The Autism Toilet Training Handbook: Essential Strategies for Home and School

By Mary Wrobel

When it comes to toilet training children on the autism spectrum, Mary Wrobel’s latest book is a must-have.

Toilet training is challenging for most children; autistic kids bring different challenges and different situations. Wrobel’s step-by-step tips and expert insights are an excellent roadmap for toilet training kids with Asperger's or autism.

• Language: English
• Publisher: Future Horizons
• Release date: May 2, 2023
• ISBN: 9781957984186

Book preview

The Autism Toilet Training Handbook Essential Strategies for Home and School

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© 2023 Mary J. Wrobel

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No part of this product may be reproduced in any manner whatsoever without written permission of Future Horizons, Inc., except in the case of brief quotations embodied in reviews or unless noted within the book.

ISBN: 9781957984087

eBook Designed by Acepub

Dedication

This book is dedicated to Eleanor, Wallace, Isla, and Cora. You are my inspiration and my heart.

Acknowledgments

Special thanks to Allison Rothamer for her suggestions, contributions, and editing of this manual. Thanks also to the many students, parents, and teachers who helped inspire the information in this booklet.

CONTENTS

Introduction

1. Autism & Toilet Training

Toilet Training Is Difficult Whether a Child Has a Disability or Not

Readiness Often Isn’t the Issue

How Schools Succeed When Parents Fail

Tips and Strategies to Remember

2. Laying the Groundwork for Successful Toileting

When to Begin the Toileting Process

Start Diapering in the Bathroom

Tips and Strategies to Remember

3. Getting Started

Begin with a Plan

Toileting Is a Time Commitment

Issues to Consider

Tips and Strategies to Remember

4. Language & Communication

Addressing Language/Communication Needs

Effective Communication Systems

Picture Exchange Communication System

Communication Boards and Folders

Behavior Is Communication

Tips and Strategies to Remember

5. Addressing Anxiety

Autism and Anxiety

Possible Anxiety Triggers for Children with ASD

Strategies and Incentives to Tackle Anxiety

Possible Signs of Anxiety

Strategies to Help a Child Calm Down

Tips and Strategies to Remember

6. Addressing Sensory Sensitivities & Aversions

Autism and Sensory Sensitivities

Common Hyper-Sensitivity Responses

Signs of Hyper-Sensitivities in the Bathroom

Common Hypo-Sensitivity Responses

Signs of Hypo-Sensitivities in the Bathroom

Questions to Think About Regarding a Child’s Sensitivities in the Bathroom

Handling Sensory Issues in the Bathroom

A Case Study

Tips and Strategies to Remember

7. Creating a Toileting Plan

Start with What Your Child Can Do and Is Comfortable Doing

Consider Toilet Training with a Potty Chair

Allow Your Child to Choose Their Potty Chair or Toilet Seat Insert

Think in Terms of Small Steps

Set Schedules and Routines

Take It Slowly

Work with School

Commit to the Plan

Parents/Caregivers Need to Stay Motivated

Use Support Stories and Visual Supports

Tips and Strategies to Remember

8. Rewards & Incentives

When and How to Reward

Tips and Strategies to Remember

9. Implementing the Plan

Preparing to Implement

Visual Supports

Steps Toward Achievement

Creating a Schedule and Routine for Home

Tips and Strategies to Remember

10. Charting Progress

Why Should You Chart?

Sample Chart

Tips and Strategies to Remember

11. Older Children & Toileting

What to Expect

Establishing New Routines

Tips and Strategies to Remember

12. Tackling Problems Associated with Toilet Training

Withholding

Withholding Case Study

Constipation

Treating Constipation

Poor Interoceptive Awareness

Fecal Smearing

Reasons for Fecal Smearing

Addressing Fecal Smearing

Aggression and Retaliation

Tips and Strategies to Remember

13. Diapers to Underpants

Transitioning

Steps to Successfully Wearing Underpants

Tips and Strategies to Remember

14. Nighttime Toilet Training

Problems Associated with Night Training

Taking Precautions

Tips and Strategies to Remember

15. Support Stories

Writing Support Stories

Tips and Strategies to Remember

Sample Generic Support Stories

People Use the Toilet

Many People Like to Use the Toilet

I Can Wear Diapers in the Bathroom

The Toilet Is Sometimes Scary

A Toilet Is Like a Big Drain

I Can Sit on the Potty Chair

I Like My Potty Chair, But Now I Need to Use the Big Toilet

Mommy (Daddy) Will Help Me Learn to Use the Potty

Anxiety Can Make Me Feel Scared and Upset

Thinking About Using the Toilet Makes Me Anxious and Upset

I Want to Feel Calm When I Use the Potty (Toilet)

I Don’t Want to Feel Uncomfortable in the Bathroom

I Get Distracted in the Bathroom

I Will Try My Best to Use the Toilet

Rewards Are the Best!

I’m Not Afraid to Poop in the Toilet

Pooping in the Toilet Feels Funny

Going Potty is Something We All Have to Do

I Don’t Want Hard Poops!

Sometimes I Can’t Go Poop

Using Toilet Paper

I Don’t Wear Diapers

I Know When I Need to Use the Toilet

Poop is Very Dirty!

I Use the Bathroom at School

Sometimes I Might Pee or Poop While I Sleep

People Need Privacy in the Bathroom

Using Different Bathrooms and Toilets

Using a Urinal

There Are Rules for Using a Urinal

Sometimes I Might Have an Accident in My Pants

Conclusion

References, Resources & Additional Reading

Internet Resources

Suggested Visual Supports

Suggested Books for Children

Introduction

Whether you have a child with autism or another disability, toilet training can often be a struggle and at times may seem to be an impossible achievement. But we know that being able to use a toilet independently and successfully is an important skill for everyone. Society expects children to, ideally, be toilet trained by the time they enter school, allowing them to fit in and function independently, like their peers.

Individuals who can’t reach a level of toileting independence will need to depend on the assistance of adults and will often be segregated from other students in school, and later possibly segregated from others in society, perhaps for the rest of their lives. Not being able to independently use a toilet limits what a person can do and where they can go. It impacts their social acceptance and self-sufficiency, and further isolates them from their peers. If a person doesn’t learn to use the toilet on their own, they will always be dependent on others to help them, and unfortunately, this makes those individuals much more vulnerable to molestation and sexual abuse. Learning to use a toilet isn’t just convenient and cost-saving; it is important for a person’s safety, independence, and social-emotional health.

If a child or older individual is physically capable of using the toilet, they should be able to be toilet trained, regardless of their cognition, level of anxiety, sensory sensitivities, or language capabilities. It is my hope that this manual will help parents and educators with the arduous task of teaching children with ASD the very important skill of using the toilet.

Toilet Training is Diffi cult Whether a Child has a Disability or Not

Teaching a child to use a toilet is difficult even if the child doesn’t have a disability. Adding a disability to the task of toilet training can make it monumentally challenging. Many professionals believe that children with autism spectrum disorder (ASD) are more challenging to toilet train than any other population due to their rigidity, dislike of change, sensory issues, and innate anxieties. Their various language and communication challenges are also a major factor to understanding, following through on tasks, and expressing their questions and feelings during the process of toilet training. Those who have attempted to toilet train a child (or adult) with ASD by following popular toilet training methods often very quickly find that they are as ineffective as they are stressful, for all involved. And because autism is a spectrum disorder, this means each individual can be very different from others with ASD, and approaches for teaching them will vary from one individual to another. In other words, that means there is no approach to toilet training that will work with all individuals with ASD.

Toilet training for an ASD individual is not quick or easy. Toileting plans that offer quick results can often backfire and cause a child to have more fear and be more resistant to the process. Becoming an independent toilet user is a long process, even for neurotypical children, and setbacks and accidents are to be expected. It’s not only a learning process for the child, but for the parents as well, who often dread the time when they need to introduce the concept of using the toilet versus wearing diapers. It can be a difficult and stressful transition involving a lot of time, effort, and patience.

Readiness Often Isn’t the Issue

It’s widely believed that a child needs to be physically, mentally, and emotionally ready before the process of toilet training can begin. We often hear parents and teachers comment that a child who is still in diapers just isn’t ready to use the toilet. Parents and teachers will look for signs from the child that indicate the

Reviews for The Autism Toilet Training Handbook

[ladycato · Rating: 3 out of 5 stars]

My feelings on this are mixed. The description on Amazon was rather misleading that this was an ideal book for parents on introducing concepts like puberty and sex to autistic children. It turned out that the book is more about developing such curricula for teachers, with a lot of bad clip art, PECS, and very grainy black and white pictures. But it does contain useful information and advice as well. The author clearly knows her subject matter and her frank, honest approach is refreshing. The print is large and the vocabulary is very simple so that it's approachable for kids across the spectrum. She knows to write without relying on similes, metaphors, and other plays on language that ones typically finds with these subjects.

I bought the book because my son is almost ten and I know we need to start discussing puberty, and I already know he's going to have a difficult time understanding it. The hygiene pages in here are also useful; we'll find useful the sections on nose-picking and putting hands in pants. The sexual education section discusses issues like masturbation (again, I appreciate her no-nonsense, approach; there's no moralizing here), stranger danger, the importance of clothing, and it offers very detailed advice of teaching autistic girls about periods. However, it doesn't discuss the act of sex, which was surprising because that seems like the most important part of sexual education.

I'll continue to look for a more comprehensive book on the subject, but I do think this is a good starting point, especially for special education teachers.