Studies show children with autism spectrum disorder take longer to potty train when compared with their non-ASD peers. On average, children with autism take about 1.5 years to potty train to stay consistently dry and may require an additional six months (so two full years) to achieve bowel control. As with many aspects of working with children on the autism spectrum, it’s best to think of the process as a marathon, rather than a sprint, so patience and compassion are a necessity.
However, every child with ASD is different, which means much of the behavioral support we use works best when it’s personalized to your child and family. If you’re struggling to potty train your child with autism, we recommend contacting ART or a similar agency dedicated to providing behavioral assessment and support for individuals with autism and their families.
Understanding why it can take children with ASD longer to potty train helps you shape your child’s personal training program. Consider which of the following are the most relevant to your situation, and then you can decide which tips are most likely to be effective.
Additional physical or medical reasons. Nearly 75% of children with autism have additional medical conditions, called co-occurring disorders. These can complicate the potty training process. Disorders such as anxiety, ADHD, Down syndrome, Fragile X syndrome, or gastrointestinal issues may create issues that require extra attention.
Non-verbal or delayed verbal abilities. If your child doesn’t speak yet, s/he won’t ask to go to the bathroom so parents and caregivers must look for other cues and establish a clear routine.
Complications getting dressed. Children who struggle to pull their pants and underpants down and then pull them back up (which also may translate to difficulties wiping themselves) require more support.
Fears. Children with heightened anxiety or fears may be afraid of the toilet, dread loud flushing noises, or not trust the feeling of a bowel movement dropping out of their body. A child afraid to use the toilet will happily find other alternatives until they’re desensitized and can trust otherwise.
Missing body cues. Some children with autism simply don’t feel or recognize the body’s natural cues signaling it’s time to empty the bladder or bowels until they’ve already soiled their pants.
Varied toilets/bathrooms. Many children with ASD potty train at home but have difficulty in other locations due to different setups, varying flushing mechanisms, etc.
Again, we know it’s so challenging, but patience and the ability to remain calm - even in the midst of accidents - are essential to slowly but surely getting your child to trust and participate in the potty training routine.
Less is always more when communicating with an individual with autism. That’s especially true if the child is largely non-verbal. In this case, start with clear statements, not questions: it’s time to go to the bathroom. Visuals are essential. Place clear visuals on a wall or exterior shower door/curtain with the information your child needs, such as: sit on toilet, wipe until clean, flush toilet, and wash hands. There are plenty of free, online visuals to support these steps.
Children with autism are often highly-sensitive, which means anything from cold toilet seats, loud flushing mechanisms, or dangling legs can be enough to make them avoidant. Make sure the bathroom and toilet are as comfortable as possible and consider using a cloth toilet seat cover that diminishes the cold seat issue. A smaller training toilet is ideal for younger or smaller children.
Also, constipation can make bowel movements painful, so check for bowel consistency. If your child seems slightly constipated or like bowel movements are uncomfortable or painful, speak to their physician about higher-fiber snacks and alternatives to keep things moving.
That same extrasensory sensitivity can make accidents a nightmare if your response is one of heightened anger, gesturing, or loud vocalizations. Your child is more prone to tantrums and meltdowns when you’re stressed, anxious, angry, or raising your voice. The more you’re prepared for accidents and remain calm while cleaning them up, the closer you are to a potty-trained child with autism.
Capitalizing on that notorious sensitivity, we highly recommend shifting your child into training underwear or regular underwear as soon as you can. Contemporary diapers and pull-ups do a fantastic job of wicking up moisture, and that becomes a problem. The drier your child stays, the more content s/he is, which may delay potty training. The discomfort of wearing soiled pants is often an impetus for children with autism to get to the bathroom.
Once your child seems to be getting the hang of it in your home bathroom (always the priority), make sure to explore other bathrooms so s/he’s exposed to all of the possibilities. Public restrooms are notorious for having extremely loud flushing mechanisms, so be prepared. It may even be worth not flushing in these restrooms to keep your child moving forward. If possible, we recommend having earplugs or sound-canceling headphones for that reason or having your child step out while you flush the toilet for them.
Positive reinforcement is the foundation of any behavioral/disciplinary plan, and it’s essential when you’re potty training a child with autism. It may take a while to get all of the different steps in place, but immediately reward his/her urination or bowel movement. Waiting too long (like after s/he’s completed all the steps) may confuse the message. By rewarding him/her right after urinating/defecating, s/he learns that is the most important step. The rest you can continue to work with overt ime.
Are you struggling to potty train a child with autism? Or, are you having a difficult time understanding what part of potty training your child struggles with? The Autism Response Team (ART) is here to help. We rely on applied behavioral analysis to get to the heart of the individual and then apply what we learn so they can fully participate in the full range of everyday activities at home, school, church, and their community at large. Contact us to learn more about what we offer or to get in touch with autism support networks in your area.