and normal language development and experimentation with speech abruptly stop. This can be disconcerting for parents and is often a sign that its time to investigate further by seeking professional help.
Even in cases where autistic children do speak and demonstrate pretty typical signs of normal language development, they often repeat unrelated words and phrases over and over and, in essence, speak without really communicating or conveying a feeling, thought or desire.
Early intervention is key to helping autistic children learn to communicate, whether it is through spoken language, or in more extreme cases, through sign language or even an alternative augmentative communication device.
If Those Dont Work Try Something Else
The attempt in the summer of 2006 had to be different. Marc could read and was interested in the printed word. When Brenda Smith Myles spoke for Autism Awareness Centre, she talked about the use of Power Cards. Power Cards use the childs special interest as a way to motivate them. The Power Card is a recipe sized card with the rules you want the child to follow as told to them by whom or what interests them. We decided to try this technique using Queen Elizabeth, someone Marc is very interested in.
Instead of putting all of the toileting steps on one card, we wrote out one step per card and avoided the use of all pronouns since Marc did not understand them. We kept the text as simple as possible. Everything was stated in the present tense using Marcs name Marc sits on the toilet. Poo comes out. His reward was a scrapbook to collect photos of the Royal Yacht Britannia. He was to get one photo of the yacht to paste in the scrapbook each time he made an attempt on the toilet. We soon discovered the Power Cards were anxiety provoking, and were back to square one.
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Autism Toilet Training Dilemma: 6
Perspective and stepwise advice from experts in the Autism Speaks Autism Treatment Network
Im trying to toilet train our 6-year-old, who has autism. But every time I try to take her to the bathroom, she fusses and fights all the way. So far, Ive just given up. Help!
Todays Got Questions? response is by behavior analyst Daniel W. Mruzek and graduate student Angeles Nunez, a candidate for certification as a child-life specialist. Both work with children at the University of Rochester Medical Center, one of 14 sites in the Autism Speaks Autism Treatment Network .
Editors note: The following information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional and/or behavioral therapist.
Thank you for asking! While toilet training can be anxiety provoking or just no fun for any child, it proves particularly challenging for many children on the autism spectrum. Were glad to offer a number of strategies to help your daughter.
As a general reference, we recommend the ATN/AIR-P tool kit Toilet Training: A Parents Guide, available for free download.
Beginning Potty Training: The Parents Q& a
1. When should I start thinking about potty training?
The worst thing you can do when starting on this journey with a stubborn child is begin the process too early. If they arent ready to start, they will not cooperate. Period. The power struggle will be in play right from the get go and even if you stop and take a break for a month, theyll remember who won this round and will try it again next time. Trust me.
Most children are ready to begin potty training between the age of 2 and slightly after their third birthday, with boys tending to come in later in this time zone. About 50% of boys are trained by age three while 66% of girls are trained by age three. Potty training kids with special needs will most likely take longer.
Dont try to rush the process by starting when your child is too young. The American Association of Pediatrics reports that kids who begin potty training at 18 months are generally not fully trained until age 4, while kids who begin training at age 2 are generally fully trained by age 3. Many kids will not master bowel movements on the toilet until well into their fourth year.
2. When will I know my child is ready to potty train?
Your child will show you tell-tale signs that they are ready. Here are some things to look for:
Your child is not ready to potty train if they are resistant or afraid of the toilet, have a bowel movement or urinate right after youve had them sit on the potty, or wet their diaper in less than two hour intervals.
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Encourage Your Child To Ask For The Potty
In the beginning, you will probably need to take your child to the bathroom before he asks to go. Asking to go requires a certain level of functional communication that may be challenging for your child. However, if you notice any type of bathroom request, even if it doesn’t produce the desired result, reward your child right away. To encourage your child to ask, decide on a signal or word that you’ll use every time you take your child to the bathroom. Your child may use this word to communicate with you.
Why Are There Toileting Difficulties
I believe there are two main problems in toileting difficulties.
I have also heard of individuals who do not understand that different types of toilets are all toilets and you do the same thing in them. This may need to be taught if the toilet at school is very different from the toilet at home .
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Q: I Have A 4 Year Old Whose Has Not Been Officially Diagnosed With Autism But We Have Been Told He Is Autistic We Are Waiting For The Official Diagnoses But We Have Been Told He Is On The Mild End Of The Spectrum He Refuses To Have A Bowel Movement In The Toilet Do You Have Any Recommendations On How I Can Get Him To Stop Going In His Pants
A: Potty training is a difficult process that requires a lot of patience and creativity on the parents end! The literature shows that potty training a child on the autistic spectrum is especially challenging, so know that you are not alone in your experience.
You may want to begin by assessing your childs level of readiness for using the toilet for pooping. If he showing interest in using the toilet to urinate, then youre at a good starting point already! If you are doing so already, continue to have a potty or potty seat in to the bathroom and let him continue to sit on it and explore it.
You may want to take a ride to your local library and check out some books and videos about potty training. This may help him to validate his feelings about potty training, especially if he is able to relate to a characters experience in the book. It may also help to give him the visualization of the process so that he can internalize it and carry it out himself. Check out some of these titles:
Once Upon a Potty book The Potty Book for boys Potty Time Potty Time with Bear book I Gotta Go! Music Video
Another strategy may be to offer him a role model. That is, you may need to use the open door policy in the bathroom and allow your son to watch you or other family members going through the motions. If you are not comfortable with him watching you or a family member, then pretend but make sure he is watching.
Answered by Dr. Elizabeth Matheis
He Drank From A Bottle For A Really Long Time
Not being able to adjust well to change is very normal for autistic children.
In hindsight, I am positive this is why it was so hard to wean him off the bottle. He never used a soother so at the time I thought the bottle was just very comforting to him but there was actually a little more to why he couldnt let it go.
This isnt the only way he was resistant to changes. He used to insist on keeping his shoes on in the house, sometimes wearing them to bed. It would take half the winter to get him to wear a winter hat, and then half the summer to get him to wear a sun hat.
My current challenge is finding him the same sneakers, over and over again, as he grows and needs a bigger size.
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Potty Training And Autism: How To Toilet
Potty training a child whether autistic or not can be challenging.
When Charlie was 2 1/2, we decided to give potty training a shot with the help of his ABA therapists. Having a child with autism, I worry about not knowing whether or not my son will ever be able to take care of himself. Its really important for me to teach Charlie self-care skills. He has several daily-living goals in therapy like toilet training, teeth brushing, and hand washing.
When Charlies BCBA told us that she didnt see any reasons not to try potty training, Im not gonna lie, I was skeptical. How was he supposed to understand the concept of peeing in the potty, let alone accepting sitting on the potty? It seemed impossible. To put it into perspective, when Charlie was 2 1/2, he had no words, no way of communicating , he couldnt follow directions, he screamed an average of 60 times per hour and he had regression after regression. Well, I was wrong, it took a couple weeks of tears, accidents, and tantrums but after that, Charlie was able to pee on the potty. We still have to take him or else he wont go on his own. Hes not fully potty-trained but if we remember to take him every hour or so, he will stay dry. Its a big success for us.