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Toilet Training for Students with Autism and Developmental Disabilities: 3 Strategies for Success

Toilet training is a significant milestone for every child, but for those with autism and developmental disabilities, it can be a more complex journey. As a BCBA with a passion for teaching functional and adaptive skills, I understand the challenges that come with toilet training. In this blog post, we’ll explore some evidence-based tips and personal insights on three crucial aspects: reinforcement, collaboration with staff and families, and data collection to track progress.

Getting Started: Practical Tips

Before diving into the intricacies of reinforcement, collaboration, and data collection, it’s essential to get started on the right foot. Here are some practical tips to begin the toilet training journey:

  1. Hydration is Key: Ensure the child stays well-hydrated by offering plenty of fluids throughout the day. This increases the frequency of bathroom visits, creating opportunities for successful toilet use.
  2. Scheduled Bathroom Breaks: Take the child to the bathroom at regular intervals, such as every 30 minutes to an hour. Consistency is vital in helping them understand the purpose of these visits.
  3. Comfortable Clothing: Request that the family dresses the child in simple, easy-to-remove clothing. Avoid complicated zippers and buttons, as this can reduce potential stress for the child.
  4. Extra Clothes: Ask the family to provide extra sets of clothing to be kept at school and home. Accidents are a natural part of the process, and having spare clothing on hand can make these situations less overwhelming.
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Reinforcement: Making Success Rewarding

Toilet training success often relies on the effective use of reinforcement strategies. Research supports the use of reinforcement-based toilet training procedures. Here are some tips to ensure this process is both effective and engaging:

  1. Identify Meaningful Reinforcers: Each child is unique, and their preferences for reinforcers can vary. Collaborate with your student, their staff members, and family to identify what motivates them. It could be a favorite toy, a special treat, or praise. I find that a consumable reward (e.g., M&M, chip) works best because it can be delivered immediately after a successful opportunity, and you can provide a small amount so that the child does not become satiated or bored with it over time.
  2. Use a Visual: Consider implementing a visual such as a sticker chart, where the child earns stickers for successful toilet use and can earn a more substantial reward upon reaching a desired goal number of stickers. This provides a visual representation of progress and can be especially motivating. I typically begin the toilet training process with direct reinforcement (successful void = reinforcement immediately) and then fade to a visual reinforcement system once the child has experienced a few successful opportunities.
  3. Consistency is Key: Ensure that reinforcement is immediate and consistent. Praise and rewards should follow successful toilet use to reinforce this desired behavior. You may want to consider reserving the reward for ONLY successful toileting visits at first, so that it remains particularly motivating to the student!

Collaboration with Staff and Family

Toilet training is a joint effort that requires collaboration between teachers, support staff, and families. Here’s how you can build a strong team:

  1. Open Communication: Foster open and regular communication with all team members. Discuss strategies, and any challenges that arise. Holding regularly scheduled, brief meetings to review progress can help team members motivate each other to continue to work toward success, especially if progress is not occurring as quickly as we’d like!
  2. Training and Education: Provide training and resources for staff and families. Make sure everyone is on the same page regarding the chosen strategies and techniques. I typically print out guidelines such as these, and post them right in the classroom bathroom, or keep on a clipboard with the data tracking sheets we are using, for easy reference.
  3. Consistency Across Settings: Consistency is crucial. Ensure that the strategies used at school are consistent with those used at home. This can help reduce confusion for the child. For example, are staff saying, “Time for potty” while parents are saying, “Let’s go to the toilet”? or is the child being taken to the bathroom every hour at school but every 30 minutes at home? All of these little factors can add up to make a big difference. It is, however, natural at times for students to initially show more success in one setting than the other, so be patient and don’t give up if this is the case!

Data Collection for Toilet Training

Data collection is at the heart of evidence-based practices. When it comes to toilet training, data can help us make informed decisions and adjustments to the strategies we are implementing. Here’s how to collect and use data effectively:

  1. Define Measurable Goals: Start by setting clear, measurable goals. What do you want to achieve in the toilet training process? This might include voiding on the toilet and reduced accidents for one learner, increased independence with unfastening and putting back on clothes for another learner, or desensitization to entering a novel bathroom for still another learner.
  2. Select the Right Data Collection Method: Once you have your measurable toilet training goal in place, it becomes easier to develop a simple data collection method to track progress with this goal. If you’re using a paper and pencil data collection sheet (like those pictured here), I suggest keeping them in or near the bathroom, or even hanging a new one on the bathroom wall each day. This way, staff can easily record the data after each visit.
  3. Analyze and Adjust: Regularly review the collected data to identify areas for improvement. Digital data trackers such as this one can help visually display progress over time and identify trends. Adjust your strategies based on the data to better meet the child’s needs. For example, if the student is meeting with success consistently for several consecutive days, consider fading direct reinforcement to a delayed form of reinforcement using a sticker chart. If the student is consistently having accidents, consider decreasing the time interval between bathroom visits or doing a preference assessment to identify a more motivating reward.

Conclusion

Toilet training is a journey, and each child’s path is unique. With the right combination of reinforcement, collaboration, and data collection, we can provide successful support for our learners. While we aim for success, it’s essential to celebrate the small victories along the way. Progress may not always be linear, but with a dedicated team and a personalized approach, we can help our students achieve this significant milestone.

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