Toilet Training Your Aspergers Child: Part II

By Mark Hutten, M.A.

Physical Environment--

When beginning the toilet training of a child with Aspergers or High-Functioning Autism, you want to help the child learn that this set of behaviors (i.e., elimination) is associated with a particular place (i.e., the toilet). Moving all changing, cleaning, and toileting-related dressing to this setting helps the child realize the purpose of this room.

A second goal for creating clear physical structure to assist in toilet training is to create an environment that is secure and not over-stimulating. The child will be calmer and more responsive with good physical support for his body. Think about adding foot support, side rails, or other physical supports.Think also about the plumbing noises and echoes of many bathrooms. Many Aspergers children appreciate soft music playing or the addition of sound-absorbent materials.

Using Visual Supports--

For the Aspergers child, it may be helpful to provide pictures to demonstrate the sequence of events that occur surrounding toilet training. At the most basic level, a transition object may be used to let the child know that the toilet routine is beginning. An object that is associated with toileting may be given to the child to serve as the transition object that takes the child to the correct location.

Once the transition to the toilet area has been made, it is important to continue to visually support each step of the toileting routine. You will need to let the child know each step he is to accomplish, when the sequence will be finished, and what will happen when the sequence is finished. Again, using an object sequence, a picture sequence, or a written list are all ways to communicate this information to the child.

Trouble Shooting--

Once you have begun the process, you may notice areas that are more challenging. Below are some common problems and their solutions.

If you child resists sitting on the toilet:
  • allow him to sit on the toilet without removing clothes 
  • allow him to sit with the toilet covered (e.g., cardboard under the seat, gradually cutting larger hole, or towel under the seat, gradually removed)
  • use a potty seat on the floor rather than up high and take turns sitting
  • use a doll to model sitting on the toilet seat 
  • as he gradually begins to tolerate sitting, provide him with some entertainment (e.g., a sing-along)

If your child is afraid of flushing:
  • don't flush until there is something to flush
  • start flush with child away from toilet
  • give advance warning of flush
  • allow him to flush

If your child only wants to flush:
  • physically cover toilet handle to remove from sight 
  • give something else to hold and keep him busy
  • use visual sequence to show when to flush (e.g., after replacing clothing)
  • when time to flush, give child a sticker that matches a sticker on toilet handle

If your child plays in the water:
  • give him a toy as distraction 
  • use a padded lap desk while seated
  • cover the seat until ready to use
  • put a visual cue of where to stand

If your child plays with the toilet paper:
  • remove it 
  • roll out amount ahead of time
  • give visual cue for how much

If your child resists being cleaned:
  • try different materials (e.g., wet wipes, cloth, sponge) 
  • consider temperature of above material
  • take turns with doll

If your child has bad aim:
  • supply a "target" in the water, such as a Cheerio
  • supply larger target as toilet insert (e.g., contact papered or laminated cardboard with target drawn on it), gradually moved down
  • add food coloring in the water to draw attention

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