Is your child:
Toilet training is often a challenging process in families with and without developmental difficulties. Parents may hear that they have to wait for the child ‘to be ready.’ However, in clinical practice, we see more often that the parents need to be ready. Children with a developmental age over 20 months are generally old enough to learn.
It is not necessary that that the child knows when he has to go to the bathroom or communicates that need. Instead, as a parent, you have to be willing to commit to the process. Prepare to be patient, consistent, and positive. It is helpful to track your child’s natural schedule for urinating or having a bowel movement.
Think about your child’s diet. Consider reducing dairy products and increasing foods that are rich in fiber and liquid, such as fruits and fruit juices. It may be necessary to consult your child’s doctor to ensure that no medical issues are restricting the potential to toilet train and to supervise any dietary changes.
Toilet training falls under the adaptive skills or ‘activities of daily living.’ Although any child could struggle with toilet training, children with disabilities tend to have additional challenges.
This struggle could be because of delayed development of language, lack of motivation to toilet train, lower degree of social skills and reciprocity, sensory problems, and digestion issues.
This program is a best-practice approach to toilet training, which can be effective for children with or without developmental disabilities. The program prescribed below, is provided in consultation with and the permission of Susan Hepburn, Ph.D., Clinical Psychologist.
The most success comes from experience without diapers. It is important to begin with daytime urination training. Later, you will teach bowel training and night training. So, for now, the child can wear pull-ups at night. Also, if special circumstances arise (such as a long car ride or school field trip) in which going without a diaper is just not practical, you can decide to put one on your child. However, more time spent in diapers will make the training go slower. You have choices, don’t make yourself crazy, but know a trade-off is involved. Also, you may find you want to put plastic sheets on car seats or on furniture.
For most kids just starting out, combine scheduled trips (where you initiate taking them to the toilet at a time when you think they might be successful) and taking them as soon as it looks like they might be voiding. To do this approach well, look at your child’s typical toileting patterns. For example, how long after your child eats or drinks does he/she usually go? For most kids, we don’t want to do too many trips – or else is becomes meaningless – so aim for no more than 1 trip per hour.
Any combination of methods may help, depending upon the child’s learning style. For example:
Whatever methods you choose, commit to following your plan for at least 3 weeks before you change it. If possible, have the child practice this skill in many different places.
You need to know the times the child voids and where it happened (accident or in toilet).
Talk to your team (school, family members, or other parent) about when the successes are happening. What can be done to make them happen more often? Implement any additional rewards or structure of teaching that you think will help to learn this skill.
Remember, most behavior plans do not work immediately. Your child may not be motivated by the rewards you chose. Your child may get frustrated and lose interest suddenly. You may find that the plan does not work as well when you are on the go. Regardless of these issues, don’t give up.
If you do not get sufficient progress within 3 months, seek some more guidance from a professional such as an Occupational Therapist or Psychologist who does a lot of toilet training. New methods are always available to try!
If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.
Children who have significant problems in this area may have any of the following potential disabilities. *Note, this information does not serve as a diagnosis in any way. See the ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.
If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.
These professionals may recommend or administer the following tests if toilet training is an issue:
Toilet training products: http://www.galaxy.com/rvw93474-41438/Toilet-Training-Made-Easy-Sinkems.htm
Toilet training products: www.webehave.com
Bed wetting solutions. THERApee: www.bedwettingtherapy.com
Books on toilet training: http://www.parents.com/fun/entertainment/books/potty-training-books/
Toilet training tips for children with disabilities: http://www.specialchild.com/tips06.html
Toilet training for children with down syndrome: http://www.ds-health.com/train.htm
Tips for children with autism: http://www.bbbautism.com/pdf/article_25_toilet_training.pdf
Alarms and adaptive equipment for older children www.bedwettinghelp.com
Toileting Tool Kit: www.autismspeaks.org
Recent article from autism treatment network on toilet training: https://www.autismspeaks.org/blog/2016/07/22/toilet-training-dilemma-our-6-year-old-fights-going-near-bathroom
Article on dealing with constipation in children with autism: Autism Speaks ATN/AIR-P Guide for Managing Constipation in Children –
Dr. Susan Hepburn, PhD, Clinical Psychologist consulted on this article. She is a leading clinical researcher and published author, teaching courses, training clinicians, and supporting community agencies in rural areas in best-practice assessment procedures and interventions. Dr. Hepburn is an expert in toilet training and consults with families and school districts to promote effective evaluations and treatment for children with autism and other developmental disabilities.
Dr. Marcy Willard, PhD, Psychologist, co-authored this article with Dr. Hepburn to disseminate this important information to families around the globe. Dr. Willard is a Nationally Certified School Psychologist and a Licensed Psychologist. She works with children from kindergarten-middle school on social, daily living, and academic skills.
Description the idea of training the child to the potty with a toy bear, which also sits on a toy potty
Stock Photo ID: # 115482563 (Big Stock)
Previously Licensed on: October 21, 2016
Stylized by Katie Harwood exclusively for CLEAR Child Psychology