Does the idea of toilet training your child with Autism fill you with dread? Or are you excited to begin this new adventure with them?
The reason I am asking this is because our attitude as we embark upon our journey to toilet town is going to be one of the most important things to strengthen and solidify. Using the toilet and anything to do with peeing and pooping is a big let go (both physically and mentally) for our children and they can often be controlling about how and when they go. If we, ourselves are feeling tense and uncomfortable around it then we will be a model of uncertainty and doubt. Our children will pick up on this attitude and may relate it to their whole experience around the toilet.
So the first step is to really check in with yourself….how do you feel? Are you “needing” them to get this skill? Are you feeling uneasy about the thought of them not toileting yet and trying to rush and push? Are you “grossed out” by the thought of cleaning up any pee or poop accidents which may happen?
Or……are you seeing this as a delightful and easy-going step to helping your child master the art of more fully taking care of themselves. If you are doing the first part (discomfort) – that’s OK, congratulations! Acknowledging your attitude is the first step to change. I suggest you actually hold off from starting this until you feel more at ease. Perhaps for the next couple of weeks you can really start to deepen your comfort level with each diaper change or mention of any toileting that is going on in your household or around family life or your child’s school. If you are feeling easy and relaxed, you are ready to begin!
Over the next few weeks, start to show your child that in your household, this is no longer a secretive, hidden thing you do but a natural, normal, healthy and exciting part of being a human and taking care of ourselves. We are the greatest role-model’s our children have so it’s up to us to show them our easy and open attitudes around this. Next time you have to pee or poop, proudly and excitedly exclaim that you feel something in your lower belly, a feeling that is kind of a pushing sensation and it must be time to go to the potty! Do this out loud and ask your other family members to do the same so that everyone in the household can promote it.
After you have announced it must be time for you to go, you can invite your child to come with you and actually show them what is happening when you visit the toilet! Dads show your sons and Moms show your daughters. If they choose not to come, that’s OK, when you come out you can tell everyone about your experience (e.g. “Ooh I just went poop, I feel so much better now, I got to wipe, so now I feel fresh and clean! Hey! I even made room for my next meal!”) If your child comes with you, make it fun and playful, perhaps they can flush it for you or you could wave goodbye to it as it spins around and down the toilet! When the other family members come out of the bathroom, ask them about their experience and give them a high five! Your other children will love this!
Another reason this is useful is that part of the art of going in the toilet is KNOWING you have to go and being in touch with the feeling. This is how our children learn to make the transition from going in a diaper to going in the toilet, so you are telling them when you have the feeling and explaining what it feels like is a great step toward them being more aware of the signs their body is giving them and knowing it's time to visit the toilet!
So now you have relaxed in your attitude around the toilet and you have started to model to your child how fun and amazing it is to take care of our bodies in this way, it’s time to start inviting your child to get involved with all things toilet!
For pooping – if they are currently wearing a diaper, begin to really talk about and show them the poop they have just done. So instead of saying things like “Pee-ew” and grimacing when you are changing their diaper, smile and get excited about the event that has just occurred. You will be a model for them to start seeing how pooping is an easy and relaxed experience and one that is perfectly healthy and normal. You can animate your face (in a good way) and say “This is so wonderful…you pooped! Your body is doing what it’s supposed to do….yay!” Then, instead of wrapping the diaper up in a ball like you usually do and quickly disposing of it, show your child the poop that is in the diaper and then take them to the toilet to show them where it goes. You can say “Ooh, did you know, your poop actually goes in the toilet, I’m so excited to show you! Come on in and see!” Then you can explain the whole process as you tip and shake the poop in to the toilet. Tell them how it’s so awesome that their body made that. That you then get to flush and see it spin around and around and then celebrate that they did it again!
For pee – it’s not going to be possible to put it in the toilet from the diaper because the diaper locks the pee away and so instead, start to notice signs that your child is ready to try out some underwear. Signs include, them seeming more aware of their diaper, touching it, telling you they have peed or even taking it off. Also knowing when they have had lots of fluids and may be inclined to have more pee coming. Invite them to the toilet when it’s time to change their diaper so they can get used to being in the bathroom, seeing the toilet and associating that this is the place to be when it’s time to go! Talk about how excited you are for them to start peeing in the toilet as you change their diaper.
So, you have become comfortable and easy in your attitude around toileting. You have modeled how amazing and wonderful it is to use the toilet. You have shown your child with autism their own poop and where it goes, please continue doing all of this as you move to the next step.
Now……..it’s time to ditch the diapers! The best way for your child to be more aware of their own peeing and pooping occurrences is to put them in some underwear. So invest in some fun and interesting underwear that they can start wearing. If your child is younger and likes Spongebob or Mickey Mouse, get some character underwear. If your child is artistic, you could decorate some plain underwear with fabric pens together to prepare for wearing them. If they like letters and numbers, you could sew some on the underwear or use an iron on transfer. If your child is older, perhaps you could include them in the selection of the underwear you buy. Try different types, briefs, boxers, natural fibers if your child is sensitive, etc. If you are not ready to ditch the diapers yet, you could start with them wearing the underwear over the top of their pull-up or diaper to get used to this transition.
Letting go of the diapers is a really great way for your child to actually experience the feel of not having something that locks away the pee when they go. They will feel lighter and freer and could become more aware of what their body is telling them and how it feels when they are ready to go.
Prepare for some accidents – they will happen. If you have a nice Persian rug or leather couch you want to protect and it helps you, bring in some dustsheets or a cover to protect them and make sure you have plenty of extra clothes, underwear, old towels, wipes, plastic bags hand sanitizer, etc on hand in each room so that you are never far away from an easy clean up. Doing this in the Son-Rise Program playroom is going to be the most suitable environment to do this because you will be able to be more present with your child and the cleanup will be confined to just one room.
Now as you watch for signs and you know they have a pee coming, start to bring awareness to their body and the toilet regularly throughout the day. Explain to them, “You know it’s been a couple of hours since you peed and it looks like you may need to go, I’m so excited! Let’s go to the toilet….” If they don’t make it – it’s important that you don’t react in a negative way, which could lead to them seeking this interesting reaction by doing it more or it being a less relaxed and easy experience for them which makes it harder to encourage and inspire. So instead of pulling a disapproving face and saying “Oh no, you did it on the floor/in your pants”, etc, keep it neutral “Oh, you peed! Did you know that next time you can totally put it in the toilet!” If they do have an accident, let them sit in their wet underwear for a couple of minutes, instead of rushing immediately to clean it up like it never happened, it may be useful for them to feel the wetness against their body where the diaper used to lock it away.
Make a regular invitation to the toilet, even when you don’t see signs, beginning to get in to a routine is helpful. So perhaps once every 20 minutes to 1 hour you can do another playful invitation.
Incorporating the toilet in to your daily activities with your child is going to help you to remain persistent and experiment with the way your introduce using the toilet to your child with autism. Now that they are in underwear, it’s about offering the toilet in fun and playful ways. So think about what your child loves and bring the fun to the toilet! If your child loves control, perhaps you could decorate the toilet like a King or Queen’s throne with stickers of jewels and gold tassels and each time they sit on it you offer them their favorite items on a red velvet cushion (e.g. snacks, a drink, books, etc). They could even wear a special crown to sit on this special “toilet throne”. If your child loves Thomas the Tank engine or Lightening McQueen, you could create train tracks or a road out of artists tape on the floor that leads right up to the toilet. During your play, ride the train or the car to the toilet and have them drop off their pretend cargo in to the toilet. If your child loves physical play, you could give them, helicopter rides to the toilet and the toilet itself could be the landing pad. If they love Dora the Explorer or Bob then Builder then stick some pictures of these characters on the toilet. Have a toilet party! Decorate the bathroom and the toilet with balloons and invite all your child’s favorite puppets or figurines to the party. If your child is older, play them a pop song on the guitar when they sit on the toilet, the acoustics in the bathroom can often sound cool and echoey! If your child likes privacy, you can hang up a curtain around the toilet and give them some space and time to sit on it on their own. Also, experiment with different adaptations that will make sitting on and using the toilet more suitable and user-friendly for them. If your child is little, a smaller potty, or step stool and potty seat may be a good fit. If they are older and bigger, perhaps a camping toilet in your playroom would work for them.
Happy Toilet Training!