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How to toilet train a child with autism

Toilet training is a daunting, yet necessary process. For the child to assimilate well with the outside world, good toilet habits are fundamental habits that would serve them well if properly trained from young. In this article, we’ll be sharing with you a clear and step-by-step plan on how to successfully toilet-train your autistic child.

WHEN SHOULD I START TOILET-TRAINING?

Toilet-training usually begins when the child turns two. However, a better guide would be when the child displays the ability to control his/her bowels muscles. Training before this would be pointless as the child would be physically incapable of holding back pee or poo.

A PRACTICAL PLAN FOR TOILET-TRAINING

This plan is split into three main segments: before self-initiation, after self-initiation and the accident procedure.

The Set-Up

Place the child’s regular play table or mat near, and in view of, the toilet to allow ready access.

THE PROCESS

Before Self-Initiation

Through our years of experience with toilet-training children, we’ve found that working in
cycles of 30 minutes works best.
• Spend the first 20 minutes engaging the child in some form of activity while giving him/her as
much fluid as possible.
• After which, gently prompt the child to sit on the toilet bowl for 10 minutes.
• If the child urinates, reward the child generously. This is important and should not be
skipped.
• If the child does not urinate, don’t fuss. Simply allow the child to get off the toilet bowl and
return to the table. Do not reward.
• Repeat the cycle while doing a dry-pants check every 5 minutes when the child is not on the
toilet bowl.
• Should the child inadvertently wet her pants, activate the Accident Procedure, as outlined
below.
The main objective of this phase in the toilet-training process is to reach the point of
self-initiation. When the child learns self-initiation, he/she learns to go to the toilet to urinate
when needed, without being prompted. When this is achieved, the child moves into the next
phase of the toilet-training process.

After Self-Initiation

• When the child has self-initiated twice, begin to move away from the toilet and into his/her
regular surroundings that include the usual distractions that he/she may likely come across
throughout the day.
• This is to help the child to further internalise his/her newfound skill and learn to apply it
across all environments and settings.
• From this point forth, the child will no longer be on the half-hour (30 minutes) cycle.
However, accident procedures and dry-pants checks continue to be conducted by the
caregiver.

The Accident Procedure

When the child wets his/her pants, conduct the Accident Procedure. This is an important process because it gently, but firmly, communicates to the child that wetting his/her pants is frowned upon and “not good”.

• Get the child’s attention and say, “No, you wet your pants”.
• Get the child off the chair and onto the toilet bowl.
• Keep the child on the toilet bowl for 2 minutes. Do not talk to child.
• Get the child to feel the wet pants.
• Say “clean up” and get the child to assist in the clean-up by guiding the child, hand-overhand, to take off her pants and wipe down with a cloth.
• Get the child to put their soiled pants into a designated basket.
• Instruct him/her to get some clean pants and put them on.
• Get the child to wipe their chair if it has urine on it.
• Bring the child through the toilet routine once more. While the child is on the toilet say,
“Wee in the toilet”. Keep the child on the toilet bowl for about 10 seconds.

ADDITIONAL TIPS

Have a designated bucket where the child can place their soiled clothes.
Make sure that there are clean pants in the toilet that is readily accessible for the child.
Have a cloth ready for the child to clean up whenever they wet their pants.
If the child is reluctant or throws a tantrum, do not give in. Firmly ignore the behaviour
and go through the procedure. In fact, it is actually a good sign as cleaning up becomes a
negative consequence for the child.


Toilet-training is a process that requires a huge amount of patience, effort and love. However, it is an essential developmental phase and necessary for the child’s comfortable assimilation into society.

We hope that the plan that we’ve outlined in this article would prove as effective for you as it has been for us. If you do meet with any difficulties, or have any further questions, don’t hesitate to drop us an email.

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