Toilet Training and Autism Spectrum Disorder (ASD)



                                                   
   


Children with Autism Spectrum Disorder (ASD) often prefer structured routine in their life. It is important to understand child’s level of awareness, strengths and challenges before starting toilet training. Most of the times children with ASD or Developmental Delay have sensory issues and poor motor planning skills causing too much of difficulties while understanding and carrying out this essential and unavoidable life-skill task.

Parents are advised to carefully identify and understand the indicators or signs of “good time to start” toilet training of their child. Usually, children display different behavioural patterns such as being fidgety or distracted when they are wet. They may show gestures of discomfort. Sometimes children also express their concerns by pointing towards their nappies. This is a strong indicator that child has developed awareness about wee and poo.

Children with tactile defensiveness might display greater sensitivity towards wet or soiled nappies, however, those with tactile hyposensitivity might not have awareness of wetness, being soiled or when they started/finished weeing or pooing.

Developing a toileting routine can be an insurmountable problem which can cause a lot of frustration to both parents and the child. Changing routine from wearing diapers or nappies to using the potty or going to toilet is a challenge for every toddler or a very young person, however, small but consistent steps towards this ultimate goal can make child independent in toilet training. Due to lack of social motivation children with Autism may not demonstrate any interest or inclination to use the toilet. Moreover, sensory issues such as a sound of the flush, toilet lighting, or the sound of toilet extractor fan can cause anxiety among children.


Toilet training tips for toddlers or very
young kids


It is advised to change child’s diapers or nappies in the toilet so that child can have acquaintance with bathroom/ toilet activities. Due to change in routine, it is expected that child may behave differently as ASD kids hate routine changes. So, it is important to understand your child and empathise with him. Parents should inform nursery or school about toilet training initially so that they can also follow the same approach and same size toilet seat should be sent school (if the school doesn’t provide) so that child does not have difficulties in sticking to same routine or toileting pattern.


For both toddlers and young children, it is imperative to make observations and identify the regular pattern of their toileting. They should be taken at set or fixed times to the toilet when there are greater chances of them doing wee or poo. This develops a systematic routine and frequent acquaintance towards washroom activities. Taking him at fixed times does not mean the child will not wet himself at another time but his frequency to approach toilet will definitely improve with time and steadiness.


Apps help initiate toilet training which can work as extremely helpful tool for parents and kids to work together and accomplish the goal.  Different apps can be used such as iCan Toilet Training Program, See me Go Potty, Potty Training Social Story.

Visual Sequence (as visual reminders) can be made and placed on the wall near to toilet so that child can follow the sequencing easily. For example, trousers down, pants down, sit on toilet seat etc. Keep it laminated!


                                                 






Show child easy to understand U-tube videos or pictures of how to use toilets. A lot of children understand and get motivated to use toilets on watching online videos as this helps them to understand process easily and comfortably. Even if they do not continue to open their bladder or bowel, continue to follow the visual sequence.The following link may be helpful for educating a child.
                                                    



 Toilet training tips for teenagers


Structuring the bathroom and removing all distractions can help the child understand what is expected of him while in the toilet. Removing objects which are not associated with toileting such as toothbrushes, make-up and laundry will help aid child understand and avoid distractions.

Think about making the bathroom as comfortable as possible, adding foot supports, reduced lighting, switching off the fan and a smaller toilet seat can all help reduce anxieties for Child. Everything in the bathroom should be set up to encourage independence.

Giving a drink 10 to 15 minutes before toileting can help the child to increase the chances to successfully doing a wee on the toilet but avoid giving too much as this creates an unnatural routine.

Some children enjoy and respond to social praise ('good boy'/well-done) however others respond better to a reward. Some children find praise difficult and keeping a calm, structured routine with a preferred activity after toileting may work better. It's important to remember that all children are different and they will not all respond to the same teaching techniques - what works for one child may not work for another.

If the child has a fear of flushing the toilet, then mum may wish to remove this from the visual sequence and leave it until the end of the routine - after he has dried his hands. Then he may stand in the doorway while you (mum) flush the toilet and gradually stand closer each time until he is able to flush for him.

Playing calming music to drown out the noise of the flush may also help child to be soothed.

There is a range of absorbent pants and swimwear for older children available.

If the child is learning to use the toilet in another setting as well as at home, e.g. school, praise him. Appreciation makes a lot of difference.

To help your child to independently manage his own toileting routine when they are older, you can buy watches which you can set to vibrate at certain times throughout the day. Mum can then teach the child when the watch vibrates he is to go to the toilet.