I have found an Institute called “Education and Behavior” which provide an online library of practical and effective research-based strategies to help families, caregivers, school educators and therapists to create positive experiences for children with developmental disabilities. They focus on learning, behavior, and social-emotional development.
In their web page, there is a specific site for Autism Spectrum Disorders. I read an interesting article about toilet training with ASD children. In this post I’m going to summarize the most relevant information in the article.
Some researchers have indicated that there are prerequisites to initiate toilet training:
· Regular urination and bowel movements
· The ability to void urine in a large amount
· The ability to sit on the toilet
Foxx and Azrin (1973) recommend that individuals should be able to walk, see, and hold before toilet training begins. She defined two goals to achieve toilet independence:
- Control of body functions: the child must recognize the sensation of having to urinate or defecate.
- Dominate the sequence of behaviors related (e.g., walking to the bathroom, pulling pants down, eliminating in the toilet, wiping, pulling pants up, flushing toilet, washing and drying hands).
Strategies to teach a successful toilet training:
1. Graduated guidance
It involves prompting the individual through the steps of the toilet training process using the least intrusive prompts possible and increasing the level of prompting as needed.
For example, if children need to pull down their pants, a least intrusive prompt may be encourage them to do it by themselves and waiting patiently next to the toilet. If that is not successful, we can try to explain how they should pull down their pants or show them what to do.
2. Positive Reinforcement-Based Training
It consist in incorporating positive reinforcement into the toilet training program. For example, giving food or doing their preferred activity after using a toilet correctly. Rewards should be gradually faded.
3. Scheduled Sittings
Children have a schedule that indicate periodic intervals when they should go to the toilet (e.g., every 15 to 30 minutes). Once children eliminates in the toilet, they received a reinforcer. The time between sittings should be gradually increased (e.g., every 30 minutes to every 45 minutes) to increase the chances of self-initiation.
4. Elimination Schedules
In this method, the adult record the time of the day when the child goes to the toilet. This strategy allows an individualized training. Once the adult has identified a toilet pattern, he can organize the schedules taking into account those times for visiting the toilet.
5. Punishment Procedures
Researchers indicate that positive behavior support is more effective than punishment. However, they suggest that using over-correction and restitution is helpful to incorporate in a toilet training program.
6. Hydration
Research suggests that hydration is an effective procedure for toilet training, especially when it is used with schedules. On the other hand, it is important to drink moderate and not overdone it.
7. Manipulation of Stimulus Control
If you identify a condition in which the individual is likely to have an accident, you can remove it during the time when elimination is expected to occur.
For example, sometimes when children are watching a movie, they do not go to the toilet to avoid missing the film. One solution would be to do not watch a film during the moments while it is expected to go to the toilet.
8. Nighttime Training for Diurnal Continence
The dry bed training procedure includes: positive reinforce one hour before bedtime, an alarm that sound when the child wets the bed, waking the child to use the toilet in established hours and basic cleaning training after accidents. You can remove alarm and hourly waking gradually.
9. Priming and Video Modeling
Priming consist in preparing children for a subject or activity before it actually occurs. For example, we can show a video about toilet training before they use the toilet. This strategy allow children to familiarize with the activity and its expectations.
Education and Behavior has a YouTube channel, I share it in case you want to take a look!
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