http://www.personal.kent.edu/~depeters/data/toilet/toilet.htm

See list of other resources on the net about potty training at the end of this article below. Or click here.

FACTS FOR FAMILIES: 

TIPS FOR TOILET TRAINING CHILDREN WITH DISABILITIES

Children with disabilities are often more difficult to toilet train than other children.  Not all children will respond in the same manner to a particular technique.  Therefore, if is often helpful to be aware of different strategies.  Overall, it is important to be consistent, patient, and never punitive when there are toileting accidents. Remember, this is a learning experience for your child, so treat accidents in a neutral way! 

Assessing Your Child's Readiness

Before beginning any training, assess your child’s readiness by asking the following questions:

Does the child have awareness of, and control over, his/her own body? 

Children with autism may not have awareness of or control of his/hers body. Scheduled toileting may be needed and diapering at night may need to be used.

Is the child socially motivated to be trained?  (Is s/he pleased by the thought of being a "big boy" or "big girl", or of wearing big kid's underwear? 

Frequently children with autism are not motivated by these occurrences.

Is your child able to speak and/or understand the language used in the process?

Sometimes a child with a disability may not understand the explanations or process involved.

Is your child able to sequence and organize information and attend to relevant stimuli or information?

Many children with autism have difficulty following steps, keeping their focus on the relevant information, or have difficulty with awareness of bodily sensations.

Is your child agreeable to changes in routine? 

Some children may balk at changes due to toilet training, such as wearing underwear when they had been wearing diapers.  They may also have difficulty switching their focus from the activity they were engaged in before the potty session.

Is your child able to integrate sensory information, such as establishing a relationship between bodily sensations and the need for toileting functions?

Many children with disabilities, especially autism, are not aware of the cues that signal a need to visit the bathroom.  Also, some children are overwhelmed by the sensory stimuli in a bathroom, from the sound of rushing water, to the sight of the huge hole in the toilet, to the tactile senses in taking their clothes off and on.

If you were able to answer "YES" to the previous questions, your child may be ready for toilet training!

If, however, you answered "NO" to many of the questions, your child may need more structure and visual cues to help him or her succeed at toilet training.  Following the steps outlined below may help the child with autism and other disabilities reach the goal!

Follow these important steps to help guide you in the toilet training process:

1.    Define a reasonable goal for your child. 

Your child may need many smaller steps before reaching the final goal.

    2.    Observe and assess your child’s understanding of  the toileting routine.

Consider your child's disability and look at the task from your child's point of view.

3.    Establish meaningful routines and collect “data” about  your child’s readiness for toilet training. Ask yourself the following questions: Does my child remain dry for long periods of time?  According to the data, does he or she have a regular schedule for wetting or soiling?  Is the child aware that he or she is wet or soiled?  Are there signals or clues that the child is about to, or is engaged in, wetting or soiling?  

    If you answered “no” for all of these statements, your child may not be ready for toilet training; however, you may be able to work on bathroom routines in the meantime.  

    You may need to teach the child how to dress and undress him/herself. 

    You may need to work on allowing the child to get used to the noises and sight of flushing.  

     You might consider working on consistent routines for your child, and expanding his or her attention span long enough to complete a bathroom sequence.   

     It may also be necessary to assess you child’s ability to complete each step of the toileting sequence.  

     Then proceed to teach one step at a time, using a task analysis sequence, such as entering the bathroom, pulling pants down, pulling training pants down or diaper off, sitting on the toilet/ getting toilet tissue, using toilet tissue, throwing tissue into toilet, standing up, pulling clothes up, flushing toilet, washing hands, drying hands, leaving bathroom, returning to the play area.

 Specific Toilet Training Tips and Methods:

    Many teachers and parents of autistic children have found it helpful to incorporate physical and visual structure to the process.  Using a concrete or abstract transition object allows some children to make the transition easier, such as carrying an empty baby wipe box or a picture of a toilet on a card.  Making the bathroom and toilet area secure by providing stepstools, rails, and opening reducers have helped many children.  A visual sequence of the process using picture cues is often helpful for those with sequencing and attention problems, including what happens when the child finishes the process (to provide closure, as task completion is a powerful motivator for some children with autism).  

The "DRY PANTS " METHOD:

Another popular method is to teach children the difference between wet and dry sensations, and to deliver reinforcement contingent upon having dry pants. 

For this method, it is important to not use diapers or Pull-Ups on the children, so they can actually begin to feel the difference between wet and dry.  Instead, use cloth training pants with rubber pants over them.  

Complete a dry pants check every 1/2 hour to 1 hour, using a timer.  Ask the child, “Are your pants wet or dry?”  If they are dry, reward the child.  If they are wet, give only a neutral expression.  If the child answers incorrectly, guide the child’s hands to his or her pants and say, “They are (complete the correct word) wet/dry”.

Use a sticker chart to reinforce the child for urinating and having bowel movements in the toilet.  

Make the learning experience one of fun and excitement, by offering books, a stool, music, and other comforting items.   

 Adding Structure to the Child's Environment

Many teachers and parents of autistic children have found it helpful to incorporate physical and visual structure to the process.  Using a concrete or abstract transition object allows some children to make the transition easier, such as carrying an empty baby wipe box or a picture of a toilet on a card.  Making the bathroom and toilet area secure by providing stepstools, rails, and opening reducers have helped many children.  A visual sequence of the process using picture cues is often helpful for those with sequencing and attention problems, including what happens when the child finishes the process (to provide closure, as task completion is a powerful motivator for some children with autism).  

MORE TOILET TRAINING TIPS:

Use a problem solving process when you are troubleshooting problem areas.

-Remember to think about the process from the child’s perspective.

-Consider how you can manipulate the environment to simplify or clarify the process for your child.

Internet References:

Boswell, S. and Gray, D. TEACCH Preschool and Center          

E-mail: Susan_Boswell@med.unc.edu

Hoverstott-Cockrell, K.   e-mail: cockrell@softhome.net

www.KidsHealth.org

National Network for Child Care

www.aacap.org

Prepared by Dianne Peters, M.Ed.

Other resources on the internet. The site following is very informative.

Title: http://www.pottytrainingguide.com
URL Address : Potty Training Tips
Description : - New and exciting site provide guide, article, tips and free
newsletter about potty training for children. Visit us to get free ebook and
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page updated 6/10/05