Potty Training A Child With Autism Using Aba
Dr. Anna Kaplan is a writer and a licensed physician. She completed a 3-year residency and board certification in Family Practice and was in active practice for 15 years. A parent herself, Anna still remembers the “I know how to use the potty” song that her children sang.
Make Sure Your Child Is Ready
When assessing whether or not your child with autism is ready for potty training, behavior is more of an indicator than age. Your child may be ready if they ask to be changed when theyre wet or soiled either verbally, by removing a dirty diaper or by getting a clean diaper. You also want to make sure your child can follow simple, one-step directions before you tackle potty training.If your child is nonverbal, there are some extra steps you can take to ensure clear communication. Keep an eye on your childs behavior as you start to potty train so you can pick up on their signals that they need to go to the bathroom. You may notice them wiggling, rocking or looking intently at you or in the direction of the bathroom. To encourage communication, you may give your child a picture of a toilet that they can point to when they need to go. They can keep it in their pocket or attached to their clothing for easy access.
Have A Reward System The Same Way As You Would When You Train A Typical Toddler
Children and adults both will provide good work based on an incentive. Think about it. If your boss announced that if you were to complete a project by a certain timeframe that you would end up with a $200 extra bonus. You would be motivated to get that work done and make it a priority because it is an excellent incentive.
The same goes for your autistic child. As long as they have the cognitive development of a toddler that is at least 18 months old, they will grasp the fact that if they do something that they are asked to do, they will be rewarded. You most definitely will want to praise the child after doing #1 or #2 in the toilet. But you also in addition to that want to have a tangible reward such as a new toy. Children with autism and even adults that are moderate to severely affected by autism lack the ability of abstract thinking.
They need to be able to see the reward. And if they can tie together the cause and effect of going to the bathroom in the potty meaning they will get a toy, then that will make a huge difference in regards to it being done successfully.
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What If My Child Has A Fear Of Flushing The Toilet
Being afraid of flushing the toilet is very common for children with autism. The flushing sound can be loud and scary to children and can overwhelm their sensory system. If your child is fearful of flushing the toilet, do not flush when potty training your child. Wait until he/she is out of the room to flush the toilet. When your child is potty trained and feels comfortable in the bathroom, have your child stand outside the bathroom when you flush the toilet. Then have him/her stand in the bathroom while wearing earplugs or headphones when you flush the toilet. Last, have your child with autism flush the toilet by himself or herself. Eventually, your child with autism will get used to the toilet flushing sound, and he/she will be less fearful of it.
Be Sure To Start At The Right Time For You
Parents with children that have autism know that potty training will be a long process. This means they have to be emotionally ready as well, and not agree to do it for the sake of pressure that they are getting from their own parents or other members of their extended families.
This process also must be done when nothing else stressful is happening such as what was mentioned in the previous point. The toilet training process must be done when the parents are able to fully commit to doing it. With that said if the child with autism is 7 years old and is showing signs of readiness, but the childs grandmother is ill and needs a lot of care and is taking up the parents time as well, that is not the time to start. There must be no additional major stressors in the way.
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Find The Root Of The Issue If Possible By Trial And Error
I realized there was much more to transitioning from diapers to the toilet. We had to discover what the root cause of the anxiety was. This is difficult to do when a child has very limited language skills. Was it having to sit down on toilet rather than stand? Was this a fear of having something fall away from Marcs body? Did he think he was losing a part of himself? Was he in physical pain sitting down trying to release a bowel movement? It was time to try another strategy.
I tried draping a towel across the toilet bowl so Marc would not have the feeling that something was falling away from him didnt work. We then changed the emphasis to just sitting on the toilet. We asked Marc to simply sit on the toilet and then rewarded him with chips if he did. During the toileting process, Marc was smearing his feces all over the house. He picked out just enough to relieve the bowel pressure.
Seven Toilet Training Tips That Help Nonverbal Kids With Autism
Todays Got Questions? answer is by psychologists Courtney Aponte and Daniel Mruzek, of the University of Rochester Medical Center, one of 14 sites in the Autism Speaks Autism Treatment Network.
We’re looking for help toilet training our 7 year old. He is very limited verbally.
Great question! Many children with autism take longer than is typical to learn how to use the toilet. This delay can stem from a variety of reasons.
- Many children with autism have a general developmental delay. That is, they simply learn new skills more slowly than other children do.
- Many children who have autism have great difficulty breaking long-established routines in this case using a diaper. Plus, there are relatively few opportunities to practice toileting during the day, as there are only so many times a child genuinely needs to go.
- Communication challenges such as your sons limited verbal abilities clearly add to the challenge for many children on the autism spectrum.
- Its also common for children with autism to develop anxiety around toileting.
For example, some children with communication challenges wont understand the question Do you need to you use the bathroom now? Or they may not know how to respond to it or otherwise signal that they need to use the toilet.
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Potty Training Kids On The Spectrum
Potty training is not fun at all. Nope, not a single tiny ounce of it. In fact its one of my most grueling and excruciating parenting experiences to date. But on the bright side: yes, it is awful and hard, but then you will most likely forget all of that awful part and instead be left with a happy, more independent, self sufficient potty trained child. You will be SO PROUD of them and I will be SO PROUD of you.
I am not a big- You need to do it this exact way- kind of a gal. Instead Ill tell you- Heres what worked for us and I hope it works for you too. I will give you the steps we used with both of my autistic boys, most which were recommended and modeled for me by our home ABA company. I tackled this major milestone when the boys were about 3 1/2 years old. Now Greyson is 10 and Parker is 8. It took Grey about 3 weeks to finally just start to get the process and soon after that for his daily successes to grow bigger in number than his accidents. Pooping independently on the toilet took about 10 months .
These tips can work on typical children, as well as any variety of different developmental delays besides autism. Im going to break it down into four steps because I like things in bite sized chunks.
STEP TWO: THE SCENE + SUPPLIESFirst, you need a child and a potty! Shew, so glad we got those basics covered. I recommend a bathroom that isnt far from where you are spending your time. You need to be able to pop in there in a jiffy.
How To Potty Train A Child Who Refuses
Some children a just afraid of the noise itself. The dreaded toilet flushing can disrupt a child with autism or a Sensory Disorder. If thats the case then wait for your child to leave before flushing the toilet. Its the little things that can put the brakes on potty training. Dont let the small stuff get to you. When you go to the store let them pick out their own underwear. Just the act of picking out their own undies can be a big influence on them using the toilet. Not every child will be toilet trained around the same age. All children learn in time some take longer in toilet training than others. Take your time and dont give up. Be patient when training your child. Tell your child they can pick out what the get to wear the next day since they are getting big now. That alone might be a great incentive to poop and pee in the toilet. Put your child in big boy or girl undies that way they will be less likely to mess in their favorite undies then they would a diaper.
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What Are The Signs That A Child With Autism Is Ready To Be Potty Trained
When children with autism are ready for toilet training, they will begin to demonstrate the Three Signs of Readiness listed below:
How To Potty Train An Autistic Child
Potty training children in the autistic spectrum tend to be challenging for a variety of reasons: the presence of a developmental delay, a speech delay, fear of changing an established routine, fear of the unknown, loud sounds and anxiety in general.
Below you will find our step by step plan to lead your autistic child through their potty training journey:
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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 .
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.
How to help your autistic child with potty training?
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Developing A Toileting Routine
Remember that independent toileting is the ultimate aim and may take many months but there will be many small steps and successes along the way. As well as physical factors associated with toilet training, there are social factors to consider. It is rare for an autisticchild to have the social motivation to want to be like mummy/daddy/friend and use the toilet. After using nappies for a number of years, your child might not see the point in starting to use the toilet. It’s important to remember that all children are different and they will not all respond to the same teaching techniques.
Children on the autism spectrum often like routine. You can build upon this desire for predictability to develop a successful toilet training routine.
What If My Son Has Difficulty Standing While Urinating
If your son is used to sitting while urinating, you can teach him how to urinate while standing by providing a visual chart on how boys use the toilet. If he is afraid or does not want to touch his privates, you can ask a trusted male family member to show how to aim it in the toilet bowl. You may also use some target objects such as a colored toilet paper or a paper boat to encourage him to urinate in the bowl.
When To Give Up or Take a Break
Potty training children with autism may take a long time. As long as the child is making progress and it is a positive experience, continue the process. However, if the child becomes resistant to going to the bathroom or sitting on the toilet, or if the child is having more accidents in his/her underwear than successes in the toilet for over a week, then stop toilet training. These are indicators that the child is not ready to be potty trained. At this time, take a break from potty training for at least three months and revisit it at another time. Do not think of it as a failure, but think of as both parent and child are not ready. Once everyone is ready, potty training will be an easy and positive experience.
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Break Down The Process Into Stages And Dont Give Up
I discovered the key to toilet training an older child is patience, persistence, and breaking down the process into achievable goals. I wanted to give up when the fecal smearing was happening throughout the day for the first month. I was discouraged when the Power Cards didnt work. I combed the internet for some words of wisdom and found nothing. The key was going in stages and rewarding each stage, then raising the bar as those goals were achieved. Any habit can take weeks to break. Marc had been in diapers for nine years and I was kidding myself thinking toileting would not take several weeks, maybe even several months. It was also important to take the emphasis off of having a bowel movement into the toilet. Getting into the bathroom was the first thing that needed to happen. We had jumped too many steps, not realizing how hard this transition was going to be for Marc.
Even though toilet training Marc was a challenge, it was worth it. He gained a new level of independence and confidence. Marc was so proud of himself. As parents, we were relieved to have achieved this milestone, one that we are still celebrating nine years later.
Understanding Fecal Smearing And Other Toilet Training Issues
What helped me the most mentally was understanding why the fecal smearing was happening. This is a misunderstood behavior and one that tends to be the most upsetting. When a child withholds their stool, it becomes harder in consistency as the days go on leading to constipation. Constipation can cause an itchy anus which then leads to picking to relieve the itchiness and pressure. I believe this why our son was picking because of the itch and by removing some fecal matter, he could relieve some pressure which allowed him to continue to hold in his stool.
My daughter was quite different. She used to eliminate on the carpet without warning. When she was 6, I told her if she went to the bathroom in the toilet, she could have some Smarties. She replied, OK and the process was done in one day. I will never know why she was so easy and my son was not however, my daughters cognitive functioning is higher than my sons. Both were very late talkers just before their 5th birthday and missed most developmental milestones.
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