Potty Training kids on the Spectrum

Categories: Behavior

Potty training.

(Big sigh)

Potty training is not fun at all. Nope, not a single tiny ounce of it. In fact it’s one of my most grueling and excruciating parenting experiences to date. But on the bright side: yes, it is awful and hard, but then you will most likely forget all of that awful part and instead be left with a happy, more independent, self sufficient potty trained child. You will be SO PROUD of them and I will be SO PROUD of you.

I am not a big- You need to do it this exact way- kind of a gal. Instead I’ll tell you- Here’s what worked for us and I hope it works for you too.  I will give you the steps we used with both of my autistic boys, most which were recommended and modeled for me by our (amazing) home ABA company. I tackled this major milestone when the boys were about 3 1/2 years old. Now Greyson is 10 and Parker is 8.  It took Grey about 3 weeks to finally just start to get the process and soon after that for his daily successes to grow bigger in number than his accidents. Pooping independently on the toilet took about 10 months (that’s probably a whole ‘nother post).

These tips can work on typical children, as well as any variety of different developmental delays besides autism. I’m going to break it down into four steps because I like things in bite sized chunks.

STEP ONE: AWARENESS
A few months before potty training we spent (even more than usual) naked time outside. Each time I would see my son urinate, I made a big deal out of it to create an awareness of his own bodily functions. Up until then he hadn’t shown any realization. “LOOK! You go pee pee!” I would exclaim as he was going, making sure he was looking at me and my point towards his stream. I would also make similar comments when I noticed he was going #1 or #2 in his diaper. Neither Parker nor Greyson were showing very many behavioral or cognitive signs of potty training readiness but this was a good step to create more awareness.

STEP TWO: THE SCENE + SUPPLIES
First, you need a child and a potty! Shew, so glad we got those basics covered. I recommend a bathroom that isn’t far from where you are spending your time. You need to be able to pop in there in a jiffy.

We used a potty cover like this, and an adult toilet. I preferred using a cover as opposed to a small potty because like many people with autism, my oldest can sometimes struggle with generalizing skills, especially one as complicated as this. Most likely if my boys were trained on a small potty – we would then have to partially re-train them to use an adult potty. I also need to be able to see inside to see if they are urinating. I know some children are more versatile and can use either, or start with one and transition without too much additional stress.

You will be spending A LOT of time in the bathroom. More time than you ever have in your whole entire life so far COMBINED. This needs to be as fun for the child as possible. Be sure to stock and rotate games, toys, books, an ipad, a coin bank and coins, bubbles, and anything that can help keep your child engaged and distracted. I also made sure to have small toys available for them to hold so they do not mess with their junk. Yes, that is the appropriate medical terminology. (Junk- noun. Private parts.)

Most likely your child’s legs will not reach the floor. You need a step stool tall enough for them to rest their feet. Otherwise, the less comfortable they will be- then the more likely they are to want to get off of that darn toilet.

You also need a chair for you because guess what?- you need to be comfortable too.

I used training underwear because it’s thicker and holds more pee during accidents.

And for the final and practically MOST IMPORTANT tool (next to aforementioned child and a toilet)- A REINFORCER! Something HIGHLY rewarding to give the child each time they have a success on the toilet. Parker LOVES the Hershey Drops you see on top of the toilet. During the potty training process, we made it so they ONLY got this particular reward for a potty success. The reward needs to be much greater than the pain associated with sitting on the toilet. Keep this item in the bathroom so you can deliver it INSTANTLY after a successful pee pee in the potty. It’s also good for the child to see it so they can connect the desired behavior (peeing in the potty) to the reward. Grey doesn’t like screaming and clapping and hoopla- so I kept it as tame as possible (man was that hard ) and we made it more about the reward. “You go pee pee-you get chocolate. Great job going pee pee in the toilet.” Parker likes the hoopla (like me) so I BROUGHT IT. WOOOOO HOOOO!!!!!

Every time they went, especially at the very beginning, It’s the GREATEST feeling in the world.


STEP THREE: THE TECHNIQUE

We do potty training boot camp -which basically means full throttle from day one. We went straight to underwear (no pullups!) in the hopes that they boys would more quickly be able to instantly realize when they were urinating. We also drank lots of juice to increase the frequency of urination. Unfortunately neither boy was bothered or even seem to notice if they are wet or dirty. (Do not fret- they are now 100% potty trained so this did not hinder them from catching on). We also let him hang out in his underwear while at home to make the whole process easier. We stayed home a lot, because most places are not pants optional. Which is a good thing about the world.

You DO NOT need to wait until your child is verbal or has words for going to the bathroom to potty train. In fact, many typically developing, verbal 2-3 year olds will instantly answer “NO” when asked if they have to use the restroom anyway.

So do NOT let a child’s non-verbal status scare you or stop you from trying. At first all you really are trying to do is time your bathroom breaks to catch as many successes as possible. Then you are trying to create a mental connection within the child so that they understand that this desired behavior (peeing on the potty) gives this desired reward (a handful of chocolate). It is much more a cognitive/behavior task than communicative at this point. As that cognitive connection is being made you will overlay communicative intent by using a picture or icon of a toilet. Start with a picture of a toilet- yours or a stock photo from Google. Make several. Laminate. This suckers going to see a lot of use.  Have the child hand you the picture when it is time to go to the bathroom.

Depending on your child’s ability- have the child verbalize or approximate or say on a device, “potty”, “Toilet”, or whatever word you want to use.

Now you are ready to go for it. Make sure the child pulls down their pants, gets on the stool and sits on the toilet on their own doing. If they are not able to do this- then at first you will need to work on that skill. Adjust per any specific physical limitations your child may have. Pulling down their pants and getting on the toilet is an important part of gaining independence, learning self-help skills and the entire potty training experience.

At first keep the time spent of the toilet short- just a few minutes. Keep track by setting a timer because the bathroom is a time-sucking vortex. If your child urinates, do this same thing in an hour (and thank your lucky stars and buy a lottery ticket). What most likely will happen though- is nothing. Tick tock tick tock- and the timer goes off. Then you try again every 15-25 minutes until the child is successful. Remember to keep the time they spend sitting on the pot fun and engaging.

This is all beginning to sound a little too easy- right? So here’s what USUALLY happens. You sit them on the potty and nothing. So you take them off. And despite the 15-25 minute subsequent bathroom breaks your child will still have an accident. There were days we easily had 10+ accidents, and I was CERTAIN we were going to be in the Diapers For Life Club. Accidents are part of the path to success. You’re just starting out- so don’t consider it a failure- it actually helps you figure out how often(ish) your child goes potty. Many children average somewhere between an hour and an hour and a half. Adult consistency is a very important factor at this stage.

We followed these loose rules:
Successful potty: attempt again in an hour. As time goes by- you can increase that number to 90 minutes if it is more in line with your child’s frequency.

No potty: Try again every 15-25 minutes until successful.

Accident: Try again in 30-60 minutes, and then every 15 minutes until successful. If we keep having accidents we go completely underwearless in order to catch the pee midstream so we can then place the child on the toilet to finish.

We use pull ups for naps, nighttime and anytime we were going somewhere further away than 5 minutes.

Lucky for you, The Autism Helper Teacher Pay Teachers store has All About the Bathroom Life Skills Unit. There is something for all learners in here, and some activities you can even do while your child is sitting on the toilet.

STEP FOUR: GO EASY ON YOU
This is hard stuff and I don’t say that to deter you, I say it to encourage you. It’s hard when you hear a parent of a typical child say- “Potty training was so hard- it took us a week.” I know there are some of you that have been working at this for months and even longer without success. YOU ARE AWESOME. All we can do is get up every day, wipe the slate clean and try again. Like all hard things in life that we must move directly through- it’s a mind game and our attitude and willingness to extract some of our ego and emotion is imperative to our child’s success. It helped me get less frustrated when I reminded myself that my boys and I were on the same team and they needed me to show him how this is done. Physically- it’s not a big deal. You spend a ton of time in the bathroom and clean a bunch of dirty underwear. Mentally we can work ourselves in a TIZZY of frustration and fear that this will never happen.

I’m here to tell you, it will. And I can’t wait for YOU to tell me that it worked for you too.

Chrissy Kelly
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15 Comments

  1. Hello,

    I liked your article. Thank you for sharing your thoughts and experience. My son is 5 years old and he is in the spectrum. We’ve been potty training him for 3 days in a row. So far so good the only thing is that he is not ready to let us know when he needs to go to the bathroom.
    I know that for every kid is different but could you please tell me how long did you potty training your child?

    Best regards
    Ivette

    Reply
  2. Hello Ivette- it took about 5-6 weeks for them to urinate in the toilet on their own. They still didn’t tell me- they either just ran there or they waited until I took them. It took them about 10 months to have a bowel movement in the toilet consistently.

    Reply
  3. This is great. Since my son is home from school (he’s 6) we’re really focussing on trying to get the potty training to stick. We’re lucky he’s always been good about going when he needs to poop for a while now. He seems be getting more aware re: pee. It’s just so great to read about someone else’s experience!

    Reply
  4. You’re definitely not alone, it’s tough. Hang in there! Thanks for reading 🙂

    Reply
  5. I’m so encouraged to read your experience and was wondering what steps if you don’t mind sharing did you take to get your son to poop in the potty? I have a little girl that’s 8 and on the spectrum and she has being peeing in the potty for a long time but pooping is NOT coming along as easily. Took away the pull ups as I feel this is just giving her a way to not poop in the potty…so lost on this issue.

    Reply
  6. Hi Chrissy
    Thank you so much for this very encouraging and motivating article…my little girl Keely is 8 and on the spectrum. Do you have an article like this for poop? I am at a loss on this one we have just started trying for poop in the toilet…I am going to use some of the things you listed for pee to see if that works. Thanks again!!

    Reply
  7. Hi Chrissy! I realize you wrote this some time ago, however, may I ask for further advice? For the 2020-21 school year, I have a 5 year old in my Resource A classroom that has zero awareness of bodily functions as you mentioned in your first step. Do you have suggestions for teachers with students that need to gain awareness while in the school / classroom setting as a part of potty training?

    Reply
  8. Hi! I think that’s one you will have to bypass for safety and privacy reasons (ie- how my boys ran around with no pants on ). However- I didn’t feel like my oldest really had awareness, and being soiled didn’t bother him, which can make things harder. However, with frequency, consistency- and me catching him pee a few times on the toilet (after filling him with juice, and then instantly rewarding) he caught on after a few weeks.

    Reply
  9. Hi! I think that’s one you will have to bypass for safety and privacy reasons (ie- how my boys ran around with no pants on ). However- I didn’t feel like my oldest really had awareness, and being soiled didn’t bother him, which can make things harder. However, with frequency, consistency- and me catching him pee a few times on the toilet (after filling him with juice, and then instantly rewarding) he caught on after a few weeks.

    Reply
  10. First, I worked to figure out WHY they were avoiding pooping on the toilet. (Questions to ask yourself- does she have a step stool- is it uncomfortable? Is the flush too loud? and so on.) When you understand the WHY it can make it easier. For my boys- I don’t think it was sensory, we ruled out medical with the doctor. I knew their signs of needing to poop- and then we increased attempts. For my youngest- I couldn’t let him out of my sight for several months- because if I did- he would hide and poop. It was a TON of work- but it worked! For reinforcement for poop- we went big time. Like presents. I kept their present up out of their reach- but they were still able to view it while they sat on the toilet. They also got icecream for each poop for about a month- no matter what time of day it was. Each child is a little different- so figuring out the specifics and fully committing to the process is key!

    Reply
  11. Hi I am very appreciative of your post. My grandson is 3 and we just found out he has Autism. His mom and her mom are not as consistent with the training as I am and I know that makes it very difficult. I have him for 4 to 7 days some times I get him every 2 weeks. Is this something that you would say I am able to do in that time span or do you advise anything that can help me train him. I had purchased the little pot but I will get the cover and step stool to better train him in the time I have with him. I will let him be naked bottom down and reward him with a favorite treat I will also limit the bathroom time from 30 to 15 minutes. Looking forward to your advise.

    Reply
  12. Thanks for this post and your encouragement! My son is 8.5 years old with Down Syndrome and Autism as well as Speech Dyspraxia, so he’s mostly non verbal. We’ve been trying on and off for years! He seems ready and then he backslides or gets sick. This summer we are trying harder to get him potty trained. I just started again yesterday with underwear only and taking him to the potty every 15-30min. This morning we sat on the potty for almost 10 minutes. I knew he had to pee cause his diaper from about 4am was dry. But alas, nothing. We went downstairs and I put him in a diaper to sit and eat breakfast (we have cushion chairs) and he peed before breakfast. So, no more diapers, just underwear. Took him multiple times more throughout the morning, nothing. Then about 3minutes after the last attempt, he went around the corner by the stairs, took off his underwear and pooped on the floor *rolling eyes*. I did pick it up, walked him with it to the potty and dumped it in, saying “this is where the poop goes”, then sat him on the potty again. I’m trying to find the best reinforcement and rewards for him, gummy bears seem to help, and if he sits nicely on the toilet, he gets one. If he goes, I plan on giving him a little bag of them. Baby shark playing on the iPad is a nice distraction for him in the bathroom, just trying to find other things too.
    Nonetheless, your post really helped encourage me, so thank you!!

    Reply
    • Thank you so much for the kind words. You are doing great Mama-, keep at it!

      Reply
  13. Hi, Thank you for this article. My son is 8yrs old and on the spectrum. He has been peeing on the potty for several years now but pooping has been a challenge for us. We have tried just about everything but he is super afraid of doing it in the toilet despite many examples and techniques used. Any help is greatly appreciated or if you have something I can read it would be very much appreciated.

    Reply

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