Tips to Help with Toileting Skills

• Toileting independently is an important skill that affects quality of life and social acceptance. Not being toilet trained can create social barriers and prevent participation in recreation programs and impact employment opportunities. Work with teachers and therapists to develop toileting skills.
• Teaching this skill can be easier if a person shows readiness signs for toileting. Readiness signs include staying dry for an hour at a time, following one step commands, and understanding cause and effect. Looking uncomfortable when wet or soiled may not be a readiness sign for people with ASD due to reduced body cue sensations.
• Commit to toilet training. It can be challenging, but it is worth it.
• When committing to toilet training, it is important that the person wear underwear instead of diapers or pull-ups. The person needs to begin to recognize the sensation of feeling wet or soiled. Disposable garments prevent a person from that sensation.
• One method is to have the person practice sitting on the toilet for two minutes at a time, with five minute intervals between practice sessions. Choose a time when the person is most likely to need to have to “pee” or “poo.” During these times, provide cues for actions required for toileting.
• Find a reward that is highly motivating for the person and only associated with toilet training. Let this reinforcer be visible in the bathroom, but not accessible – indicating that it will be given as a reward for successful toileting.
• If the person wets or soils himself or herself, have him or her participate in the changing and cleaning processes as much as possible. Be calm and remind the person that the “pee” and “poo” go in the toilet. Have the person assist in undressing, cleaning, and washing hands.
• Once signs of success have been observed, work on ways to encourage the person to self-initiate the toileting skills.
• Visual schedules and charts can be helpful for many people with ASD. A sample schedule is available at www.childrens-specialized.org/KohlsAutismAwareness. Having this type of schedule laminated in the bathroom can serve as a guide during the toilet training process.
• A helpful teaching tool is to model appropriate toileting skills. A trusted family member could bring the person into the bathroom to demonstrate the steps of toileting. If this is not comfortable, there are toilet training videos available to use as visual models.
• It is important to be consistent when teaching toilet training skills. Communicate among all the people involved in the life of the person with ASD, including teachers, therapists, relatives, friends, and other caregivers. It is helpful to have a written plan about how the person currently performs the skills, how often he or she goes to the bathroom, what terminology is used, what rewards are given, and how to handle toilet training accidents.

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For more information about this program contact: KohlsAutismAwareness@childrens-specialized.org

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