Potty Training Tips for Children with Autism

What’s inside this article: Tips for successfully potty training a child with autism. Including how to tell they’re ready to potty train, when to switch to pull-ups, and tips for successful visual supports.

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Potty training is something that a lot of parents with autistic children struggle with. The same “rules” don’t apply as they do for neurotypical children.

Potty training an autistic child may be a long and challenging process. Be prepared to be patient and persistent.

Plus, children with autism may not be developmentally ready to potty train at the same age as their peers.

A common potty training method involves switching to underwear. Then, give your child lots of water or juice, and plop them on the potty every 30 minutes or so over a few days until they get the idea.

Although that method works for a lot of children, it’s probably not the best route if your child has autism.

Autistic children struggle with changes and transitions due to cognitive rigidity. This can make it extra difficult for them to say goodbye to the diapers that they’ve always used and transition to wearing underwear and using the toilet.

Potty Training Readiness

Most children are developmentally ready to potty train somewhere between 2 and 4 years old.

However, autistic children tend to have uneven development in different areas. This means they may be older before they’re actually developmentally ready to begin potty training.

Instead of using age as a guide, use these signs of potty training readiness to tell you when it’s time to start the training process.

• Pulling at their wet/dirty diaper
• Hiding when they pee or poop
• Interested in others using the washroom
• Starting to go longer periods with a dry diaper
• Waking up dry from a nap
• Telling you when they’re about to go, or when they’ve just gone.

What if your child is outgrowing diapers but isn’t ready to potty train yet?

If you have private health insurance, they may cover incontinence products (larger diapers or pull-ups) as medical supplies. You will likely need a letter from your child’s physician explaining why they’re needed.

If your child is covered under Medicaid, their diapers or pull-ups should be covered under Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) once they’ve outgrown standard diaper sizes. 

If the above solutions aren’t an option, Pampers sells a product called “Under Jams” designed for nighttime bedwetting that are available up to a Youth XL, and Huggies sells a similar product called Goodnites.

The Abena: Abri-Flex line is also a quality line of pull-up style products that come in a broad range of sizes.

Use pull-up products for as long as necessary.

Kid’s with special needs who struggle with making transitions will benefit from taking this change one small step at a time. 

If you try to make the switch too quickly, it could cause them to regress, extending the process.

Tips for Potty Training an Autistic Child

1. Familiarize Your Child First

Before even asking your child to sit on the potty, you should make sure it is a familiar object to them, first.

Do this by having the potty in your bathroom, so it’s something they see every day – but without drawing too much attention to it in the beginning.

You can also read stories to your child that include the potty to increase the familiarity. These are my favorite books about potty training.

2. Take Baby Steps

Start out with small expectations. Don’t expect your child to use the potty the first time you ask them. Actually, don’t even expect them to sit on the potty undressed at first.

If your child is nervous, take baby steps. You should take this at your child’s pace.

• Start by sitting on the potty or toilet, fully dressed
• Next, ask them to sit on the potty wearing a diaper or pull-up
• Once they’re comfortable sitting on the potty, encourage them to pee sitting on the potty (while still wearing their pull up).
• Undo the sides of their pull up, and get them to use the potty while sitting with the pull up undone.
• Place a clean pull up under the lid of the potty and have your child use the potty undressed so they’re peeing into the pull up while sitting on the potty
• Have your child use the potty on their own!

3. Use Rewards

Reward your child any time they meet your potty related expectations. In the beginning, you may be rewarding them for just sitting on the potty. Later, they’ll be rewarded for using the potty.

Verbal and physical reinforcements should be given within 3 seconds of the behavior occurring. In other words, you need to have the reward ready when you take your child to practice using the potty or toilet.

The reward should be something they only get for using the potty/toilet and it should be something that motivates your child.

Rewards could be anything from tokens on a potty chart, to stickers, to jelly beans. It just needs to be motivating.

4. Keep the experience positive

You do not want your child to have any negative feelings associated with going to the potty. If your child has bad feelings about the potty it will make the process even more difficult.

So, to the effect — if you ask them to use the potty and they say “no”, simply say “okay” and move on. If your child tends to avoid demands you can find some tips here.

Never hold your child on the potty or not allow them to get up until they use it.

5. Don’t punish accidents

If your child does have an accident in their pull up don’t punish them, or scold them.

It takes time for kids to learn to recognize the cues that their body sends to say it needs to go, and learning something new that’s such a big change can be difficult.

Patiently, clean your child up after an accident without drawing too much attention to what happened.

6. Help them learn to recognize their body’s cues

Interoception is the sense of our body’s internal state. This interoceptive awareness is what tells us we need to use the bathroom.

Children with autism often struggle to recognize their body’s signals which can add to the challenge of potty training.

It may help to show your child that they can check if their bladder is full by gently pushing on their lower abdomen.

7. Use visuals

Children with autism sometimes struggle to follow multi-step directions. Well, it doesn’t feel like it since we’ve been doing it so long, but there are many steps to using the toilet.

You need to:

• Pull down your pants
• Pull down your underwear
• Sit on the toilet
• Use the toilet
• Take some toilet paper
• Wipe
• Pull up your underwear and pants
• Flush the toilet

That can be a lot to remember! Use visuals to help your child remember the steps.

I found a bunch of great toileting printables on Do2Learn that cover all the steps. Print and laminate these and hang them near your child’s potty or toilet to provide a visual aid.

8. Address constipation or other gastrointestinal issues

According to the American Academy of Pediatrics, 36% of children with autism have significant gastrointestinal issues (compared to 2-5% of peers).

Constipation can make toilet training a child with autism more difficult. Especially when it comes to using the toilet or potty for bowel movements. Addressing these issues can make potty training easier.

Some children require an abdominal radiograph to actually assess the degree of constipation. Your physician can guide you on the right way to manage constipation depending on your child.

Personally, we use both a daily fiber gummy and a daily prebiotic/probiotic for GI health.

9. Don’t rush nighttime training

Even after a child is completely potty trained during the day, it can take time (sometimes years) before they’re able to stay dry during the night as well. Don’t rush nighttime training.

If your child is getting self-conscious about needing a pull-up at bedtime. Or, you want them to start trying to go through the night without the pull up to see how they do but still have protection, try Peejamas .

Peejamas are nighttime training pants that are an alternative to disposable diapers. Meant to support your child with nighttime incontinence or to get over that final hump of potty training.

They’re significantly more absorbent than daytime training pants and can be used (and washed) up to 300 times before they start losing absorbency.

This makes them both an eco-friendly and economical alternative to night time pull-ups.

They currently offer up to a size 7 but are releasing a size 9 by 2020.

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