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Potty-Training Children with Autism Spectrum Disorders: Special Considerations
"Any tips on potty training a child with an Autism Spectrum Disorder?"
Potty-training success hinges on physical and
emotional readiness, not a specific age. Many children with Autism Spectrum
Disorders (ASD) show an interest in toilet-training by age 2, but others might
not be ready until age 3 or even older — and there's no rush. If you start toilet-training
too early, it might take longer to train your youngster.

Is your ASD youngster ready? Ask yourself
these questions:
- Can your youngster pull down his/her pants and pull them up again?
- Can your youngster sit on and rise from a potty chair?
- Can your youngster understand and follow basic directions?
- Does your youngster complain about wet or dirty diapers?
- Does your youngster seem interested in the potty chair or toilet, or in wearing underwear?
- Does your youngster stay dry for periods of two hours or longer during the day?
- Does your youngster tell you through words, facial expressions or posture when he/she needs to go?
If you answered mostly yes, your youngster
might be ready for toilet-training. If you answered mostly no, you might want
to wait awhile — especially if your youngster has recently faced or is about to
face a major change, such as a move or the arrival of a new sibling. A toddler
who opposes toilet-training today might be open to the idea in a few months.
There's no need to postpone toilet-training if
your youngster has a chronic medical condition, but is able to use the toilet
normally. Be aware that the process might take longer, however.
When you decide it's time to begin toilet-training,
set your youngster up for success. Start by maintaining a sense of humor and a
positive attitude — and recruiting all of your youngster's caregivers to do the
same.
Next, follow these practical steps:
- If your ASD youngster has frequent accidents, absorbent underwear might be best. Keep a change of underwear and clothing handy, especially at school or in childcare.
- Some ASD children respond to stickers or stars on a chart. For others, trips to the park or extra bedtime stories are effective. Experiment to find what works best for your youngster. Reinforce your youngster's effort with verbal praise, such as, "How exciting! You're learning to use the toilet just like big children do!" Be positive, even if a trip to the toilet isn't successful.
- After several weeks of successful potty breaks, your youngster might be ready to trade diapers for training pants or regular underwear. Celebrate this transition. Go on a special outing. Let your youngster select "big kid" underwear. Call close friends or loved ones and let your youngster spread the news. Once your youngster is wearing training pants or regular underwear, avoid overalls, belts, leotards or other items that could hinder quick undressing.
- When you notice signs that your youngster might need to use the toilet (e.g., squirming, squatting holding the genital area, etc.) – respond quickly. Help your youngster become familiar with these signals, stop what he/she is doing and head to the toilet. Praise your youngster for telling you when he/she has to go. Teach females to wipe carefully from front to back to prevent bringing germs from the rectum to the vagina or bladder. When it's time to flush, let your youngster do the honors. Make sure your youngster washes his/her hands after using the toilet.
- If your youngster resists using the potty chair or toilet or isn't getting the hang of it within a few weeks, take a break. Chances are he/she isn't ready yet. Try again in a few months.
- Accidents often happen when ASD children are absorbed in activities that — for the moment — are more interesting than using the toilet. To fight this phenomenon, suggest regular bathroom trips (e.g., first thing in the morning, after each meal and snack, before getting in the car, before going to bed, etc.). Point out telltale signs of holding it (e.g., holding the genital area).
- Place a potty chair in the bathroom. You might want to try a model with a removable top that can be placed directly on the toilet when your youngster is ready. Encourage your youngster to sit on the potty chair — with or without a diaper. Make sure your youngster's feet rest firmly on the floor or a stool. Help your youngster understand how to talk about the bathroom using simple, correct terms. You might dump the contents of a dirty diaper into the potty chair to show its purpose, or let your youngster see family members using the toilet.
- If your youngster is interested, have him/her sit on the potty chair or toilet without a diaper for a few minutes several times a day. For males, it's often best to master urination sitting down, and then move to standing up after bowel training is complete. Create a potty-training social story, read a toilet-training book, or give your youngster a special toy to use while sitting on the potty chair or toilet. Stay with your youngster when he/she is in the bathroom. Even if your youngster simply sits there, offer praise for trying — and remind your youngster that he/she can try again later.
- Occasional accidents are harmless, but they can lead to teasing, embarrassment and alienation from peers. If your toilet-trained youngster reverts or loses ground — especially at age 4 or older — or you're concerned about your youngster's accidents, contact his/her doctor. Sometimes wetting problems indicate an underlying physical condition (e.g., urinary tract infection, overactive bladder, etc.). Prompt treatment can help your youngster become accident-free.
- Most ASD kids master daytime bladder control first, often within about two to three months of consistent toilet-training. Nap and nighttime training might take months — or years. In the meantime, use disposable training pants or plastic mattress covers when your youngster sleeps.
- ASD children don't have accidents to irritate their moms and dads. If your youngster has an accident, don't add to the embarrassment by scolding or disciplining him/her. You might say, "You forgot this time. Next time you'll get to the bathroom sooner."
- Have plenty of patience, keep it simple, and make it fun!
Resolving "Homework Battles" with Children on the Autism Spectrum
"Getting my son to do
his homework has become a nightly battle. We are at the point of arguing
constantly, which clearly is making a bad problem worse. Is there a way I can
help him understand the importance of education and to develop some interest in
following through with schoolwork?"

·
they do not
understand why they are expected to do schoolwork at home
·
they find
school stressful and do not want any reminders of it at home
·
they might
have difficulty with organization skills
·
they find it
difficult to remember to write down all the homework and remember deadlines
However, there are a number of
tips that can help these young people in the future:
1.
Allow kids on the spectrum to make choices about homework and related issues. They could choose to do
study time before or after dinner. They could do it immediately after they get
home or wake up early in the morning to do it. Invite them to choose the
kitchen table or a spot in their own room. One choice kids do not have is
whether or not to study.
2.
Doing
homework can suck on its own. It’s even worse when your youngster is hunched
over the books alone thinking that the rest of the family is having a party in
the other room. Sit with your youngster, review the work, encourage and help
(but don’t you dare do the homework yourself!). If you must get things done, at
least park your youngster in the same room so you can answer questions as you
make dinner, pay bills, or post of Facebook.
3.
Eliminate
the word “homework” from your vocabulary. Replace it with the word “study.”
Have a study time instead of a homework time. Have a study table instead of a
homework table. This word change alone will go a long way towards eliminating
the problem of your youngster saying, "I don't have any homework."
Study time is about studying, even if you don't have any homework. It's amazing
how much more homework Aspergers and HFA children have when they have to study
regardless of whether they have homework or not.
4.
Only help if
your youngster asks for it. Don’t do problems or assignments for kids. When
your youngster says, "I can't do it," suggest they act as if they
can. Tell them to pretend like they know and see what happens. Then leave the
immediate area and let them see if they can handle it from there. If they keep
telling you they don't know how and you decide to offer help, concentrate on
asking than on telling. Ask: "What do you get?" … "What parts do
you understand?" … "Can you give me an example?" … "What do
you think the answer is?" … or "How could you find out?"
5.
Disorganization
is a problem for most of these special needs kids. If you want them to be organized, you
have to invest the time to help them learn an organizational system. Your job
is to teach them the system. Their job is to use it. Check occasionally to see
if the system is being used. Check more often at first. Provide direction and
correction where necessary. If your youngster needs help with time management,
teach them time management skills. Help them learn what it means to prioritize
by the importance and due date of each task. Teach them to create an agenda
each time they sit down to study. Help them experience the value of getting the
important things done first.
6.
If your
child can’t do his homework at school, he might need to unwind and relax when
he first comes home, instead of launching straight into work. Giving him time
to reduce his stress levels may mean that he then finds it easier to focus on
the work later on. Some kids may also benefit from using either a reward system
or a behavior contract. If he successfully completes his homework every day for
a week, could he get a reward at the weekend? Alternatively a behavior contract
could be drawn-up with everyone in the family, with everyone agreeing to do one
task every day - and it could be agreed that completing his homework will be
the thing that your child will do.
7.
If your
child finds it difficult to understand why he does homework at home, could he
do it at school instead? Some kids find break and lunchtime very hard and they
may find it preferable to sit in the library or a quiet place in the school and
do their work. Some schools also have after-school clubs or homework clubs,
which your child may find of use.
8.
If your
child has more than one piece of homework, it may be useful to ask the teachers
in each lesson to either make sure your child has written down the homework in his
diary, or write it in for him. They may also need to provide written
instructions to take home which breaks the task down further as well.
9.
Keep the
routine predictable and simple. One possibility includes a five minute warning
that study time is approaching, bringing their current activity to an end,
clearing the study table, emptying their back pack of books and supplies, then
beginning.
10.
Replace
monetary and external rewards with encouraging verbal responses. End the
practice of paying for grades and going on a special trip for ice cream. This
style of bribery has only short term gains and does little to encourage kids to
develop a lifetime love of learning. Instead make positive verbal comments that
concentrate on describing the behavior you wish to encourage.
11.
If homework
is something your children have to squeeze in between karate, piano lessons and
soccer practice, they’re not going to think of it as important. And, unless you
really enjoy over-dramatic tears and hearing every excuse in the book, avoid
doing homework right before bedtime at all costs.
12.
Time slams
to a crawl for many Aspergers and HFA children when faced with a stack of papers and a
#2 pencil. Set a timer for 15 minutes and, when it dings, tell your youngster
to take a quick break to stretch, get a drink of water or collapse on the floor
and moan “I hate doing homework” over and over again. Really active children
may need to run around the house before they get back to the books.
13.
Use study
time to get some of your own responsibilities handled. Do the dishes, fold
laundry, or write thank you notes. Keep the TV off! If you engage in fun or
noisy activities during that time kids will naturally be distracted. Study time
is a family commitment. If you won't commit to it, don't expect that you kids
will.
14.
You need to
use leverage to get some children to do anything. Do they love television?
Computer games? Guitar Hero? Unplug it all until homework is done. You can even
exchange homework time for something they love: 15 minutes of effective
homework time = 15 minutes with their beloved plugged-in whatnot.
15.
There comes
a time when your child has to accept that homework is his
responsibility. So, if you’re really tearing your hair out and aging
prematurely due to the nightly fighting, it may be time to let your little bird
fly on its own. Let your youngster go to school with an unfinished assignment
and accept the consequences. Collaborating with the teacher ahead of time may
insure an appropriate response to “the dog ate my homework”.
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