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.