The Autism Program of Illinois Tip Sheet: Tips for Daily Life - Toilet Training

1. Autism Spectrum Disorders
Tips & Resources
Tip Sheet 29
Tips for Daily Life - Toilet Training
In an effort to help parents with what can be an overwhelming challenge, Little Friends Center for Autism has created
a set of tips for toilet training your child with autism.
• Preparation for toilet training is a major key to success. Before toilet training your child, create a baseline chart
documenting your child’s bowel and bladder frequency and accidents as well as their rate of fluid intake for 3-5
days.
• Commitment and consistency are important parts of toilet training. Start training when you have at least two
days in a row that are fairly calm and routine and when you will be committed to toilet training your child all
day.
• Having the right equipment makes training easier and more interesting for your child. Start by buying several
pairs of underpants, let your child pick them out if he likes characters on them. Training underpants are much
thicker than regular underwear and work well with plastic pants over them. Only use pull-ups over underwear.
When used alone, pull-ups prevent the child from having an uncomfortable, wet sensation. Extra pants that can
be easily slipped on and off are also helpful. During training, use clothes that will be easy for your child to get on
and off such as sweat pants, shorts, shorter skirts with elastic waists, etc. If using a potty seat, one that fits on
the toilet works best as it can be difficult to transition from a potty chair to the toilet.
• Create a picture schedule for your child by taking pictures of all the steps of your child’s toileting routine.
Include hand washing. Write numbers on the picture in the sequence they are performed. This schedule should
be reviewed with your child 2-3 times a day at a time when they do not need to use the bathroom. Once they
begin to improve the review can be faded to one time per day and eventually faded completely. Teach everyone
who will be doing toileting with your child the same routine so your child has consistency. The toileting routine
should always be done the same way from start to finish.
• Choose a word to indicate going to the bathroom that will be used in your family long term. Ask your school to
use this term also. Children get confused when being asked about going to the bathroom when people use many
different terms. Using a word that your child can use their entire life is preferable and prevents having to re-
train a new word.
• Once the preparation is over, start the first day by dressing your child in their new underwear right away. Using
pull-ups or plastic pants over the underwear will minimize leakage. Using the baseline chart as a guide, at the
scheduled time, take your child to the bathroom and have him follow the picture routine. As you child goes
through the toileting process, point to the picture schedule using minimal language. Give the least amount of
assistance possible for each step. This will promote success and lead to independence once the steps are
mastered.
Rev.0612
Tips provided by - Little Friends Center for Autism www.littlefriendsinc.org
Prepared by: The Autism Program of Illinois www.theautismprogram.org

2. Autism Spectrum Disorders
Tips & Resources
• When you take your child to the bathroom, check to see if he is dry and praise him with a phrase like “yeah dry
pants!” If he has an accident, tell him in a neutral voice, “no wetting or “no poop in pants”. Have your child sit
on the toilet for 3 minutes at a time using a timer or First/Then transition aid to let him know when he is done.
Stay in the bathroom with your child so he feels safe and comfortable. If he has trouble sitting for the 3 minutes,
provide a toy, sing him a song, or give him a book.
• If he goes to the bathroom and was dry praise him and give him a motivating reward such as a favorite snack,
blow bubbles or give him a favorite toy. If he goes to the bathroom but was wet or soiled, only praise him for
going to the bathroom. If he was dry but does not urinate or have a bowel movement, praise him for being dry
only. Rewards for toileting should be very motivating and only used for toilet training. If your child begins to get
bored with a reward, change it. Rewards should be enough that they are reinforcing, but not so large that your
child will become easily satiated with the reward.
• When your child has an accident, tell him “no wetting.” Show him the picture schedule and take him to the
bathroom following the complete sequence. Have him sit for two minutes using the timer. If your child goes to
the bathroom, praise him but do not give him a reward. When your child has an accident, you may want to have
him take his dirty clothes to the laundry room. You should also have your child get dressed by himself with the
least amount of assistance possible. At no time should you scold your child or be punitive. As your child
improves, rewards can be faded.
• As your child stays drier for longer periods, increase the time before taking him to the bathroom by 15 minutes.
Your goal will be to fade these times to more natural times such as first thing in the morning, before lunch, after
lunch, after school, after dinner and before bed. You will also be working towards your child initiating toileting
on their own.
• For bowel movement training, take your child to the bathroom at the times the baseline chart indicates they
have a bowel movement. Have them sit for up to 20 minutes using the timer or transition aid. Make the
environment relaxing with books or calm music. Stay with your child so they feel safe. Follow the same reward
procedure as for toileting.
• Bowel training is best started when a child has regular bowel movements and does not soil at night. Do not
allow children to sit in wet or soiled clothes for long periods. Allowing them to remain wet may desensitized
them. If they are not uncomfortable when wet or soiled they may lose their motivation to be toilet trained.
• Do not be overly concerned about night time accidents. Many children do not master this until they are eight.
Rev.0612
Tips provided by - Little Friends Center for Autism www.littlefriendsinc.org
Prepared by: The Autism Program of Illinois www.theautismprogram.org