Making Toileting An Enjoyable Experience

February 19, 2014, TBH Blog
TBH Blog

What’s that? Toileting can be an enjoyable experience? Yes, it can!

Overview

Toileting is a pivotal skill that can open doors for many young children. Many schools won’t allow children to attend if they can’t use the restroom independently. Therefore, it’s an important skill to teach and one that can be learned in a short amount of time.

Doctors Nathan Azrin and Richard Foxx developed a toilet training plan for individuals with special needs in the 1970s that has been empirically supported and extended by other researchers (e.g., LeBlanc, Carr, Crossett, Bennett, & Detweiler, 2005). The Azrin and Foxx (1974) plan has sold over 2 million copies and has been used by families with both neurotypical children and children with special needs (e.g., autism, intellectual disorder). Common reasons for children not being toilet trained may include that they are “lazy,” “stubborn,” or that they “don’t care.” However, a common misconception is that toileting is a skill that needs to be learned (i.e., taught by others).

Is Your Child Ready?

To answer this question, consider the following:

  • Does s/he understand and follow simple direction?
  • Does s/he differentiate the sensations of being wet versus dry?
  • Does s/he understand toileting words?
  • Does s/he prefer being dry and/or clean?
  • Can s/he pull his/her pants up and down?
  • Is his/her environment calm?

As much as we’d like to answer “yes” to all of these questions, it’s not entirely necessary. As long your child demonstrates some of these behaviors, it may be okay to start toileting. The child should be free from medical problems, demonstrate readiness skills (e.g., follow directions, have a communication method, hold urine for a short period of time), and caregivers should be ready.

The Process

So how do you toilet train a child? First, make sure the environment is ready. The child should be able to sit comfortably on the toilet with his/her feet resting on the floor or a step stool.

Second, identify rewards that the child will receive after producing on the toilet. The rewards should be used only for toileting to make them extremely valuable to the child.

Third, identify a communicative response the child will use to indicate s/he needs to use the restroom.

Fourth, determine if your child has any unique needs related to toileting (e.g., sensitivity to the bathroom – lights, loud fan, flushing the toilet, etc.).

Fifth, set a toileting schedule such that you bring your child to the bathroom when they are likely to urinate. An easy way to determine this is collecting data on the time of day and amount of liquids the child has had for 3-5 days prior to toileting. Once the set schedule is in place, make sure to honor the schedule. Make sure the child comes in contact with success by initially prompting consumption of liquids and conducting “dry pants checks” every 15 minutes. Urine alarms have also proven effective in “catching” accidents. When on the toilet, have the child sit for up to 5 minutes and reinforce success by providing enthusiastic, behavior-specific praise and the special reward.

Finally, if your child has an accident, do not punish him/her; bring him/her into the bathroom and have him/her assist you with changing clothes.

When toilet training, the most important components are patience, consistency, team work, and humor! Toilet training won’t happen overnight; however, if everyone in the child’s environment is on board and consistent with the procedures, independent toileting will happen! Don’t give up or quit!

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