Month: December 2024

It’s no secret, potty training any child is rarely easy. However, if you are a parent of a child with autism, you may find that you need additional patience and some research-backed strategies to help your child master this life skill. 

Even though potty training is challenging, you can alleviate the stress by setting realistic expectations, using some tried-and-true methods for establishing good bathroom habits, and providing a safe and positive space for your child to learn. 

The team at Stride Autism Centers understands that parents want to get their kids potty trained as soon as possible. We’ll talk about some of the unique challenges children will face during potty training, how to tell if your child is ready, and give you some tips for keeping the experience positive and successful. 

Understanding Unique Challenges

Every child has trouble understanding the concept of using the potty. The toilet can be viewed as something new and scary. Recognizing the sensation of needing to go and requesting to go are very common issues children must overcome to be toilet trained. However, a child with autism will likely have additional challenges with the potty training process.

Sensory Sensitivities

Children with autism often have sensory issues that may make everyday experiences overwhelming and difficult to manage. They may not feel comfortable with the loud flush of the toilet, the cold surface of the toilet seat, or the sensation of pulling their clothing off and on to use the bathroom. 

Communication Difficulty

Children with autism may have difficulty with communication, have a limited vocabulary, challenges getting a communication partner’s attention, or have no functional communication. Communication delays make it harder for your child to tell you when they have the urge to go, or when they do not have to go. 

Resistance to Change

Routines are important for children with autism, but sometimes those routines may make it harder for children to change. Your child may resist the change from wearing a diaper or pull-up to underwear. They may also resist a new addition to the routine that involves going to the bathroom, especially if they don’t like it.

These challenges can make potty training take longer, but with a little extra patience you can ensure the experience doesn’t become unpleasant. If it does, your child could avoid potty training, which could make the concept even harder for them to accept. Here, we’ll share some tips about keeping potty training stress-free, and learning how to celebrate small victories along the way.

7 Tips for Potty Training a Child with Autism

It will take time, but your child can learn to use the potty like their peers. These tips help keep potty training manageable and maybe a little fun, so that neither you nor your child becomes overly frustrated during the process. 

Try to be patient with the process, your child, and yourself! Learning something new takes time and energy. Use these tips to help your child work on this new skill.

1. Begin the Potty Training Journey at Right Time

There’s no specific age to begin potty training, and your child’s readiness may be years before or after another’s. Make sure you wait until you see signs that your child is developmentally ready before you begin the potty training process. 

Stride BCBAs can help work with you on recognizing these signs and working towards readiness! Signs of readiness can include:

• Staying dry for longer periods of time
• Very wet diapers when they were recently dry
• Hiding/finding a quiet place to have a bowel movement
• Showing interest or curiosity in the bathroom
• Being able to follow simple instructions or pictures

It’s important to note that staying dry overnight isn’t a requirement to begin potty training. Most children (both children with and without autism) will not have dry nights at the same time they are potty trained during the day. Often this comes months or even years later!

2. Establish a (New) Routine

Your child already has a routine they are used to that involves a diaper and frequent diaper changes. If not, try to change them in the same place (the bathroom if possible) and have them sit on the toilet or start by approaching it. 

Adjusting to a new routine will take time. Children with autism thrive on predictability, so ensuring that your new routine is adopted slowly and then followed regularly is key. 

Make it clear what times you will visit the restroom, and what will be expected when you visit the restroom. Break this down into small, manageable steps. For instance, before breakfast we will visit the bathroom. First, we will pull down our pants, next, we will sit on the potty, etc. 

3. Practice Communication

When you first start toilet training, you will take your child frequently and as initiated by an adult; however, the goal is that they will be able to recognize the need to go and initiate the process independently. This means it’s very important to start to practice communicating about using the potty from the beginning. It’s not important that your child talks, this can be any type of communication. 

The biggest thing is that it will eventually be recognizable to others at home, in the clinic, and even at school. To do this, pair the word/sign/picture card “potty” (or whatever you choose), so your child begins to make the connection between the communication and the event. 

Even if you are initiating a trip to the restroom, still prompt them to say/communicate “potty.” This will help your child make the connection and lay the foundation to generalize this skill. 

4. Use Visual Aids

Visual aids like schedules, charts, or stories can help your child understand the steps involved with using the toilet. A pictorial aid might show that before bedtime, you visit the bathroom. 

Once in the bathroom, you follow certain steps (called a task analysis) to use the toilet and wash hands. These aids can be extremely useful for children who have limited vocabulary. If you have a child who struggles with communication, using a visual tool can also help them learn to better communicate their need to use the bathroom. 

A sign they can point to or a hand gesture they can use to signal their need to go to the restroom can be a wonderful potty training aid. 

5. Use Reinforcement and Rewards

Positive reinforcement is a tool that works well for kids and adults alike. This foundational method helps us learn new skills. 

Using strong reinforcers, things your child most enjoys (e.g., extra iPad time, a special small treat/snack, singing their favorite song) helps them learn more quickly. 

For example, every time your child indicates a need to use the restroom, or completes any small bathroom-related task, be sure to praise and reward them to help motivate them to continue trying. 

6. Address Sensory Issues

Sensory issues can be frustrating for parents and children. Validating and recognizing your child’s sensory issues can help you give them a better environment in which to learn. 

If, for instance, your child does not like the feel of toilet paper against their skin, you can offer an alternative method of cleaning like a bidet or flushable wipes. You can also gradually expose your child to sounds and textures that might be different for them. 

For instance, if loud sounds upset your child, have them step outside the bathroom and explain that you will flush the toilet and it will sound loud. 

Hand dryers in public restrooms can also be overwhelming for many children, so coming up with plans for a different drying method are helpful. You also may want to prepare your child for a loud noise if someone else uses them.

7. Be Patient With Accidents

Accidents are a normal and expected part of the potty training process. Using absorbent underwear or disposable training pants can help you eliminate the frustration often associated with an accident. 

Try your best to be gentle with your child, avoiding punishment and focusing on positive reinforcement instead. Gently remind them that when they feel the need to go and keep practicing communication! 

In addition to these tips, it’s important to make sure your child’s entire team of clinicians and teachers are supporting your efforts. Start communicating with them prior to starting this process, so they can best support you along the way!

Involving Therapist and Educators

When you decide to potty train your child, you’ll want to alert their team of therapists and educators so they can help. If your child is enrolled in ABA therapy, let the Board Certified Behavior Analysts (BCBAs) who work with them know you are interested and ready to start, so they can work with you to develop plans and support both at home and in another therapy setting. 

Collaboration is key to helping your child become fully immersed in potty training and to help them understand that using the toilet isn’t just an “at home” event. Involving your child’s team of educators and practitioners can not only help support your child, but also support you as you navigate this often stressful phase.

Addressing Setbacks and Regression

Autism toilet training regression can be a normal part of any child’s potty-training journey. A child with autism may experience setbacks and regression more frequently. Setbacks and regressions can be because of new or stressful situations. 

For instance, if your child seems to be fully potty-trained but then begins school, switches therapists, or experiences a major change in their routine, you may notice some potty training regression. 

Stay patient, and remember to continue to encourage communication and use positive reinforcement to encourage those toileting related goals.. Accidents do happen and remember, a setback or regression does not mean that you will have to start from the very beginning, work with your child’s clinician to adjust the plan if needed. 

It’s Time To Go!

Potty training might not sound like a fun task for any parent, but you can help your child be successful with the right tools and support. Establishing a routine, using visual aids, reinforcing positive behaviors and actions, and addressing sensory challenges can give your child the best opportunity to be successful with potty training. 

Be patient, and take it one step at a time. Reach out for help, and remember that setbacks and regressions are normal. For even more help and to have an individualized therapy plan custom-tailored for your child, reach out to Stride Autism Centers. We’d love to meet with you and discuss how we can help your child thrive. 

 

Sources:

Potty Training Children with Special Needs – HealthyChildren.org 

Review Paper: Routines in Families of Children With Autism|Rehabilitation.USWR.ac 

Potty Training For Autism – The Ultimate Guide|Autism Parenting Magazine 

FAQ Individualized Education Program (IEP) – PACER Center

Research published in the Journal of Autism and Developmental Disorders found that early intervention programs can significantly improve communication and social skills in young children diagnosed with autism, helping them reach their full potential. This underscores the importance of recognizing early signs of autism and seeking support as soon as possible.

As a parent, noticing differences in your child’s development can be both confusing and concerning. If your toddler is showing behaviors that seem unusual or delayed compared to same-aged peers, you might wonder if it’s time to seek an autism evaluation. 

Clinic psychologists and developmental pediatricians are often called upon to assess children who show signs of autism. 

Understanding Autism Spectrum Disorder (ASD)

First, let’s talk about what autism is and what it is not. According to the Association for Science in Autism Treatment (ASAT), autism is a neurobehavioral disorder characterized by impairment in reciprocal social interaction and communication, and the presence of repetitive patterns of behaviors, interests, and activities. 

Symptom onset typically occurs by 3 years of age and there is a wide range of how autism is expressed which is why we refer to it as a spectrum of disability. Recognizing this diversity and providing tailored resources allows individuals with autism to feel seen, valued, and to thrive. 

Autism is not an intellectual disability. While some autistic individuals may have learning differences or intellectual disability; many have average or above-average intelligence. Autism is part of who they are, and many embrace their identity with pride. For many, autism is considered their superpower. 

Strengths and Talents of Autistic Individuals

Autistic adults who have received services and supports often go on to excel in areas such as:

• Enhanced Focus and Concentration: The ability to deeply engage with tasks can lead to exceptional productivity and efficiency.
• Attention to Detail: Having an eye for precision and a strong memory make them invaluable in roles requiring accuracy.
• Pattern Recognition and Problem-Solving: many autistic people are naturally skilled at recognizing patterns and generating creative solutions.
• Creativity: unique perspectives and out-of-the-box thinking often result in innovative ideas and artistic expression.

3 Common Early Signs of Autism

Intervening early when your child receives an autism diagnosis makes a tremendous impact on their future potential. But, how do you know what signs to look for and when to request a formal assessment? 

Below are 3 common symptoms of autism among toddlers and young children. 

1. Speech Delays:

• Limited babbling or use of gestures in toddlers.
• Difficulty responding to their name or looking to others seeking conversation 
• Understanding what is said (receptive communication) while struggling to express themselves (expressive communication).

There is a distinction between speech and language which is important to understand when looking for early signs of autism. Delays in speech are common and tend to be due to auditory processing and/or motor planning challenges. Other children experience delays in functional language development meaning they may have an average or above-average vocabulary, but word choices may not seem appropriate to a situation or conversation. 

While an autistic child may understand the meaning of a vast number of words, they may not be able to properly or sensically express them. This can create extreme and understandable frustration.

2. Navigating Social Environments:

• Reduced eye contact or limited back-and-forth play.
• Less interest in other people or group activities, preferring solitary play.
• Difficulty adjusting behavior based on social expectations within their cultural context.
• Difficulty with transitions or flexibility.

It’s important to note that social interactions vary by culture so a child displaying some of the early signs of autism listed above may actually be behaving appropriately given cultural practices they are accustomed to in the home. 

3. Repetitive Behaviors & Sensory Sensitivities:

• Often repeating words either immediately after they are said (echolalia) or repeating the same phrase/quote in the same way.
• Repetitive actions, such as hand-flapping or rocking.
• Strong reactions to textures, sounds, or lights.
• Seeking or avoiding sensory input, like covering ears or intensely focusing on specific objects or parts of objects.

One common early sign of autism is echolalia, where a child repeats words or phrases they’ve just heard. While once thought to be meaningless repetition, research shows it can be an adaptive way to communicate and demonstrate intellectual understanding. Recognizing echolalia as a learning strategy can help caregivers better support language development in autistic children.

Why Early Detection Matters

Early autism diagnosis during toddler and young childhood years allows kids to access therapies that can support critical areas like communication, social interaction, and motor skills. Because young children’s brains are still developing, early intervention can have a greater impact on long-term outcomes than starting therapies later in life.

Recent research published by the National Institute of Health supports the significant benefits of early detection including improved cognitive, language, and social-emotional functioning in autistic children. Additionally, parents receiving an early autism diagnosis reported lower stress levels and better access to support services. As with everything in life, it is less scary and stressful once you know what you’re dealing with and can develop a plan.

Developmental Milestones to Watch

Understanding typical developmental milestones can help parents identify potential concerns early. Monitoring progress in areas such as language development, motor skills, and social interaction ensures that delays are recognized and addressed in a timely manner. Parents should stay informed about developmental milestones using trusted resources like the CDC’s milestone tracker and the ASAT Developmental Checklist. 

Here is a handy infographic from Apollo Cradle & Children’s Hospital that shows milestones from 3 months to 5 years old across several developmental dimensions.

(Image source from: https://www.apolloclinic.com/for-patients/services/consultations/paediatrics/milestones-tracking) 

Diagnostic Process and Professional Evaluations

If you have concerns about your child’s development, seeking a comprehensive autism assessment is a crucial step toward understanding their unique needs. At Stride Autism Centers, our diagnostic process is designed to provide clarity and support for families.. 

Here’s what you can expect:

• Initial Consultation: We begin with a detailed discussion to understand your child’s developmental history, behaviors, and any concerns you may have.
• Comprehensive Evaluation: As the resident licensed clinical psychologist I personally conduct a thorough assessment, which may include standardized tests, observations, and interactions with your child to evaluate various aspects of development.
• Personalized Feedback: After the evaluation, we provide a comprehensive report outlining your child’s strengths and areas where support may be beneficial. This includes recommendations for interventions or therapies tailored to your child’s specific needs.
• Ongoing Support: Whether or not an autism diagnosis is made, we guide you toward appropriate resources and support services to help your child thrive.

Early Intervention for Children Diagnosed with Autism

Early intervention programs focus on building essential skills through personalized learning plans. Evidence-based therapies like Applied Behavior Analysis (ABA), speech therapy, and occupational therapy help children improve communication, social interaction, and daily living skills. These therapies work best when caregivers are actively involved, reinforcing new skills at home.

Applied Behavior Analysis (ABA):

ABA is a structured, evidence-based therapy that uses positive reinforcement to encourage helpful behaviors while reducing those that may interfere with learning. ABA sessions can take place in a clinic or at home, depending on the child’s needs and what works best for the family. 

ABA Goals often include improving communication, social skills, and adaptive behaviors like self-care and problem-solving. Stride Autism Centers offers full-day, ABA therapy in a clinic setting that allows for personalized plans and social skills development to prepare children for elementary school.  

With a high ratio of Board Certified Behavioral Analysts (BCBA) and Registered Behavioral Technician (RBT) to students, Stride tailors programs to meet pre-school aged learners where they are to deliver meaningful outcomes. 

Communication & Occupational Therapy:

Speech and communication therapy focus on helping children develop the ability to express themselves effectively, whether through spoken language, sign language, or alternative communication devices. Activities may include practicing vocabulary, articulation, and using visual supports.

Occupational therapy supports motor development and daily life skills like dressing, feeding, and sensory integration. Therapists may engage children in play-based activities that build coordination, fine motor skills, and self-regulation.

Therapies can be accessed through specialized clinics, in-home services, or school-based programs. Many providers offer individualized treatment plans tailored to each child’s unique needs, ensuring comprehensive developmental support.

Conclusion & Next Steps

Taking action early can make a significant difference in your child’s development. Remember that you are not alone—there are many supportive resources are available to guide you through each step of the journey. If you have questions or concerns about your child’s development, consult trusted sources like your physician and organizations like the Association for Science in Autism Treatment. 

Please reach out to us at Stride Autism Centers for more information about autism assessments or enrolling your child if they are between 2-6 years old and have already received an autism diagnosis.

About the Author:
Dr. Ashley Whittington-Barnish, PhD, LCP, BCBA-D, NCSP

Dr. Whittington-Barnish is a Licensed Clinical Psychologist, Board Certified Behavior Analyst – Doctoral (BCBA-D), and Nationally Certified School Psychologist (NCSP). With over 20 years of experience supporting individuals with autism and developmental disabilities, she is passionate about helping children and their families thrive.

As Chief Clinical Systems Officer at Stride Autism Centers, she leads clinical programs and enjoys seeing clients make meaningful progress. Ashley also teaches at The Chicago School of Professional Psychology, where her research focuses on staff and caregiver training. She lives in the Chicago area with her family and two dogs.