Toilet Training- Common and Effective Methods

Are you wondering where to start when deciding how to toilet train your child with autism? We always recommend creating a plan. This will allow everyone involved in the process to know their role and the steps that will allow your child to be most successful in the shortest time. If possible, teaming up with a professional in the field, such as a behavior consultant or behavior analyst, can be beneficial to create a toileting plan and provide ongoing consultation. Special Learning provides virtual consultation to parents that want access to a behavior analyst.

As you may know, there are several choices to make when selecting procedures. Most procedures today are a modified version of the rapid toilet training methods designed by Azrin and Foxx (1971). There are procedures that tend to produce quicker results, but requires you to remain the in the bathroom with your child nearly all day. Another procedure may take a little longer for your child to become “toilet trained,” but it allows for more flexibility in terms of moving about your home. This article will briefly describe these procedures and additional considerations.
 
Inherent to nearly all toilet training procedures is positive reinforcement (Kroeger & Sorensen-Burnworth, 2009), or rewards provided for success. It’s important you choose a variety of highly motivating rewards that can be provided immediately following a void in the toilet. Rewards can also be provided when the child is dry, or accident free. Rewards provided for successful toileting should only be provided for just that—toileting. Motivation to pee or poo in the potty will diminish if access is provided at any other time.
 
Another common technique and typically used with the procedures described below includes increased hydration. Giving your child more fluids during the toilet training process will increase the opportunities to practice this new skill. It also is likely to keep them more hydrated, making a bowel movement more likely.
 
Toilet Training in a Day
 
Sometimes called “the big day” or “the short way” to toilet train, this procedure requires the parent (or caregiver) and child to remain in the bathroom for the day (and possibly days to follow). The child begins by spending long periods of time sitting on the potty. This sets your child up to successfully void in the potty, preventing accidents from occurring. As the child is successful, the time spent sitting on the potty shortens and the time off the potty increases. The child also receives reinforcement for successful voids.
 
The child will likely need activities to do while sitting on the potty to prevent boredom and other not-so-desirable behaviors from occurring. The process should be systematic and require data collection to accurately track success and next steps.
 
Scheduled Sittings
 
Sometimes called “trip training” or “the long way” to toilet train, the child is taken to the potty to sit (or stand) at pre-determined times. Sit times are usually an interval of time, every 30 minutes for example. Sit times and break times can vary and be modified throughout, while some programs have the child remain on the toilet until voiding occurs. The interval in which the child is taken to the potty can and should be adjusted. Typically, the child is receiving extra fluids during the initial stage of toilet training to increase their opportunities to use the potty, but once those are faded out, the time between scheduled sits can be lengthened. Data will also drive if the interval between sits is too long or too short.
 
For example, if you take the child every 30 minutes but notice they sit for 10 minutes before voiding, taking them every 40 minutes may still allow them to be successful. And similarly to the procedure described above, the child receives rewards for being successful with using the potty and staying dry.
 
Additional considerations
 
If you want your child to become more independent with toileting behavior, they must also learn and master the steps of the “bathroom routine,” such as handwashing and pulling pants up and down. Communication during the toilet training process is another imperative step so requests/initiations to use the potty are taught. These topics will be covered in a future article.
 
References:
 
Azrin, N. H., & Foxx, R. M. (1971). A rapid method of toilet training the institutionalized retarded. Journal
 
of Applied Behavior Analysis, 4, 89–99.
 
Kroeger, K.A. & Sorensen-Burnworth, R. (2009). Toilet training individuals with autism and other
 
developmental disabilities: A critical review. Research in Autism Spectrum Disorders, 3, 607–618

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