Is my child ready?
Prior to beginning a toilet training program, consider the following readiness skills:
· Bladder control: can he/she hold their urine for several hours?
· Does he/ she appear to know they are about to urinate? (e.g. facial expressions, posture changes, lets you know when their diaper is wet)
· 1-step instructions: Are they able to follow simple commands, imitate simple tasks? (e.g. sit on the chair, throw this away, stand up, etc.)
· Communication: does he/she have a functional mode of communication for requesting? (e.g. expressive speech, picture exchange, electronic talking device, etc.).
If the child demonstrates these readiness skills, he/she may be ready to start toileting.
Training supplies and setup
1. Have a potty chair, stool, and timer ready.
2. Clothing: light colored, and limited clothing will allow you to detect a urine accident immediately upon its occurrence.
3. Fluids: free access to a variety of high preference fluids to increase the need to urinate.
4. Modeling: use videos, books, smartphone applications that model going to the bathroom.
Reinforcement, Reinforcement, Reinforcement!
Conduct a preference assessment: identify items and edibles to use as reinforcers that will motivate and increase on-toilet urinations. (e.g. iPad, drinks, candy)
Note: the reinforcers selected should be kept out of reach of children and access should be limited outside of the bathroom.
o If child urinates on toilet, then provide reinforcers!
o If child does not urinate on-toilet, then no reinforcer is provided.
Remember to make toilet training fun! Keep toys, books, etc. in the bathroom to make it an enjoyable and positive experience for the child.
It's Potty Time!
Set a timer for 30-minute intervals. Prompt the child to the toilet at the scheduled time. Prompt the child to functionally communicate before going to the toilet (e.g. "Go potty", give you picture of toilet, etc.) Immediately prompt to toilet if an accident occurs before the timer goes off. When on the toilet, have the child sit for up to 5 minutes and reinforce success by providing enthusiastic, behavior-specific praise (e.g. Good job peeing on the toilet!) and provide the reinforcer selected from the preference assessment. I like to call it throwing a "party in the bathroom"!
If your child has an accident, do not punish him/her. Instead bring him/her into the bathroom, sit them on the toilet, and have him/her assist you with changing clothes.
During toilet training, it is important to have consistency, patience, and humor. Toileting is a process that will not happen overnight but remaining consistent with procedures will lead to independent toileting.
Azrin, N. H., & Foxx, R. M. (1974). Toilet Training in Less Than a Day, Simon and Schuster, New York.
Azrin, N. H., & Foxx, R. M. (1971). A rapid method of toilet training the institutionalized retarded. Journal of Applied Behavior Analysis, 4, 89-99.
Cicero, F.R., & Pfadt, A., (2002). Investigation of a reinforcement-based toilet training procedure for children with autism. Research in Developmental Disabilities, 23, 319-331.
Kaerts, N., Van Hal, G., Vermandel, A. and Wyndaele, J.-J. (2012), Readiness signs used to define the proper moment to start toilet training: A review of the literature. Neurourol. Urodyn., 31: 437–440. doi:10.1002/nau.21211
Kroeger, K. and Sorensen, R. (2010), A parent training model for toilet training children with autism. Journal of Intellectual Disability Research, 54: 556–567. doi:10.1111/j.1365-2788.2010.01286.x