Most children with autism can learn to use the toilet independently. But the process often takes time, energy, and perseverance!
If your child seems to gastrointestinal problems, check them out before you start toilet training. Signs of GI problems can include unusual crankiness, positioning to press on the abdomen, reluctance to use the toilet or poop, or inability to evacuate. See your pediatrician and, if necessary, a pediatric gastroenterologist. It may even be possible to treat constipation with something as simple as prune juice.
These signs, while appropriate for typical children, may be irrelevant to a child with autism. Children on the spectrum may have less sensitivity when it comes to cold, wet, or sticky sensations. They may also have muscle tone issues that make it harder for them to pull pants up or down. In addition, while many toddlers actively want to use the toilet because they see others doing it, children with autism rarely compare themselves to others.
Because of these differences, autistic children may be ready to use the toilet before they’ve mastered all those other skills. Says Kimberly Kroeger-Geoppinger, Psy.D., a clinical psychologist and assistant professor of pediatrics at the Cincinnati Children’s Hospital Medical Center, “For us, the prerequisites include ambulation, the ability to get up and down—and that’s it.”
Make sure that the toilet is comfortable. For some children, that will mean wrapping the seat in towels for extra cushiness. Other children may be most comfortable on a potty seat with handles that help them feel secure while sitting on the toilet.
Sooner or later, during the course of the day, your child will urinate into the toilet. When he or she does do the deed, celebrate! Give your special motivators, toot horns, whatever it takes to show that you’re proud. Take a break, and then go right back to the toilet.
The key to success is making it possible for your child to succeed and earn that motivating prize.
Figure out when your child is going to poop, and have him poop in the diaper while in the bathroom. Slowly, transition to having him poop into the diaper while on the toilet. Next, have him pull his pants down before sitting on the toilet. Last of all, have him sit on the toilet with diaper off.
These steps may take a long time, and you may need to break them down further and further.
She recommends starting by carefully recording when your child is urinating and making a bowel movement. Based on that schedule, you can sit your child on the toilet when you know he’s most likely to go to the bathroom. The more often you do it, the better, since it gives your child more opportunity to be successful, win motivating prizes, and reinforce positive behavior.
Once you know why your child is smearing feces, you can fill their need in another way. For example, you can give them attention and praise when they go to the bathroom without touching their feces.
