One of the most important things to consider is how your child’s sensory issues may affect toilet training. We have lots more information and tips on this and also ways to reduce toilet anxiety, and other stresses.
Help your child to understand toileting and become used to going to the toilet in different places such as nursery, friend’s houses, and public toilets. Remember signs can be different in public toilets and other settings outside your home.
Try to use the same words and language to talk about wee and poo and going to the toilet.
Use our Toileting Social Script and Toileting Visual Schedule as part of the programme.
You can also download this social story created by one of ERIC's Trustees, Dr Eve Fleming, about understanding how children can learn to use the toilet.
If you are a professional working with a child and their family, remember that families and education settings often need regular and ongoing support. It is always helpful to have a clear plan and explanation, with regular reviews of progress.
- Try to see toileting experiences from your child’s perspective. Help your child to become comfortable in bathrooms and sitting on toilets.
- Think about anxiety and how to reduce this. Children often need a great deal of reassurance, games and songs.
- Keep the toilet experience fun and relaxed. Consider using special fiddle toys, or books to practice sitting on the toilet.
- Check your child’s position on the toilet. Let them use a footstool so their knees are raised, and often leaning forwards. This makes sure the large bowel is at a good angle for emptying.
- Some children may like a toilet seat with padding, or a different shaped toilet seat to feel secure.
- Help your child understand about weeing and pooing in the toilet. Pictures stories and picture cards will help your child to understand how their body works, and where wee and poo comes from.
- Break up the toileting programme into small steps.
Lots of children withhold their poo, by tightening their abdominal and bottom muscles. The triggers for this are constipation and anxiety, and both very common in autistic children.
Look out for signs of straining while your child is sat on the toilet or standing up. Usually, they are not trying to pass their poo, but trying to stop it from coming out. They may cross their legs and lean backwards, making all their muscles become tight to hold the poo in.
Children don’t do this on purpose or to be naughty. Withholding is a learned reaction which usually happens after a child passes a poo which they found uncomfortable or painful.
Get more information about withholding poo and how to support your child so the cycle of holding on can be broken.
For autistic children, it is essential to treat the physical causes of constipation in combination with strategies to help their anxiety. Once their poo is helped to be soft, it is easier to help them relax and let it go. Read more about supporting austistic children with constipation.
Sensory differences/needs are very common in autistic children and may be linked to distress if your child is upset by too much sensory stimulation.
Anxiety is often a cause of avoidance of toileting, bathrooms and toilets. It’s important to try to find out what makes your child uncomfortable in bathrooms and make adjustments to make the environment feel safer and more comfortable.
Lack of sensation often leads to the child seeking additional sensations to help give adequate feelings and awareness, which are needed to develop toileting skills.
Think about the different sensations and profile of your child. A detailed sensory assessment by an Occupational Therapist may be very helpful for creating a programme that meets your child’s need.
Read more about sensory issues and toileting.