Toilet Training Strategies for Children With Autism and Sensory Processing Issues

These strategies have worked for a wide range of children on the spectrum and/or those with sensory processing issues.  Every child is different, but the following techniques are the best I know for most families:

  • Time potty time about 20-30 minutes after meals and snacks.  The act of digestion and drinking should stimulate urination and bowel movements, and you might get results whether or not your child can respond to subtle sensations.  You can then work backward, and help your child connect the event with the sensation.
  • Know your toddler.  Most parents can easily identify when their child is ready to have a bowel movement by their expression or posture.  Some children duck behind the couch or stand in a corner.  Signs of urination are often more subtle, but wiggling while sitting or standing is a common one.  That’s the time to announce a trip to the bathroom!
  • What goes in on schedule will come out on schedule!   Avoid constant drinking throughout the day while training, and switch to only drinking at meals and during scheduled “drink breaks” through the day.  The goal is for you to be able to anticipate when his bladder will be full, and then have him use the toilet successfully 20-30 minutes later.  Connecting the sensation of having a full bladder and the experience of urination is easier this way.   This may be a big change for the child who carries around a covered cup and sips all day long, but once he is trained, you can go back to the “sippy life” if you wish.
  • Make sure that you have a plan, whatever it is, and know why you are doing it that way.  If you have a nanny or daycare provider, make sure that they know your plan and your rationale for it.  Children do best when they sense your confidence and support.  That doesn’t mean you cannot adjust things, but if you are just tossing new ideas out there every few days, it can be very hard for a sensitive child or one with limited modulation to handle all that change.
  • If your older toddler really struggles with control issues, and you suspect that they are resisting toilet training to establish their control rather than just struggling to learn a skill, then you need to address this first.  Establishing limits and building communication skills so that you are teaching more than begging is almost essential.  I suggest the Happiest Toddler methods to develop a strong alliance with you, based on mutual respect and cooperation.
  • Do not underestimate good positioning.  Toddlers that seek movement constantly, fear falling, or  those with a lack of stability all need to get their feet steady on either a stool or on the floor.  Some children with sensory issues can use the little rings over a standard potty, but it is more common for children with SPD to need more support.  They may not tell you they need it, they may just want to get off, not want you to leave them, or refuse to even hop up there.
  • If your toddler is often overexcitable or under-responsive to sensory input, he may have poor state modulation.  Your occupational therapist should be able to tell you if that is an issue for your child.  A nervous system that is idling too slowly isn’t registering the sensations of a full bladder.  The children that are overexcited will be paying attention to just about anything else.  Either way, use the techniques that work to create a more modulated state.  The Wilbarger Protocol, the How Does Your Engine Run activities, and more can help your child regulate their sensory arousal so that they can accurately perceive what is happening.

Remember:  independent toileting is a skill, and your child will develop this skill.  Think of all the skills they have acquired in the past few years.  This is the next one!

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