The UK’s national children’s continence charity, ERIC (Education and Resources for Improving Childhood Continence) has provided these top tips for toilet training a child with special needs:

  1. Don’t feel you need to start toilet training just because other people are. Every child is different and develops at a different pace. Expect that it may take longer to train a child with special needs and go at the child’s pace – you may need to start with tiny steps at first.
  1. In children with special needs you cannot rely on social awareness and self-motivation as signs that they are ready for toilet training. To assess whether your child is ready, you need to assess their motor, cognitive, language and bladder and bowel development. Assess whether they can sit without support if they are non-mobile or whether they can squat without losing balance and get up without your help if they are mobile. Also, check whether they are beginning to show an interest or willingness to sit on the potty or toilet. Other sings that that they might be ready are when they can actively and appropriately search for a toy (including by eye pointing), when they can copy an action, when they engage in make-believe play, when they can understand simple instructions and communicate with signing or picture cards.
  1. Get tuned into your child’s wee and poo habits. Do they poo at about the same time(s) every day? This will help you to know good times to sit on the potty. How often are they doing a wee? Babies do lots of little wees, but as the bladder matures it learns to store more so toddlers do fewer, bigger wees. If their nappy can stay dry for an hour or two they should be able to keep their new pants dry for a while. Keep a chart for at least a week so you really assess this properly.
  1. It is difficult to know whether your child has done a wee because nappies these days are so absorbent, put some folded kitchen paper inside the nappy as this will stay wet. The wet paper will also help your child to associate weeing with being wet. You will need to work on this association if your child has special needs, for example, you could put cotton pants on under the nappy as these will also stay wet. These charts and the patterns that emerge will guide the times you should target to go to the toilet. You may need to take them to the toilet every hour and half to start with.
  1. If after assessing your child’s readiness they are not ready for toilet training, keep working on drinking appropriately, avoiding constipation and practising sitting on the toilet 20-30 minutes after meals. Re-assess their readiness after an agreed period of time.
  1. A little planning before you begin can be a big help. Think about what language you will use (don’t ask whether they need a wee or poo, they haven’t learnt to recognise the signs yet. Simply say ‘it’s potty time’ every couple or hours) or whether you will need to use picture cards or social stories (both are helpful for children with limited language). Think about what resources you might need such as fiddle toys to keep your child focused when on the toilet, a weighted lap pad to help your child feel more grounded, and a suitable toilet step or seat.
  1. Make sure the bathroom is prepared by looking at it from your child’s perspective. For an autistic child, it is a good idea to reduce the amount of visual distractions in the bathroom, also avoid strong-smelling products which might be distracting. You could put a mat on the floor to avoid having to walk on cold or shiny tiles and you could install rails to help your child balance when sitting down.
  1. Create a reward system such as a sticker chart or a game you can play or story you can tell after each achievable task such as sitting on the potty or washing hands. Make sure you’re ready to give lots of praise for each small achievement.
  1. If the leap to stop using nappies is too great, use Dry Like Me pads to help catch the mess and keep the nappy off. This helps the child learn too as the pad bulks up and helps them to recognise when they’re wet.
  1. Make sure everyone else who cares for your child, including school, are aware of what you are doing and how you are doing it, so training can be consistent.

 

Go to www.eric.org.uk and www.promocon.org.uk for more information or call the ERIC helpline on 0845 370 8008 or email helpline@eric.org.uk