Toilet training is perhaps the single skill/ability that has the most impact on the most areas and activities of our grandchildren’s lives. And there are things that we autism grandparents need to know and things we can do.
WHAT WE NEED TO KNOW:
It is common for toilet training to take a long time. Research has determined that children on the autism spectrum begin toilet training at an older age than do neurotypical children, and that it takes a lot longer. (A 1992 study by Dalrymple and Ruble found that it takes an average of 1.6 years, and longer for bowel training.)
It is common for children with autism not to show “normal” signs of having to use the toilet, such as holding themselves, crossing their legs, nervous “dancing,” etc. (Sometimes a child’s “sign” is simply a certain way of looking at you.)
Frequency of bowel movements varies – from 2 or 3 per day to 2 or 3 per week. And it is common for children on the autism spectrum to “hold” the bowel movement until they are away from the toilet.
It is common for children with autism to have anxieties or fears associated with toilet training: fear of a big hole with water in it, anxiety about being in a small enclosed room, fright from the flushing sound, etc.
Medical problems should be ruled out prior to toilet training. (The child’s developmental pediatrician can often do this.)
Praise and reward are necessary for satisfactory long-term success and pride. Punishment and scolding can negate self-pride and be counterproductive to long-term success.
Our grandchildren’s parents/guardians are in charge of our grandchildren’s toilet training, and it is helpful when our efforts complement theirs.
WHAT WE CAN DO:
We can offer to our grandchildren’s parents that we can do research on toilet training for children on the autism spectrum. Parents are sometimes so involved in daily tasks and challenges that they don’t have time for research. There is a wealth of toilet training information on the Internet, including free online guides available from Autism Speaks, Autism Parenting Magazine, Marybarberra.com (private company that also sells things), and others.
We can offer, as a result of our research, to develop a plan that all of our grandchildren’s caregivers can follow regarding toilet training. NOTE: Developing a toilet training plan requires extensive thought and research. All of the professionally developed and proven plans for toilet training for persons on the autism spectrum include details such as time schedules, visual aids, specific rewards, specific communication, types of praise and reward, necessary motor skills, hydration schedules, etc.
When our grandchildren are in our care, we can use the same words (e.g. “toilet” or “potty”?) and images (if the training plan calls for images) that our grandchildren’s parents use.
When our grandchildren are in our care, we can happily praise every successful step, even the small initial ones such as being able to sit on the toilet for five seconds.
When our grandchildren are in our care, we can immediately reward significant success by providing a special treat (favorite candy, use of the iPad, surprise toy, etc.).
When there is an accident when our grandchildren are in our care we can react and clean up in a matter-of-fact manner and without emotion. (We can save the emotion for success.)
When our grandchildren are in our care, we can document every aspect of toilet training (specific times each day, successes, accidents, circumstances that may have contributed to successes and accidents, etc.).
There are many different toilet training plans and strategies that are recommended by a variety of autism experts. What works for one child may not work for another. But learning about the current expert advice can help us autism grandparents better understand and empathize with the significance of this challenge for our grandchildren and their parents. And this research can also position us to provide helpful advice and suggestions – but of course only when truly welcomed and not viewed as interference. We grandparents can be a great source of love and positivity!