How to Treat Resistance to Toilet Training in Autistic Adolescents

People who have autism often have sensory issues and an attachment to routines and what is familiar. These characteristics sometimes combine to make toilet-training extend into adolescence. Taking the time to understand this difficulty -- and remaining sensitive to the needs of the person who has autism -- can help to make toilet-training a reality.

Instructions

• 1

  Ask the person who has autism -- if she is verbal -- what stops her from using the toilet. If she is non-verbal, use your knowledge of the person to try to understand what is stopping her. Being afraid of sudden loud noises, reluctance to give up the routine involved in not being toilet-trained or a desire to keep the feeling of a tight-fitting undergarment are all common barriers to toilet-training for adolescents who have autism. Use this information to move forward with toilet-training.

• 2

  Review the person's schedule. Is it possible that she's not being offered a toilet often enough, or that her eating and drinking schedule coordinates poorly with her bowel-movement schedule? If the person is non-verbal, she may not be able to articulate this problem to you. Tweak her schedule as necessary to make bowel movements as convenient and comfortable as possible.

• 3

  Determine if loud noises are the problem. If so, try arranging a bathroom time where the person can be alone or with one trusted person in the bathroom, and no one can come in and flush the toilet or make noises that are amplified in most bathrooms. Some people who have autism are sensitive to the flickering florescent lighting in many school or other institutional bathrooms. A lamp or two might help make toilet-training work better for the person.

• 4

  Consider whether the person craves pressure or a feeling of snugness in other areas of his life. Does he prefer tight-fitting shoes or that his sheets and blankets are tucked in firmly at night? If so, he may be reluctant to give up the feeling of wearing an adult diaper. Help him to transition into wearing similarly tight-fitting under-garments, such as spandex shorts.

• 5

  Ask the person -- or yourself, if he is non-verbal -- how important the routine of being non-toilet trained may be to him. Help him to slowly build new routines around using the toilet. Abruptly removing a routine from a person who has autism often has disastrous results, so move slowly and take your cues from him.