Toilet Training a Six Year Old with Autism: Your Advice Requested
Ryan McVay/Getty Images
What does it take to toilet train a child on the autism spectrum? Often, it's a long and difficult process. Kids with autism may not care about their same-age peers, or have a special interest in wearing "big boy" underwear. They may have sensory problems that make it tougher to feel the need to go. There may be anxieties around the toilet seat, the sound of the flush, and so forth.
One mom is particularly frustrated, and writes:
I have a 6 year old boy who will not do his bm in the potty. He has been to many, many specialists since he was - literally - less then one day old! He has had many tests and we have traveled to different progressive institutes... but no progress was made. He is slightly developmentally delayed. He urinates in the potty without reminders. He has been on mira-lax - on and off for years. We have also tried several different diets - and an all natural herb - based regiment.A while back, I wrote a full-length article offering step-by-step advice on how to toilet train your child with autism which takes most of those issues into account. To quote that article (and Dr. Beth Kroeger, an expert in the field) on the subject of bowel movements and autism:He always has a small portfion in his pants - regardless of how often he is changed. I agree with the idea that he no longer smells the odor - as that is all he knows. Other kids are picking up on the smell. We have tried incentives - as well as restriction. When placed on the potty - trantrums come out. It is preventing his involvement in many situations. We are all so frustrated! If ANYONE has any ideas - suggestions - please let me know!
Many children will have relatively little problem with urination, but seem reluctant to poop in the toilet. Many reasons can explain this, says Dr. Kroeger.What is Dr. Kroeger missing? Are there other techniques that have worked well for you and your child? Please share!"If there is a problem, we look at why. It may be constipation, or it may be that the child doesn't like the splash that occurs when a bowel movement hits the water. If that's the problem, we work slowly to desensitize." Dr. Kroeger also offers tips for managing toilet teaching when your child wants to poop only in a diaper. The key to success, she explains, is taking the process step by step.
First, figure out when your child is going to poop, and have him poop in the diaper - in the bathroom. Slowly, fade to having him poop into the diaper - on the toilet. Next, have him pull his pants down before sitting on the toilet. Last of all, have him sit on the toilet with diaper off. These steps may take a long time, and you may need to break them down further and further. The key to success, however, is making it possible for your child to succeed and earn that motivating prize.
Comments
I would try potty training rewards. This worked great for our son. He loved pushing the button hearing he is a Big Boy and opening a door to find a chocolate surprise. He was peeing and pooping in his potty within a week. I know every child is different, but have a look and see if this would work for you. http://www.pottytrainingrewards.com
Rewards were key during my son’s potty training (they have to be MAJOR rewards), and also picture icons detailing the whole process. I had actually to draw one myself (because I didn’t find it anywhere) showing the poop coming out of the butt and falling on the water. : D
My friend told me about this travel potty that works with diapers. It gets your child to sit on the potty and you can take the diaper off in stages, so that eventually your child will be used to going in just the potty. http://www.diaperpotty.com
Thank you so much for the suggestions. We have implimented several small and large rewards programs. They ranged from a small piece of candy to riding his motorized toys to even an ipod. He buys into them initialyy- but them refuses to cooperated when the time comes. Last count, we had tried five different potty seats. The strange part – he REALLY want to wear “Big Boy Pants”. The quantity and frequency of the bm is making that very, very difficult. I can not help but think that there are others that went through this situation. It really is creating tension and creating issues for the entire family. Any suggestions welcomed!!!
Our son had gross motor issues. He had a very weak core, and b/c of that, he couldn’t “bear down” to push when he was in a sitting position. Our day-care lady suggested giving him something to lean on, like a small box, so he could use all of his muscles to help him while he was pooping. Core muscle exercises and the boxes got him going on the potty all by himself!
Take away the diapers/pullups completely. This worked for us. It took about a month, but then we had success.
Hi Eileen,
I feel so much for you, as we have just finished 1 year 1/2 of constant potty training. In reality, only what we did in the last 6 months really brought on any success, guided by his school. I also went thru numerous potty seats and all kinds of techniques, but in the end only consistency helped. He is 6 and thus big enough for the normal toilet, get rid of all potty seats. I would also get rid of all diapers during the day. And we had the first successes when we took him out of underwear too when we knew it was about time and let him run around naked in the house. He had no problem pooping in his underwear, but did not want to soil himself when being naked!
And then get a social story, which you read every night to him, which talks about that mom and dad are sad if he has an accident and how happy they are if he has a success and how nice and clean the pants will be! Get a reward that he really wants (only one and always the same one, in my son’s case it was chocolate) and have it sitting in a cup only in the bathroom. And promise yourself to stick to whatever routine you settle on for the next three months. And see every little step as a success, it will probably start with him requesting bathroom when the accident has already happened. But that is a great start and deserves a lot of praise, but no reward.
Best of luck!
I so know what you’re going through, my son is 5 and like yours would use the toilet to urinate but not for bm. It’s so frustrating when they can understand one part of it and it seems like they don’t get the other part at all.
About 5 weeks ago, after reading and re-reading a ton of info from therapists, the internet and basically every autism book I have that talks about it, I ventured once again to tackle the pooping on the toilet. I decided on a Friday I would start taking data about all of his toileting, I’d keep giving him Miralax once a day in apple juice, have him sit on the potty chair insert on the toilet and a stool for his feet, every time he went-no standing to pee. Then thinking about what motivates him I decided to put the portable DVD player in the bathroom with a Potty Power video with him and just get him used to sitting. So Friday afternoon we spent along time in the bathroom, he sat and sat but no go. The sitting was progress however because previously he would always fight me about sitting longer than it takes to pee..
So the next day we tried it again and it was pretty much the same. Then on Sunday I decided to give him his Miralax with juice around 2:45 pm then at around 3 pm I put him in the bathroom with the DVD on , he shut the door and said bye-bye. Then I kept checking him every few minutes and then Voila! he pooped in the toilet! We gave him a ton of praise and he seemed very pleased with himself.
Then I proceeded to do the same routine the next day and he did it again —four days in a row. He even tries to wipe with toilet paper. So far, he’s only had a few accidents in his pants the first night. ON the fifth day we had appts that kept us away from the house at the pooping time, so we tried it at 6 and I don’t know if it was the break in the routine, he didnt need to go or what, but he didn’t go. Now he goes almost every day and sometimes will go 2 or 3 days without a bm, but then he does go eventually on the potty with no accidents in the pants. He fights leaving the bathroom because he wants the dvd player, but I try to offer up a snack, or a swim in the jacuzzi or play outside and that will usually help us make the transition.
I think if we just keep doing it the same over and over he’ll get used to the toilet and if he does have an accident he will hopefully not like it. He does ask for the dvd player and to go poopat different times now and often he doesn’t have to go, so I let him stay in there for 10-15 minutes and if he doesn’t go poop, he’s all done and we try later at the regular time.
I would try to think about what motivates your son, keep track of when he goes, use a stool for his feet so he has something to press his feet down on and they’re not dangling and maybe try having the door shut. I’ll be praying for you – it is so tough but I know you’ll figure it out – keep trying and hang in there.
I’ve been where you are, that’s for sure! My son is now 18, and doing well, so there is a light at the end of the tunnel.
When I finally realized that my son was hanging on to the diaper because he was just plain comfortable continuing to poop in it and didn’t want to adjust to going on the potty (too much of a bother, distraction from what he was doing at the time, etc.), I stopped using diapers during the day. Cold turkey all the way! I knew he would not like the sensation of poop in his pants, so I explained that he would have to go on the potty when it was time to poop and that I would help him. Yes, he had accidents. He quickly figured out that if he went on the potty instead of in his pants, no problems with poopy pants! Like all behavior management programs, consistency is the key. So, I knew I could not go back to diapers at all or risk compromising any gains. It worked, though certainly it took a little while to get the hang. I had to be super vigilant to figure out when he needed to go. Once he went on the potty, tons of praise and rewards sealed the deal.
Years later it became apparent that my son has Irritible Bowel Syndrome. So, he has had to make adjustments to keep from becoming constipated. He went through a horrrendous experience with severe constipation that was misdiagnosed. When we finally got the correct diagnosis and cleaned him out, it has simply been a matter of vigilance and maintenance. If he occasionally feels constipated, he uses Senna, not Miralax. Both my kids had this issue, and they both hated the Miralax. He rarely has to resort to laxatives now as he is very athletic and active. It is important to keep the diet bowel-friendly and ensure the proper amount of exercise. Above all, make sure you son is sleeping well and enough. If he is not sleeping well or enough that will cause constipation because the digestive system needs a full night of sleep every night to do it’s job.
Good Luck!
My son is now 12 years old, but I certainly remember the years I spent toilet training him. I found the best thing as most Autistic children are visual learners. I took photo’s of the toilet, potty, with poo and wee and then photos of his father and myself showing how happy we were when my son sat on the toilet. I made a social story out of the photos, also I used boardmaker photos. Then I read the story to him everytime he sat on the toilet. He loved seeing himself and his family.
I hope it will work for you.
Regards,
Trish from Australia
My son is non-verbal autistic, and literally became potty-trained instantly a few days after his 8th birthday. Up to that point, I tried everything. He was urinating in the toilet by age 5, but no luck with the bowel movements. Most of year 6 and 7, he was back in a pull-up, as I had gotten sick of the accidents. I had done social stories, rewards, etc. and got nowhere. I would always talk to him and show him visually what needed to be done, but no longer pushed him. I think I had resigned myself to changing his diaper forever. Then, a few days after his 8th birthday, I walked in on him pooping in the toilet, and he’s never worn a diaper since. I have no idea why. Maybe because I had given up and backed off? I wish he could tell me. He’s 11 now, still non-verbal, so I still don’t know what the trigger was. I was one happy mom that day. . .I’ll never forget it!
My son is an autistic six years old. I recently got him toilet trained by letting him wonder around the house without diaper or underwear. When I did this, he seems to understand that he should go to the bathroom. However, I have to always make sure the bathroom is close by or on the same floor. He’s been doing very well using this method. I finally got him into underwear and he’s getting very use to going to the toilet now. He still get into a mess every now and then but he improved greatly. I just wish his speech would improve too. Hope this helps.