Teaching typically developing children how to use the toilet is difficult enough- but what about our children who have developmental delays, Autism Spectrum Disorders, Down Syndrome, and communication challenges? Here are a few considerations and strategies to use when toilet training your child with special needs.
If your child is sensitive or upset by the sensory aspects of going to the toilet, try controlling your child's sensory experience during toileting.
Get your child familiar with sitting on the toilet by practicing for a few minutes every day.
Make him comfortable- consider letting your child wear socks, warm the temperature of the room, provide a foot stool for better support, consider a toilet seat reducer/insert to decrease fear of falling in the toilet, use warm flushable wipes, and try noise canceling headphones or background music to block out upsetting background noises.
Strategies for children with ASD
Children with ASD generally display the same signs of readiness as typically developing children do- but these signs might appear when your child is older. You might also be faced with challenges like excessive interest in repeated toilet flushing, or fear of toilet flushing- your child may not want to sit on the toilet, your child may want to play in the toilet water or with the toilet paper, your child may resist being cleaned, resist transitioning to using the toilet in public places, and boys may even resist transitioning from sitting to standing when urinating.
Here are a few tips:
Consider skipping the "potty chair" stage if your child has difficulty with change and go straight to putting your child on a regular toilet with a toilet seat insert. This limits the number of changes the child will experience in the toilet training process.
Use specific language on your child's developmental level. Provide clear and simple instructions at a level that your child can understand.
Provide encouragement and rewards:
verbal and non verbal praise
a favorite or preferred activity
Try a variety of rewards and use the one that your child responds to best- the one that works- even if it seems like an odd reward (like watching movie credits after a film on an Ipad). Sometimes it can be more effective to save a powerful reinforcer or limit access to the reward only for times when the child is dry on eliminates in the toilet. Also, varying rewards keeps interest and motivation high.
Provide visual supports: Children with ASD are often visual learners; visual aids can help reinforce the toileting routine and provide reminders for taking regular toileting breaks. PECS (Picture exchange system) and Boardmaker are good resources for visual schedules and picture icons. You can also have your therapist assist you with creating one that is individualized to your child and has the exact pictures of their toileting routine. Place the schedule on the wall near the toilet where you child can easily see it. Many children will also respond well to reward posters that are posted in the bathroom as a reminder.
Use video modeling/social stories: Social Stories are used to help children develop appropriate behaviors and responses in specific contexts and situations.
Use simple story lines with clear pictures
Write from your child's perspective
Describe the situation
Give details about what happens in that situation
Suggest how your child might respond in that situation
Explain why your child should respond in a particular way and discuss rewards they can earn
Ask your therapist for help- speech pathologists and occupational therapists can help create a social story for your child!
As with anything in parenting- consistency, patience, and positive reinforcement are key! Remember to cut yourself some slack and don't sweat the small stuff. Keep the long term goal and mind and use WHATEVER helps your child succeed!