Toilet training can be particularly challenging for children with autism due to difficulties with communication, sensitivity to different sensory experiences, as well as difficulties with adjusting to changes in routine. As I’m sure you are aware, children with autism rely on both visual and verbal cues to learn. You could help her to understand the process by providing photographic (of yourself) or pictorial cues (simple line drawings would be suffice) that break the process down into simple step-by-step actions. Behavioural reinforcement is typically a good option in encouraging the use of a potty or toilet. When I’ve used behavioural training programs with children with autism I typically modify the incentives so that they take into account the likes and dislikes of the child. With one boy I used anything to do with Thomas the Tank Engine – with another it was lollies (not great for the teeth but it worked a treat!), another child I worked with loved books – so every time he collected 5 stickers he was allowed to cash these in and buy a small book. Many children find the toilet frightening so it is worth checking if this is delaying the process – the key thing with children with autism is that they need to feel comfortable with their surroundings. I would begin again by encouraging her to sit on the potty or toilet when she is fully clothed so she doesn’t associate it with negative feelings. She could do this while watching a favourite program on TV or while reading a book. While I understand your desire for her to become dry during the day, if she is not showing signs that she is ready to be trained then the best thing to do is to just stop for a few weeks – this will take the pressure off both you and your daughter. When it is time to start again introduce everything slowly taking your cues from her behaviour. A ‘slowly slowly’ approach will be the key to success – if she feels forced she is likely to revert back to old habits. For additional tips please visit the following website: http://www.autism-help.org/behavior-toilet-training.htm. Good luck!

Regards,
Dr Cathrine

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