Toilet Training for Autistic Children

Hey, guys, this is Ming here, a speech therapist from agentsofspeech.com today I want to talk about toilet training for autistic children. Okay, huge disclaimer here. I'm not saying that any of these techniques are research based or evidence based or whatever. This is just what I've learned from the first clinic I've ever worked at. That is a very good method, I believe that's very systematic and has worked and served me well. I don't know if it'll work for you, but that is case by case basis. So now that we have that disclaimer out of the way, I want to tell you that this method you should try. If you've tried the other evidence based techniques, you know, like the scheduling or whatever, telling stories about, you know, toilet or whatever, if you try those, it doesn't work. Maybe you should try this because it just. It's just logical. Okay, first of all, make the toilet a good experience, all right? The last thing you want is that your child hates the place, okay? If they've struggled with you inside the toilet, you have to undo it, okay? It's not always about forcing the child to do something by, you know, getting them on it and then whatever. Even if you reward them at the end of the experience, you're also rewarding him struggling, okay? That's not a good thing. So what I would say is to get rid of this defensiveness, you have to make the toilet somewhere a little more, how to say, engaging, a little more welcoming that they can sit in, have a snack, read something, play with toys and just be themselves and have a, have a good time. Right? So sometimes we even go as far as creating a bookshelf, a toy shelf, giving them the iPad inside of the toilet, turning the lights to another color, playing some music with a Bluetooth speaker. All these will help the child to really settle down inside of the toilet and feel like, oh, man. Okay, I get it. It's not like the wet, harsh toilet and then, you know, mom's screaming and it's an echo chamber. You know, it's actually quite a disturbing experience if your child has had difficulty and failures in the toilet. So you need to undo that first. Okay? Second of all, make it easy to reward the target behavior. What is the target behavior here is that the child pees inside of the toilet bowl, not in his pants, not in the diaper. Right? So how do you do that is that you need to keep on making them want to pee. And the only way to do that is to give them water Right. When you give them water, how do you make sure that they don't fail? Which is to pee outside or pee on the pants or whatever. And that is to keep them on the toilet bowl already. Okay. And they need to be like butt naked on the toilet bowl, sitting there and sipping water as they're doing a lot of the tasks in there. Right. Maybe not tasks enjoying themselves with like books, videos, whatever, like playing together. And then when you keep on giving them water, slowly and surely what's going to happen is that they're going to pee. So you have to increase them as many times. The instances of them doing the target behavior, which is peeing in the toilet. So with you feeding them water whilst they're doing something else, it distracts them. And as they ingest more water, the inevitable will happen, which is water coming out of their body into the toilet. And then you can reward them. Okay? Reward them with something really, really, really, really good and acknowledge that they have peed. Okay. And you have to do this many, many times. Many, many, many times. Spend around one to two hours a day in the toilet. I know it's very hard and it's a luxury, but this is something that you need to do. If your child is around like three or four or even five or six, and they still haven't mastered toilet training yet, this is the foolproof training that you can do because you minimize the errors, you only give them the upside and to enjoy themselves along the way. Okay. The whole full detail is actually in our agents of Speech toilet training course. So it's a workshop that we did long time ago and it's just a recording of us telling the parents what to do. So you can go check it out. The link is in the description box below. Go to agents of Speech.com store to check it out there. Okay. So you might ask. Okay, I get it, Ming. So they get to enjoy themselves, they got to drink water, they get to pee. What's going to happen next? Well, you have to increase the difficulty systematically. What does that mean? So the biggest problem for children who are currently having a problem with toilet is that they cannot pee at the right place. Right? They cannot hold it even if they know that it's coming. They cannot get to the toilet in time. Right? So therefore, how do we do it is that once the child, you can see that they can anticipate the pee. They're like, they stop what they're doing and they start looking down and looking at their own, like bowel movements. Then what happens next is that you Try to increase the distance between the toilet bowl and the kid. And how you do that is you put a chair inside of the toilet. Okay? So you put a chair inside of the toilet and the kid is still butt naked sitting on a chair. All he has to do is to stand up and go to the toilet, right? So in the beginning, you're gonna have to help him or her a little bit to like, you know, tap him and push him onto the toilet bowl and then for him to do his business there. And as he gets a little more skilled and accidents will happen, right? As he gets more skilled, increase the distance between the toilet bowl and the chair until it's right outside the toilet so that the child knows how to just walk into the toilet himself and then pee. And then, then you can add pants or whatever. So this process is hugely simplified. Again, check out our workshop, the toilet training one. It's on agents of speech.com store. Anyways, so as you do that slowly and slowly, slowly, the other way of increasing the difficulty is to do a very highly engaging task that they need to concentrate on. So what happens a lot is that when children or human beings in general, when they concentrate on something, they tend to forget about stuff, including people start to drool. They start to, for children, they start to pee their pants by accident, right? They start to do fidgeting and everything, right? So you want to engage them into something that they are really interested in and they would concentrate a lot and to see if actually at that point would they still be able to stand up and go to the toilet. Okay? So here the reward is very, very important. Once they can do that, you need to praise them. Identify what target behavior you're trying to shoot for. It's like, oh, nice, nice going to the toilet. Good boy, nice walking to the toilet, nice knowing, and so on, so forth. Right before, like the whole thing is like this. They do at the end of the training, your child should be able to engage in a highly engaged game or something, like maybe playing duck, duck, goose or something, whatever. Like something so engaging that they're having a lot of fun to drink water and still be able to tell you and tap you and say, I want to pee. And they go themselves and they are fully dressed and then they, they, they know the whole process of going to the bathroom, taking the pants off, peeing, finishing the business, wiping up, washing the hands and leave. So that's the whole thing. If you want to see the whole thing, you can go to agentsofspeech.com store. We have a lot of online courses and especially there's a workshop on toilet training. So go there and check it out if you have any questions. I know this is a little bit more controversial that a lot of therapists will disagree with this technique. I'm okay with that. But at the same time, this stuff worked for a 30 year old ASD adult that hasn't ever had any success with toilet training. This process worked for her. I don't know if it will work for you or not, but at the very least I'm pretty confident with this. So go check it out and I'll see you in the next video really soon. Bye.