Toilet Training Guide for Children with Special Needs
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Prepare the environment.
- Roll up area rugs.
- Block off areas that are "off limits" during toilet training (carpeted areas, couches, etc.).
- Remove stuffed animals and books if you don't want them to get soiled.
- Cover fully carpeted areas with plastic sheets or shower curtain liners.
- Keep dry towels and disinfecting wipes handy for easier cleaning in case of accidents.
What to Buy:
- Many pairs of underwear (medium shades of blue and gray are the best because you can immediately see when they are wet!)
- Modified potty (optional)
- Step stool (to place in front of toilet if needed)
- Wet wipes
- Digital timer with alarm sound (child should hear it)
1-2-3, Step by Step by Step...
Reinforcement Is Key
Rewarding your child for successful eliminations in the toilet is an essential part of the process, helping him or her learn the correct steps and build confidence. The key is choosing a reinforcing item that your child can have ONLY when they successfully eliminate in the toilet.
Try to choose perishable items (snacks, drinks) and give your child a very small piece or sip so that they are highly motivated to get more. Repetition over time will teach your child the toilet training contingency: If you eliminate in the toilet, you get special treats! Make sure to give the reinforcing item directly after elimination to quickly teach this connection. You can do this by keeping the item in a clear bag in the bathroom cabinet or very close to the bathroom out of the child's reach.
It is also important to pair these treats with social praise ("Great job making pee-pee on the potty!!") because you will eventually be able to fade out the reinforcing item and provide more natural, social praise when your child eliminates on the toilet. Calling your child's favorite family member to boast of the good news may serve as a highly effective reinforcer as well.
Nadine Maher, M.Ed., BCBA, SEIT/ABA Therapist, is a NYC-based family training consultant who specializes in developmental delays and autism.