Whether potty training autistic boys or potty training autistic girls, the process of potty training a child with autism may be more lengthy, slower and a bit more of a challenge than normal potty training. Autism is a spectrum disorder and where your child is on that spectrum will influence the potty training timetable. But it can be done, and you can do it. Just be all the more patient with your child.
If you have an autistic child then there are some things that you are already aware of, both medical and behavioral, that will influence the potty training process. The most common medical condition encountered with autistic children are gastrointestinal problems. If you see or suspect a medical condition that may affect the potty training process I would urge you to consult a medical professional.
On the behavioral side, autistic children are routine driven in extreme cases even to the point of being ritualistic. That is, they do not like change. They have a set way of doing things and that is how they want it to stay. Which means, if your child is accustomed to using a diaper (and he or she probable are) they will resist changing from diapers to underwear. Change can create anxiety issues in your child that need to be patiently dealt with.
Breaking old and well-established routines is part of the challenge of potty training autistic children. But it can be done. The challenge is in creating new routines that both you and your child can live with.
Then there is the problem of general developmental delay. Autistic children generally learn slower than other children. This does not mean that the child is not smart. An autistic child may be very bright, very intelligent, but they may develop this intelligence more slowly. This just means that you will have to be a little more patient, a little more persevering.
Thirdly, in many cases communication can be an issue. You will need to understand how to clearly communicate your desires to your child and also how to understand your child’s verbal and nonverbal cues.
And speaking of nonverbal cues, in the case of autistic children, they often do not show the usual signs of the need to go that you would see in other children. They often go with any apparent warning that an accident is on the way.
Keep communication simple by using short phrases and visual aids
Much of the difference between potty training an autistic child and potty training a normal child lies in the realm of communication. Keep verbal communication very short and to the point. For example, do not say, “Do you need to go potty now?” but rather something short like “Time for potty?” or “Potty now?”
Also, visual communication used in combination with the verbal can be effective. This would consist of clear and simple cartoon pictures that you or the child can point to, such as a picture of a potty, a roll of toilet paper, etc. Pictures that show what you are wanting the child to do, or that the child can point at to show what they are wanting to do.
Follow up your communication with action. Tell your child “time for potty” point to the potty picture and then take your child to his or her potty. In the beginning do this on a regular schedule. Have them sit on the potty for a while and let them know it is OK if they cannot go. Remember part of the process of potty training an autistic child is establishing a new normal, a new routine for them to follow, so regularity and consistency is important.
Entertainment and rewards
As the child sits on the potty, keep them engaged by reading to them, telling stories, giving them a coloring book, etc. Generally, children are not interested in sitting still or extended periods of time. So, make potty time as interesting as possible.
If they do go, even if only a tiny dribble, reward them in some way. And do this quickly so they make a connection between successfully going to the potty and receiving the reward. This helps to reinforce in their mind that going potty is something desirable. But take care that the reward you use is used exclusively for potty training, and exclusively for successfully going to the potty. Do not inadvertently teach them that there are other ways they can get that reward.
If the reward is something the child desires and they learn that successfully going potty is the only way they can get it, it will motivate them and speed the learning process. Remember, your autistic child is routine driven, so be sure to make the reward immediate and be sure to be consistent with the reward.
Accidents will happen. Just stay calm, stay cool
Yes, accidents will happen, more often than you would like. When they do happen, stay calm, stay cool, and do not make a big deal over it. Definitely do not fuss or scold or give any kind of negative feedback. In other words, do not reward them with extra attention (positive or negative) when accidents occur. Let them know that accidents are OK but remind them to try to use the potty next time.
Diapers, Pull-ups or Underwear?
Normally you would transition your child from diapers to pull-ups to underwear. With autistic children you may want to skip the pull-ups and go straight to underwear. Why? Because diapers and pull-ups have become so good at absorbing moisture may not realize they peed. Not so with underwear. By using underwear early on in potty training your child, the discomfort of wet underwear becomes associated in the child’s mind with accidents and provides additional motivation to go to the potty.
Prime the pump
One tactic that is often used in training a child to use the potty is give the child a glass of water or juice about 10 or 15 minutes before you think they will need to use the toilet. But do not give them an excessive amount of water or juice. This increases the likelihood of a successful potty succession, which subsequently increase the likelihood of the child associating the sensation of the need to go with going to the potty.
Wiping themselves and flushing the toilet
As toilet training progresses you will want to start teaching them how to wipe themselves, and how to wash up afterwards. With girls you will want to emphasize that they wipe from front to back to prevent the spreading of germs from anis to vagina, thus preventing infections.
At some point you will want to start letting your child flush the toilet. First show them how it works. Let them watch you flush it when empty a few times and watch the water as it swirls. Put something in the toilet that is flushable and let them see what happens to it. Try to make flushing something interesting to the child and then let them try it themselves.
Remember, ultimately you want to teach your child to be independent. So, when they start wanting to do things themselves, let them. But do not push them to act independently too quickly. You want to keep the stress level as low as possible.
When teaching a child to flush, make it interesting, but also teach them that they are not to flush it again and again. Yes, it is fun, but the toilet is not a toy for them to play with. Teach them that they get to flush when they are successful in going potty.
Teach them to wash their hands
This is very important, and it is a habit, a routine that you want to instill in them early. It is recommended by some that you let your child pick out for themselves a special soft soap that they get to use whenever they go potty. Again the point is to make the process something special in the mind of the child.
Medical issues that may affect toilet training
As a reminder, on the medical side, it is not unusual for autistic children to have gastrointestinal issues. These may complicate the potty training process. This may manifest itself as constipation, diarrhea, bloating, etc.
As I have already noted, if you suspect that your child has any medical issues, gastrointestinal or otherwise, see your pediatrician. Get professional medical advice.