TOILET TRAINING FOR CHILDREN WITH AUTISM
strategies compiled by Kathy Oehler, Autism Consultant. Resources from the following:
TEACCH – Applying Structured Teaching Principals to Toilet Training
The Illinois Autism Project – Toilet Training
A Treasure Chest of Behavioral Strategies, by Beth Fouse and Maria Wheeler
1. Conduct a baseline for one week. Check the child every fifteen minutes. Record whether
diaper is wet or dry. This information will be used to determine when to schedule toilet time.
2. Start training when you have at least two days in a row that are fairly calm and routine and
when you will be committed to toilet training your child all day. FOR THE FIRST TWO
DAYS OF TOILET TRAINING, YOU WILL NEED TO TAKE YOUR CHILD TO THE
TOILET ABOUT EVERY 15 MINUTES.
3. Buy several pairs of underpants. Let your child pick them out if he likes characters on them.
Training underpants are much thicker than regular underwear and work well with plastic
pants over them. ONLY USE PULL UPS OVER THE UNDERWEAR. When used alone,
pull ups prevent the child from having an uncomfortable, wet sensation. During this
training period, it is important that your child feels does feel the wet, uncomfortable
sensation.
4. Choose the word you are most comfortable using to refer to bathroom time – potty,
restroom, toilet, pee, poop, etc. Make sure everyone who helps your child uses the same
word.
5. Create a picture schedule for your child. The schedule should include all the steps of
toileting, in the order in which they occur. Review this schedule with your child several
times a day between bathroom trips. Have it available in the bathroom, and refer to it as the
child is doing each step. Make sure that everyone who helps your child toilet uses the same
words and the same steps.
6. On the first day of toilet training, start the day by dressing your child in their new
underwear right away. Use pull ups or plastic pants OVER the new underwear. Take your
child to the bathroom right away and follow all the steps on the picture schedule. As your
child goes through each step, point to the picture, with MINIMAL TALKING. Use the least
amount of assistance possible. Encourage your child to do each step as independently as
possible.
7. If the underwear is dry, praise your child and say, “Yea! Dry pants!” If he has an accident,
say in a neutral voice, “No wetting.” Or “no poop in pants”.
8. Have your child sit on the toilet for about 3 minutes. Stay with him. Sing a song or read a
book if he has trouble staying on the toilet for that amount of time.
9. If he successfully goes, praise him and give him a motivating reward such as a favorite snack
or bubbles, or access to a toy that is only available when he goes to the bathroom in the
toilet.
10. When your child has an accident, tell him “No wetting” or “no poop in pants’. Show him the
picture schedule and take him to the restroom and follow the full toileting sequence. Have
him sit on the toilet for 2 – 3 minutes. USE MINIMAL TALKING. Have him finish the
toileting sequence, then have him carry the soiled underpants to the washing machine. Then
have him get dressed by himself, with as little assistance as possible. DO NOT SCOLD OR
PUNISH YOUR CHILD FOR ACCIDENTS. Just return to the toileting schedule.
11. As your child stays drier for longer periods of time, move your toileting schedule to more
natural periods – before play, before and after meals, before bed, etc.
12. Bowel training should be started when a child does not soil at night. For bowel training,
determine the time of day when the child most frequently has a bowel movement. Do his
bowel training around this time. Use the process detailed above, but have the child remain
on the toilet for approximately 15 minutes at a time.
PROBLEM SOLVING
Some children with autism will struggle with very specific fears and areas of resistance. Here are
some strategies to try if your child has one of these concerns:
Resists sitting on the toilet
 Allow to practice sitting without removing clothes
 Allow child to sit on toilet seat with part of the hole covered by cardboard or a towel
 Use a potty seat on the floor instead of up high on the toilet
 Take turns sitting; or have a doll sit on the toilet first
 Add physical support
 Help him understand how long he will have to sit (sing a potty song five times; play three
songs on tape recorder; set a timer, etc)
Afraid of flushing
 Don’t flush until there is something to flush
 Start the flush with the child standing away from the toilet, near the door
 Give advance warning, with a smile on your face – “ready, set, flush!”
 Allow the child to flush
Overly interested in flushing
 Give the child something else to hold and manipulate, such as a water tube or glitter tube
 Use visual schedule to show him when flush is supposed to occur
Playing with toilet paper
 Remove toilet paper roll if it is a big problem; use Kleenex instead


Roll out the paper ahead of time
Count the squares you want him to use. Make the counting part of his visual schedule
Resists being cleaned
 Try different materials – wet wipes, cloth, sponge, etc
 Try different temperatures of the water
 Take turns wiping a doll