Potty Training Tips for Children with ASD
We recently published a two-part article with tips and advice for potty training kids with disabilities, but we wanted to take another moment to help parents who are potty training kids on the autism spectrum.
Autism Spectrum Disorder (ASD) is a unique disability because it varies so much from child to child in both severity and symptoms. As Dr. Stephen Shore, a professor of special education at Adelphi University who is also autistic, said, “If you’ve met one person with autism, you’ve met one person with autism.”
The two main signs of ASB are repetitive or restrictive behaviors and difficulty in social situations, and both of them can specifically hamper a child’s ability to be successful in potty training.
Repetitive or Restrictive Behaviors
According to the National Institute of Mental Health, one restrictive behavior is being “more or less sensitive than other people to sensory input, such as light, noise, clothing, or temperature.” Bathrooms can be a daunting place because of the loud flushing and fans, splashing water, smelly soap, clothing that moves up and down, and harsh lighting. Just being in the bathroom can be difficult for kids on the spectrum, not to mention actually using the toilet.
Another restrictive behavior is “getting upset by slight changes in a routine.” This is a big one because up until potty training, a child has gone about his business wherever and whenever he felt the need to release. Breaking up that routine to make him stop what he’s doing and use the toilet can be jarring and frustrating.
The NIMH also states that children with autism have “overly focused interests,” which can mean that they have difficulty stopping an activity when they’re really engaged or invested. Again, pushing pause on an enjoyable activity to use the potty can be a hard battle to win.
Social Communication and Interaction
Let’s face it: potty training anyone can be extremely frustrating, but lack of social awareness can add yet another layer to the standard frustration. Without the perception of social pressure to potty train (“be a big boy” or “use the potty like daddy”), kids with autism feel little motivation.
So what can you do?
First, you need to understand you’re not alone. According to the Centers for Disease Control (CDC), about one in 54 of the kids in the U.S. have been diagnosed with ASD. It’s about four times more common for boys to be diagnosed than girls, which is a double whammy in the toileting world since boys often toilet train later than girls anyway. If you’re feeling frustrated or overwhelmed, join a support group or forum for kids with autism – they are out there and plentiful!
Second, take a deep breath. You will experience regressions, upsets, and accidents, but you won’t be alone in this. It is never too late to start potty training, and it is possible for most children.
Third, you need to arm yourself with a toilet training toolkit. Here are some possible tools:
- Keep a record: One of the best things you can do before you ever think about toilet training is to start keeping a log of when your child poops or pees. It’ll likely vary a little bit from day to day, but it should give you a pretty good idea of your child’s routine, which will help both of you be successful.
- Move all diapering to the bathroom: Routine is a tricky thing to adjust, but moving all diapering into the bathroom can help your child associate the act of relieving himself with the restroom. It can be challenging especially if your child is older and your bathroom is small, but it’s worth it to attempt the change. Additionally, to help him learn where the poop is supposed to go, have him help you shake poop into the toilet instead of just wrapping up the diaper and tossing it out.
- Relaxation is key: Any parent who has tried to poop when kids are banging on the bathroom door knows that it’s hard to do your duty when you’re tense! For this reason, prep your bathroom to make it a relaxing place. Remove stimuli that bothers him (fan, smelly soap, etc.), and play calming music. You can also bring in a squishy toy for him to knead to help him relax. You should also make sure that he feels safe on the toilet by having a step stool nearby, handrails, or a smaller toilet opening.
- Be comfortable: Especially at the beginning of the process, be sure to dress your child in comfortable, easy-to-remove clothing that he can successfully remove with little assistance. You may need to use small training steps to get your child to the point where he can remove his clothing by himself, but for now, at least, skip the buttons and stick with elastic. Additionally, if your kid loves a certain cartoon character, finding underpants with that character can be highly motivating.
- Use consistent auditory and visual reminders: Children with ASD like rules and structure, so incorporating visuals and auditory signals can help establish a toileting routine. For auditory cues, always use the same word or phrase when you’re talking about the toilet. For visuals, try to incorporate hand signals and visual reminder cards for each step of the process. Whether you purchase the cards online or draw your own, be sure to use pictures consistent with the action (if your son only sits to pee, don’t have a silhouette of a boy standing to pee).
- Understand the importance of dry runs: Once you have the visual reminder cards, it’s important to do dry runs. Depending on your child, you may want to introduce all the steps at once, or just one step at a time and practice, practice, practice without the expectation of his actually using the potty. Reference a reminder card with each step and then cover it up when it’s done so that your child knows to progress to the next stage. This builds up a routine, so when your child is ready to start using the toilet, he knows what to expect along the way.
- Skip the potty chair: In some circumstances, a potty chair might work well, but with kids with ASD, it can create a new routine that you’ll have to break eventually. It’s better to use a toilet seat insert right from the get-go so that the bathroom is always the location of toileting.
Every child is wonderfully different, and no potty training journey will look the same. Hang in there with the process—no matter how discouraging. Don’t be afraid to try again with different approaches (including our daytime trainers and overnight training pants), and reach out for support in those overwhelming moments. You got this!