First Steps – Reduce Everyone’s Stress
When I started working with Justine and her parents, we discussed that it is important to take the pressure off of Justine. If she feels stress and pressure about going to the toilet, it can make it harder for her to learn.
Many children on the autism spectrum are very sensitive to others’ feelings. Some children just have greater difficulty learning to control their bodies. When they feel something is wrong, especially when their parents are upset, it makes it harder for them to relax their bodies and learn skills, including using the toilet.
Parents Felt Judged
Justine’s parents and I discussed what to say to their extended family about why she is not trained yet. They needed some emotional support to deal with the family pressure. I also suggested that they network with other parents in similar situations, because they were feeling isolated and that they were failing their daughter. (The Autism Community in Action (TACA) has chapters across the U.S. where you can network with other parents.)
The first step of the actual toilet training was for Justine’s parents to take the focus off of Justine having to be toilet trained. They took a 2 week break and just matter-of-factly changed her diapers when needed. Visual learning is often a strength for children on the autism spectrum, so her parent went online and found a children’s toileting video that they thought Justine would be interested in. She liked it watched it often. Her parents also took a series of pictures of Justine going through the steps of using to the toilet, and put together a little book. Justine enjoyed looking at the pictures of herself. Justine’s parents also had Justine go with her sister when she went potty, because Justine looked up to her sister and often imitated her. Then her parents made a sticker chart. When she got 5 stickers, she could get a favorite figurine.
At first, Justine would get a sticker just for sitting on the toilet while they sang a potty song from the video. Justine liked the stickers and rewards, and she developed a more positive association with the toilet. She started urinating in the toilet. Her parents praised her and gave her an extra sticker. After a few days of going in the toilet, she only got stickers for when she urinated in the toilet, not just for sitting.
Justine was trained to urinate in the toilet within 1 month. She was still having bowel movements in her pants though. Her parents were coached to not make a big deal about it. They just periodically reminded her to poop in the toilet, and would have her help empty her diaper in the toilet, to reinforce the concept that “poop goes in the toilet”. It took about 3 months, and then she started having bowel movements in the toilet.
Justine continued to have some accidents and her parents did get frustrated, and hoped that Justine would be trained quicker. So, we checked in periodically, and they were reminded to remain calm and not resort to pressuring Justine, as she could regress. They did stay calm and were very patient. Justine was completely trained by the time she turned 6. I know that seems late, but that is the reality for some children on the autism spectrum.
Patience and support is what it took to accomplish toilet training Justine without unnecessary struggles and stress for everyone in the family. If you’d like help with toilet training your child, please contact us.