Our Toileting Training Journeys
I have put off publicly writing or speaking about toilet issues for over a decade. I prefer to work on this critical developmental milestone with family members in person, with a bathroom very nearby. It is also tough to offer any strategies without risks of harm. I know this, because I used others’ tips and fell into long-term skills problems. My child and I have walked every single toilet mile now: first forward the typical toddler way, then backwards due to late onset Autism, then forwards falling into every bad trap, then backwards to re-teach each skill correctly at later possible developmental windows, to finally march forward to the promise land of typical autonomous toilet competency all day and night. We made it, and I have helped hundreds of others do it, in more reliable ways. Therefore, I am ready, able, and willing to offer some fail-safe TIPS and fail-sure TRAPS to help folks map out your own toilet training journey, as you complete strategic toileting skills practice and planning with your Autism provider teams. Please, promise that you will follow the fail-safe approach tips to the letter, to avoid traps. Only get into toddler toileting after learning and doing careful readiness assessments and your mutual autonomy work. Remember, empathy and humor are guides on this trek.

TIP: Toilet train as the person will toilet later, as an adult in public.
TRAP: Rote learning of: peeing by pulling elastic pants down at an adult urinal for boys, or going poop naked--like just out of the tub.

TIP: Create generalizable visual materials--with simple stick figures.
TRAP: Drawing perfect anatomical drawings with specific clothes and childlike features with dependent scenarios--NO photos at all.

TIP: Create your own specific readiness stage toileting books using step-by-step action pictures, and/or Social Stories™ by Carol Grey.
TRAP: Using commercial toilet education materials that assume typical sensorimotor, communication and social awareness. Their juvenile strategies and trial and error learning scripts may teach longterm immaturity of toileting strategies, or life long “mistakes.”

TIP: Use puppets with infant nose bulb aspirators for them to make a doll go pee, and mixed up play doh for poop demonstrations. You each help the doll go first to show them how to “do it myself”--A HIT!
TRAP: Using live adult models for very young children--our kids can express this innocent “typical” training strategy in ways that may be misunderstood. (NEVER do this for older kids at all--It is NOT O.K.)

TIP: Time the process to match with each child’s pace and family’s style, and skills. Some kids will do it typically and timely, others will do it later, and for some each skill step may need atypical methods. TRAP: Do not go too slow or too fast, because any adult thinks they know the specific date, or age, we all will or must start toilet practice and finish toilet training. Our goals are autonomy AND competence.

TIP: Know your ADA rights to toilet access for mixed-gender dyads.
TRAP: Waiting until you or your child needs to use toilet and finding you cannot take your older opposite-gender child into your facility. That is correct. You must clear their-gender-bathroom, as their aid. THEN, what to do when YOU need to go has to be worked out ahead!


“I CAN DO” SELF CARE
“How do we teach our child with Autism who is past toddler years to dress and do self-care tasks?”

Our children with sensorimotor, communication/learning and social awareness issues usually experience disruptions, delays and even disability in doing what are toddler to kindergartener self care routines typically, age appropriately and independently. If we try to teach them before children are developmentally ready, at any chronological age, we may cause more problems than we solve. However, skilled Autism providers can help you learn how to do various kinds of life skills evaluations and use ongoing readiness checklists for: undressing and then parts of dressing, drying parts of body bathing, and then hair combing and then parts of hair washing. This is the key--to find the natural first step on the skill ladder for typical children, and see if it is the same for our kids. Then you can gradually track and train each part of each skill set at the time the child shows the readiness to learn signs during targeted assessment activities. The next support strategy is to put materials into baskets in the order they are needed in the top to bottom or left to right direction the child has shown they understand for sequencing table work tasks. Then start by chaining backwards and let them finish the last steps first working back to the first step. Work hard to keep your verbal prompts and physical help to a minimum too. You can do this by working from behind the back and hand under hand instead of hand over hand. Use simple stick figure pictures (NOT FANCY DETAILED ONES) with, or without, written words for each step. Only say those words, tapping each picture. Then we can all avoid risks of prompt dependence because the child is SEEING the directions and their own arms and legs doing the whole task eventually.

Note: these articles were originally published with the author's permission in the The Net Journal of the Autism Society of Oregon. Winter 2004 Issue. Sharone Lee, Editor and Author. They have been returned to their home at Threshold, but have been kept in our public access pages for all our parent's use.

You may send in additional questions on this topic for us to answer.