Toilet training a child with autism

Q: My four-year-old son has high functioning autism and doesn’t talk much. Can you offer some advice on toilet training him?

A: If your son cannot communicate verbally that he needs to go to the toilet, you may need to look for other cues. One boy I know picks up a book he “always” takes to the toilet. The book was introduced to him in the bathroom and, through repetition, he eventually learned that this is where he will “read” it.

You can use this idea with your son. Spend a few days figuring out when he wets or soils. Do these times happen to coincide with a certain activity or program to which he is already attached? If you find, for example, that he tends to wet his diaper after your usual outdoor playtime together, begin to take him to the toilet at this time each day. Since autistic children (and others) love routine and many have trouble fitting in anything new, it will take awhile to make the association stick. Reward successes, and make certain other caregivers know the routine and use similar positive rewards. Also remind them there is no punishment for accidents.

See what you can do to make the bathroom a more comfortable place for your son, as children with autism can be very sensitive to smells, temperature changes, noise and touch. Temperature and odour control, avoiding flushing or explaining the noise, as well as placing a rug on the floor (covering the tile) may all help.

Although this is hard work, teaching your child toileting skills may well open up new opportunities for him, so don’t give up. Promise yourself you will relax, and acknowledge this may take a long time. Many things that are worthwhile in life do.