Toilet training can be a difficult process for any child and parent, let alone a child with Autism Spectrum Disorder (ASD). It’s best to start the toilet training process after your child is already aware that they are eliminating in their diaper or pull up and show interest in using the toilet. This could look different in different children, including, but not limited to:

Your child showing interest in the bathroom/toilet
Telling you when they’ve soiled themselves and need a new diaper/pull-up
Going to a private area in the house to eliminate in their diaper/pull-up

When the signs are there and you’re ready to start toilet training, follow these steps below:

Before starting the toilet training process, check with your child’s doctor to rule out any medical issues that may prevent them from successfully toilet training.
If there are no underlying medical issues, start by getting your child into a routine of using the toilet.
Use a visual schedule to prepare your child for toilet training. Using a schedule can eliminate the element of surprise and will give your child a chance to prepare for toilet training. We have a prepared a free PDF Visual Schedule for a Boy or a Girl if you choose.

Pair the toilet training with an icon or having your child vocalize “potty” or “bathroom”. Ultimately, we want your child to learn that when they say these types of words they’ll get access to the potty, and will ultimately be reinforced in the end.
Set a timer for every 60 minutes and take them to the bathroom.
The frequency of how often you take your child to the bathroom really depends on your child. If your child is extremely resistant to sitting on the toilet, you might want to take them more frequently to increase the amount of teaching opportunities.
In the early stages of toilet training, we cannot expect your child to start using the toilet right away. Instead, provide praise to your child for just tolerating sitting on the toilet.
Pair the toilet with something reinforcing – for example, allow your child to watch a special video or give them a special treat that they only receive when sitting on the potty.
As the toilet training process progresses and your child continues to tolerate sitting on the toilet, start to fade out the reinforcement of the video or treat.
Since we already know that they can tolerate sitting on the toilet, we want to start increasing the response requirement for earning the video or treat. This means that we will start only giving the child the video or treat AFTER they go to the bathroom.
Make sure instructions are clear and concise – whether you want your child to sit on the toilet or stand, make sure it’s clear to them what your expectations are.
BE CONSISTENT: this is the most important step! If you are not consistent, the child will never get into the routine of using the toilet. Make sure to stick to the schedule and keep the expectations consistent in order to best teach your child how to independently use the toilet.

It’s important to remember that toilet training is not a “one size fits all” type of process. Each child is different and it will take various lengths of time and lots of trial and error to find what’s right for your child. Remember, don’t give up just because it’s not working right away. Toilet training takes time and patience. It’s best to consult with your doctor and team members when going through the toilet training process.

Colleen Mara, M.S., BCBA
Associate Clinical Director, Philadelphia, PA
Tuesday, October 20, 2020

Toilet Training Children With Autism