Toilet Training Tips for Children with Autism
What if the child doesn't want to give up diapers?
Some kids are really attached to their diapers and
don't want to switch to underwear under any circumstances.
You can ease them out of diapers gradually.
- Start by wearing underwear under the diaper. Let them
get used to the idea of having underwear on,
but still offer them the option of wearing the diaper
over the underwear.
- Gradually cut away small parts of the diaper. Keep
making the holes in the diaper bigger, and bigger. Keep
in mind that the last parts to cut away are around the
legs or waist.
- Allow them to switch to pull-ups. Pull-ups
aren't as likely to be so absorbent as the diapers,
some parents even let them feel when wet. Pull-ups
also let them work on the skill of pulling
up and down pants.
What do you do if your child refuses to flush the toilet?
Flushing the toilet may seem like a mysterious process to
some kids - where does the water go, how does it come back,
why is it so noisy? Most kids respond well to
predictability. Establishing a pattern to flushing will
reduce some of the fear of the process.
- Use a visual schedule to indicate when it's appropriate
- Use a verbal cue - "Ready, set, flush, all done, its time
to wash hands."
- Allow them to wait at a "safe" distance while
you do the flushing. Gradually encourage her/him to get
closer to the toilet (think baby steps.)
What do you do if your child won't wash his/her hands?
Some kids don't want to take the time to wash hands or just
don't like the process. Try to overcome his/her discomfort
by experimenting with getting hands in water or playing with
- Try shaving cream. Some kids love the feel of shaving
cream and have fun playing with it in their hands. There
are a variety of foam soaps that are similar in texture to
shaving cream, once you have them interested in shaving
cream you can switch to soap.
- Have a soap box/basket and let them choose. Load the box
up with shaped soaps, samples, and hotel give-away. Some
kids might love the option of picking out their own soap
and will be encouraged to wash.
- Use an anti-bacterial hand cleaner. Just squirt on hands,
rub and the kid is good to go.
What if the child loves to play in the water (and we don't
mean the sink)?
Sometimes diversion is the best strategy. Providing some
appropriate ways to keep hands busy can eliminate the need
for lots of cleanup later.
- Offer squishy toys for tactile input.
- Place a lap desk, bed tray or TV tray over the individuals
lap with toys coloring books, and storybooks on it. Encourage
them to get busy with the toys while sitting on the toilet.
How can I overcome my child's fear of sitting on the toilet?
Lots of autistic children develop a fear or discomfort of
sitting on the toilet. This reaction can be worked through
by helping the child become familiar with the toilet without
requiring them to actually use it.
- Practice sitting them on the toilet fully clothed.
Let the child play, read, or color while sitting on the toilet
fully clothed. They will become gradually more comfortable.
- Allow your child to sit on your lap on the toilet. As
you hold the child, they will be secure knowing you
are there to help them and will gradually relax.
- Practice the procedure using a doll or favorite toy.
If your child is able to observe the procedure with their
favorite item, and realize nothing bad will happen,
over time the unease will go away.
What do you do if your child refuses to urinate in the
Sometimes children don't fully understand what they are
being asked to do. Communication problems can make the
discussion of urination challenging. The best thing to
do may be to use the "show me" method.
- Adding food coloring to the water helps illustrate
what urinating in the toilets is all about. Just like
magic, a little urine combined with the previously
colored water will guarantee a color change. This can
be very intriguing for the child trying to master the
- Having something to aim for is always fun as well -
try biodegradable packing peanuts, special made animal
shaped toilet floats, or cheerios cereal.
What do I do if my child refuses to use toilet paper?
Some kids are extremely sensitive to the texture and feel of
toilet paper. In addition, many kids have developed a
familiarity with wipes. Offer them different options instead
of toilet paper.
- Use wipes instead. Many of the toilet paper manufacturers
are offering flushable wipes.
- Some kids are frustrated with the wiping procedure. Offer
to perform the wiping for them until he or she has developed
the skills to wipe.
- Use a teaching story to outline the procedure.
What do you do if your child plays with feces?
Some kids love to dig in the diaper and play with the
feces. Although this is disgusting to us, the child
thinks this is a fun, sensory toy. Provide them with some
sensory options or make it so difficult to get into the
diapers that they don't have the option.
- Put the child in bicycle pants. These pants are so tight
fitting, and usually come up over the diaper, that they
will have a difficult time getting to the diaper.
- Use a reinforced belt. Many outdoor recreation stores
offer belts made from a webbing material with a sturdy belt
closure. Not only will this belt be hard to work under,
but also the closure will be difficult to open.
- For small children, some parents like to use cloth dog
collars. These collars are made of a sturdy web material
and have closures that are hard for the child to open.
- Offer a belt with a variety of toys to play with attached
to the belt. Keep rotating the toys, so it's always
something new and intriguing. Koosh balls, yo-yo's, silly
putty, and cartoon toys, stretchy toys - all are good options
to keep little hands busy.
Here are a few helpful social stories videos: