If you're an allistic (non-autistic) parent of an autistic toddler, you might wonder how to proceed with potty training for children with autism. Most autistic children can be potty trained. Just like allistic children, autistic children feel good about themselves and their ability to master new skills when they learn to use the toilet.
Read on to learn what you need to know about potty training children with autism.
Is My Autistic Child Ready for Toilet Training?
While autistic and allistic children show the same signs of readiness, autistic children may not be ready for toilet training until an older age. Signs that your child may be ready for potty training include:
- Communicating — verbally, by signing, or with an assistive communication device — that they have a wet or soiled diaper
- Following basic one or two-step directions
- Seeking privacy for bowel movements
- Staying dry for at least 2 hours at a time
- Making it to the toilet with adult help
- Being motivated to use the toilet
How Should I Potty Train My Autistic Child?
Potty training an autistic child is different for every child, just like for allistic children. Toilet training an autistic child can sometimes take a year or longer, depending on your child's personality, learning style, and coexisting conditions.
If your autistic child is non-speaking, your child will need to use alternative communication methods to let you know when they need to use the bathroom. These might include sign language or a picture exchange communication system (PECS).
Throughout the potty training process, it's essential for parents of autistic children to presume competence — or, to act in ways that make the child feel that the parent knows and believes they can do it. Parents should also support autonomy, encouraging children to embrace independence. Ways to presume competence include:
- Talking to your child in an age-appropriate way — avoid "baby-talk"
- Supporting your child's communication with alternatives to speaking, if needed
- Acknowledging your autistic child as you would an allistic child — avoid speaking about them as if they aren't there
- Recognizing that behavior is communication
- Allowing your child to self-regulate through stimming, which is self-stimulating behavior such as flapping hands or spinning in circles
What Are Common Potty Training Issues for Autistic Children?
While all children can find potty training challenging, autistic children may struggle with a few things less common in allistic children.
Interoception. Interoception is a sense that helps us know what's going on inside our bodies, like hunger, thirst, fatigue, and the need to use the bathroom. Many autistic people have difficulties with interoception — autistic people's body signals may be very intense and confusing, or they may be quiet and difficult to perceive.
Building body awareness through play-based activities that bring attention to how the body feels can help improve a child's ability to read their body's cues. Washable training pants or underpants with a liner can help your child become aware of when they're wet.
Changes in routine. Learning to use the potty changes your child's daily routine. Where your child used to have diaper changes, they're now expected to use the toilet and incorporate bathroom habits into their day. This can be a lot to process for any small child, and autistic children frequently find routine changes more stressful than allistic children.
If your child struggles with change, consider skipping the child's potty. Instead, use the adult toilet and a training seat to minimize routine changes for your child. Some tools that may help your autistic child adapt to potty training include:
- Social stories that describe a daily routine that includes bathroom breaks or feature the routine of using the potty
- Timers to cue your child that it's time to use the bathroom
- Visual timetables that help your child understand what their day will look like with potty breaks
Sensory issues. Autistic children may have sensory sensitivities aggravated by aspects of potty training, such as the cold bathroom floor, the noise the toilet makes while flushing, or frequently taking clothing on and off.
Listen to your child and observe their behavior to determine what's making them uncomfortable, then provide adaptations where you can. For example, socks or a stool may help a child who dislikes cold bathroom tiles, and ear defenders may be helpful for children who are sensitive to the noise of the toilet flushing. Autistic children who are potty training may benefit from soft, comfortable clothing without buttons or zippers so that they’re easy to pull on and off.
Gastrointestinal (GI) issues. Autistic children are more likely to have GI issues like constipation and diarrhea than allistic children. Sometimes this is caused by selective eating, and sometimes there's an underlying medical issue. If your autistic child has frequent GI problems, talk to your doctor or dietician about how to proceed with potty training.