My eight-year-old son with autism still wears diapers or training pants, depending on what’s available. We have tried toilet training, and while he will sometimes go on the potty, it’s still one of the hardest struggles of his life. It can be hard to send him to school knowing how profound his needs are especially when it comes to potty training and diapers.
While pushing for toilet training can be a difficult task, it’s important to find the right support system to help your autistic children. But there are things you can do to help your child understand toilet training as they grow into adults.
Challenges of toilet training
While potty training is a very important part of childhood development, autistic children face far greater challenges than neurotypical children. Some common difficulties they may face include:
- Communication challenges
- Learning to use different toilets
- Sensory issues
- Cleaning issues
My son is nonverbal. While we work with an AAC device and sign language to help him communicate with us, he’s not able to communicate everything. Despite having an icon he can use to request a toilet, he rarely, if ever, uses it.
We encourage him to use it when he feels like he has to go to the bathroom, but it’s been a struggle that requires us to put him on the toilet at regular intervals to encourage potty training.
Different toilets, sensory issues, and cleaning issues can also present difficulty for the parents. My son is very sensitive to sound and doesn’t like public restrooms due to the echoes. He fights going into public toilets.
Meanwhile, when my son defecates, he will try to clean it himself, and that can create a bigger problem as he smears it wherever he is.
Tips for dealing with an autistic child who still wears diapers
While it’s certainly going to be tough to implement a plan to get your autistic child potty trained, there are steps you can take that will help improve the implementation process. The three main phases of potty training are:
- Planning
- Set up
- Implementation
During planning, this is when you get the tools you will need to assist in autism potty training. These tools include:
- a training potty,
- a footstool,
- a timer,
- visual supports,
- activities to keep their mind occupied and
- a data sheet to keep track of when the child uses the toilet.
The setup phase is self-explanatory as you will be setting up your toilet in a way that will hopefully make potty training easy to understand. You will still need incontinence supplies during this time, including diapers and training pants.
Tips for potty training a child with autism
Once you are ready to start implementing the plan to potty train your child, there are some tips parents should follow:
1. Be consistent
Pick a timeframe for toilet training children. With my son, we spaced it out every two hours. We would only have him sitting on the toilet for about five minutes.
If he went, great, and we would continue his hygiene. If not, it was still okay. We would try again in two hours. It’s up to each parent to set a consistent timeframe.
2. Gradually decrease trips to the potty
Once your child starts going more during a certain time of day, parents can eliminate some of those toilet training trips in between when it becomes clear their child won’t have to go.
3. Keep the task simple
Most children with autism spectrum disorder benefit from routine. Changing what you do every time you try to potty train them might cause longer incontinence issues. Keeping the same routine will make potty training easier.
4. Provide instructions clearly
Speak clearly and deliberately to let your autistic child know what is expected from them while sitting on the toilet. Consistent language also needs to be used.
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Whether it’s potty, toilet, or whatever you choose, everyone in the house should use the same language to ensure the child is not confused.
5. Use visual support
Many children with autism spectrum disorder tend to be visual learners, so using visual support can help encourage them to use the potty.
Some visual supports that can be used include:
- the Picture Exchange System (PECS),
- picture cards,
- an AAC device, or
- social stories.
There are also toilet training apps that can help encourage new skills for the potty.
6. Use praise and rewards
Many children on the autism spectrum respond favorably to positive reinforcement. Setting up a system where they are praised and rewarded when they go on the potty can increase their likelihood of completing potty training.
Arm yourself with patience and understanding
Speaking from experience, it’s a long road to get some autistic children potty trained. My son’s road has been going on for six years, and it’s been more miss than hit.
Wearing diapers or training pants for longer than expected is not a major problem, but with love and encouragement, children with autism can learn how to use a toilet.
Remember to stay calm and keep gradually moving towards wearing underwear. Help the children with autism understand they are not alone as they face these challenges. Plus, parents can contact their health insurance company to get other incontinence supplies to assist with toilet training.
Also, find a parent support group that can help you on this journey. Your child needs you, and you need to be there for your child. Support groups can boost you up to help you help your child and also provide you with resources for professional guidance if necessary.
FAQs
Q: Do autistic kids stay in diapers longer?
A: Autistic children tend to be slower in reaching major milestones. This can result in them wearing diapers or training pants longer than other children.
Q: Are bathroom issues common in adults with autism?
A: According to the National Institutes of Health, nearly 82% of adults on the autism spectrum will experience incontinence. While as many as 68% will experience constipation. One factor that may contribute to these issues is rigid bathroom behavior.
Q: Does autism make it hard to potty train?
A: It may be more difficult to potty train some autistic children due to certain characteristics connected to their autism diagnosis. These may include limited verbal abilities and communication difficulties that make it harder to learn how to use the toilet.
Q: At what age are most children with autism potty trained?
A: While it may take longer to potty train kids with autism, most will eventually learn to use the toilet properly. The average age for children to learn is 3.3 years compared to 2.5 years for neurotypical children.
References:
Francis, K., Mannion, A. & Leader, G. The Assessment and Treatment of Toileting Difficulties in Individuals with Autism Spectrum Disorder and Other Developmental Disabilities. Rev J Autism Dev Disord 4, 190–204 (2017).
Megan Simon, Sarah Wilkes-Gillan, Yu-Wei Ryan Chen, Reinie Cordier, Alycia Cantrill, Lauren Parsons, Jia Jun Phua, Toilet training interventions for children with autism spectrum disorder: A systematic review, Research in Autism Spectrum Disorders, Volume 99, 2022, 102049, ISSN 1750-9467.
Mruzek, D. W., Handen, B. L., Aponte, C. A., Smith, T., & Foxx, R. M. (2019). Parent training for toileting in autism spectrum disorder. In C. R. Johnson, E. M. Butter, & L. Scahill (Eds.), Parent training for autism spectrum disorder: Improving the quality of life for children and their families (pp. 203–230). American Psychological Association. https://doi.org/10.1037/0000111-009
Wiggins LD, Nadler C, Hepburn S, Rosenberg S, Reynolds A, Zubler J. Toileting Resistance Among Preschool-Age Children with and Without Autism Spectrum Disorder. J Dev Behav Pediatr. 2022 May 1;43(4):216-223.
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