About the Author: Dr. Yost Abrams received her PhD from the University of California, Berkeley and is a fellow with ZERO TO THREE. She is a parenting expert and early childhood researcher. Dr. Abrams specializes in parent-child attachment relationships, social-emotional development, and infant mental health.
Learning a new skill is challenging for both children and parents. For many children with autism spectrum disorder (ASD), learning to use the toilet can take longer and present some unique hurdles. Here are some common difficulties and strategies.
It can be difficult for parents to pinpoint exactly when their child is ready to start potty training. On average, neurotypical children are ready to start potty training around 18 to 24 months—though it is common for children not to be ready til age 3 or so. Every child will convey when he or she is ready in their own way. Here are some common signs a child is ready to start toilet training.
All of these indicators are common in children without neural divergence, but for parents of children with special needs, in particular children on the autism spectrum, the signs may present differently. So what should parents with autistic children look out for?
The answer to that question really depends on the unique needs and traits of the neurodivergent child. For instance, a child who is nonverbal may not use terms associated with the potty, but instead, they may occasionally sit on the toilet or show interest in bathroom-related activities like washing hands or dressing and undressing. Here are some other specific signs a neurodivergent child might showcase when they’re ready for potty training.
Every child on the spectrum is unique and potty training for a child with autism will require a patient and thoughtful approach.
Children reach milestones at different times. For instance, one child may become verbal at a very young age while another may quickly move from crawling to walking upright. The same is true for autism and potty training: some children on the spectrum may pick it up more quickly than others, and every child will tell you—in their own way—when they’re ready.
Children on the spectrum learn to use the toilet independently at a later age than neurotypical children. On average, children with autism learn to use the toilet at 3.3 years of age, compared to neurotypical children who learn to use the toilet by 2.5 years old. Additionally, children on the spectrum “require 1.6 years of toilet training to stay dry during the day and sometimes more than 2 years to achieve bowel control,” according to Autism Speaks. There are a number of reasons toilet independence can come at a delay for autistic children.
Communication: Both verbal and non-verbal communication challenges can delay toilet learning and consistently peeing in the potty. It may be more difficult for your child to tell you when they need to go or to understand your questions and instructions around using the toilet. Aim to use simple, short phrases like “potty time” instead of longer sentences. It can also be very helpful to use visual schedules and supports. Pair a picture of a potty with your verbal cue.
Sensory: Your child may be less aware of their own body cues as to when they need to go or when their clothes are wet. Moving out of diapers and pull-ups and into underwear earlier may help a child make the associations needed. Remember to try and handle accidents calmly and matter-of-factly. Use lots of positive praise and attention when your child is successful at attempting to use the toilet.
Dressing and physical skills: Being able to pull down and up pants can also get in the way of successful toilet training for autism. Loose pants with no buttons, zippers, snaps, or ties may make it easier for your child to be more independent. Also, try using a smaller potty seat or chair that allows your child’s feet to touch the ground. This will be easier for your child to get on and off on their own, and they will feel more stable and comfortable.
Routines: Learning a new routine or schedule is typically quite hard for children with ASD. Make a predictable potty schedule that you stick to each day. It will be important that all of your child’s caregivers be consistent with the new routine; this way, they can help your child learn. At first, you can aim for several trips to the potty at the same time each day, as establishing the routine is more important than whether or not your child actually urinates or has a bowel movement. Using the same words and visual cues each time will also help.
Whether parents need to work with verbal challenges or sensory sensitivities, there are many strategies for effectively potty training a child with autism. Some of these steps include adjusting the child’s routine and teaching them terms that relate to using the potty for better communication. Whatever the method, the ultimate goal is to safely introduce the child to using the toilet on their own. Here are some other strategies parents should consider.
Showing support for your child while potty training will look different for every family. Some children may respond positively to words of encouragement and a calm, matter-of-fact tone. Other children on the spectrum may find visual aids helpful, like pictures or objects representing steps of using the toilet.
No matter the method you choose to show your support when toilet training for autism, it’s also important to praise your child throughout the process. For that praise to be effective, it should be immediate and celebrate your child’s cooperation.
Showing support and giving praise are extremely important when toilet training, but it’s equally important to punctuate your child’s efforts and cooperation with a reward. Try getting some ideas by making a list of some of your child’s favorite things like toys, food, and activities.
Next, pare down your list by eliminating rewards that may be difficult to give to the child every time they complete a step or activity in their toilet training (i.e., a trip to the park, a hug from Grandma, etc.). This should leave rewards like watching a favorite video, a fun game, or a special snack.
Give your child the reward immediately after a successful trip to the bathroom, like peeing in the potty on their own. You can even distinguish this reward from other rewards by saving it exclusively for potty training-related efforts and cooperation.
When beginning the potty training process, it is important to create as much clarity as possible around expectations. This applies less so to the child and more so to the adults in their life. Parents, caretakers, siblings, teachers, and other family members in the child’s life should use the same terms and specific language when referring to anything bathroom-related. This will diminish confusion around the bathroom in situations outside of the home and around adults who aren’t the child’s parents.
Routine is incredibly important for children. So, if you and your family already have one set in stone, you’re already well on your way to adjust that routine to accommodate potty training. Creating a schedule should be done gradually and fit with your existing daily routines.
For instance, if your child enjoys their favorite snack at a certain time every day, take a moment after snack time to encourage them to sit on the toilet or wash their hands in the bathroom. By doing this, your child will begin to understand the connection between using the bathroom and finishing a drink and meal or snack. Plus, they associate the process with a daily treat.
Patience and a positive attitude will help the process go more smoothly for both you and your child. Keep trying, stick with your new routines and schedule, and celebrate each small step along the way. Praise your child with words, smiles, hugs, and high-fives for trying, even if they don’t go. Toilet learning is just one of the many skills your child will acquire, and each new milestone towards independence is a great achievement.
Additional Resources:
https://www.autismspeaks.org/sites/default/files/2018-08/Toilet%20Training%20Guide.pdf
https://kidshealth.org/en/parents/toilet-teaching.html
https://www.goldencaretherapy.com/potty-training-a-child-with-autism/