We have been discussing different methods of potty training for the past few weeks. But, what about children that are not developing typically?
The Treatment and Education of Autistic and Related Communication-Handicapped (TEACCH) explain that even in typically-developing children, toilet training is often a difficult skill to master.
While the child may have good awareness and control of his body, there are other factors, such as social factors, that determine how easily toileting skills are learned. Small children do not feel an intrinsic desire to become toilet trained. Rather, they acquire this skill in order to please their parents and to gain the social status of 'big boy' or 'big girl.' This social motivation is a critical factor in determining "readiness" for toilet training.
How might the characteristics of autism contribute to a child's difficulty in learning to independently use the toilet?
- The child's difficulty with understanding and enjoying reciprocal social relationships would certainly interfere with this process. While other 2- or 3-year-olds might be proud of their "big boy pants" and might be happy to please their parents, this type of motivation is rare in a child with autism.
- Given the characteristic difficulties in understanding language or imitating models, a child with autism may not understand what is being expected of him in the toilet.
- A child with autism typically has significant difficulty organizing and sequencing information and with attending to relevant information consistently. Therefore following all the steps required in toileting and staying focused on what the task is all about are big challenges.
- Further, the child's difficulty in accepting changes in his routines also makes toileting a difficult skill to master. From the child's point of view, where is the pressing need to change the familiar routine of wearing and changing a diaper? After 3, or 4, or 6 years of going in the diaper, this routine is very strongly established.
- A child with autism may also have difficulty integrating sensory information and establishing the relationship between body sensations and everyday functional activities. Therefore he may not know how to "read" the body cues that tell him he needs to use the toilet. He may also be overly involved in the sensory stimulation of the "product"— smearing feces is not uncommon in young children with autism. The child may also be overwhelmed by the sensory environment of the toilet, with loud flushing noises, echoes, rushing water, and a chair with a big hole in it right over this water! A further consideration is that the removal of clothing for toileting may trigger exaggerated responses to the change in temperature and the tactile feeling of clothes on versus clothes off.
To continue reading about teaching developmentally delayed or autistic children to potty train, click here to visit the TEACCH web site.
Have you ever potty trained a developmentally delayed or an autistic child? What tips can you share with other nannies and au pairs?