Toilet training autistic child - head in hands!

[ToiletTrainingSOS]

Please for the love of God someone help me toilet train my autistic/ADHD 3.5year old.
I take him to the toilet regularly where he wees, enthusiastically flushes and washes hands (with help). Needs constant prompts to pull shorts up etc although he does actually know what to do/what sequence to do things in as when asked what to do next he will say “now we flush” etc
he will not initiate going. Has never told me he needs to go. Will just say mummy I’m wet/mummy I’ve done a Pooh etc.
we have a sticker chart, a sand timer, a book, favourite character pants……please can someone give me some advice on how to just get this cracked?! My elder child is NT and it literally took a few days. I have been trying to toilet train DS for almost a year now on and off and i genuinely don’t feel like we are getting anywhere.

It’s worth remembering that some children with special needs train later. I have two children who are autistic and they were both non verbal and decided they didn’t want to wear nappies at three so used the toilet. They weren’t at all interested in character pants/rewards or star charts. It was simple a case of taking them to the loo at various times during the day and using language like wee and poo when they did it. They had some accidents but a lot less than my NT child. It just took them a lot longer to click and be able to go themselves. My youngest is 10 now and pre-verbal and just goes at home and when really desperate goes when out though they hate it.

I think it’s just a case of being super patient. They might not make the connection to feeling like they need the toilet.

Too young perhaps, I tried and failed several times. Dd was 4.5 and then barely dry

Two autistic kids here, so I’ve BTDT.

First off, the fact you’ve been trying since he was 2.5 suggests you started too early. Autistic kids very commonly take longer to toilet train compared with NT peers, so it’s unreasonable to expect them to keep to a NT development schedule.

Secondly (and I made this mistake with my second child): stop expecting him to communicate to you that he needs to go. He has social-communication delays. He isn’t able to communicate toileting signals to you yet. @Waifeandstray is also correct that due to interoception issues (interoception = feeling and understanding internal body sensations) he may not be good at interpreting the feeling of needing the toilet.

I had to take communication completely out of the equation with my son. Very early on I started taking him to the toilet at closely timed intervals, and gradually stretched out the time. Eventually he started telling me when he needed to go, but it must have been around the age of 4.5-5yo.

If it makes you feel any better I am trying to train my 3y7m daughter who is NT and she is flat out refusing. Even if I leave her with nothing on she won't go. Sits down on toilet or potty and doesn't do anything then gets up and holds her tummy like she needs to go but gets really upset and just holds it.

She completely understands the concept. Just refuses to comply. This is the 3rd time we've tried to train her

I tried maybe 4 or 5 times between the ages of 3-4.5 with my Autistic DD, she just wasn’t ready. Tried again at 4.5 (2 months after the last attempt) and she got it straight away on day 1, hardly any accidents since and was dry at night as well a month later. I did nothing different, I honestly just think she wasn’t ready until then.

I'm in exactly the same situation, DS will be 4 in a couple of months and although pre school are very understanding he is the only one still in pull-ups in his class. He does say he needs a wee about once a day but it's usually it's when I'm cooking tea (bathroom is off the kitchen)so I think it's just he wants to be nosy. He refuses to accept that poos go in the toilet, only wees, arghhh!

One of my autistic kids self trained at 2.5

The other one was 5

If they are not ready they are not ready and she out of the equation your child is demonstrating to you that they are not ready.

My autistic/ADHD daughter is exactly like me and her dad and likes to do things on her own terms. There was no way we’d have been able to train her. One day she declared she was finished with nappies and has used the potty/toilet since.

Shes 4 in a few weeks and often feels like she’s growing up too fast, so she still likes to use the potty as much as possible and have her pants/leggings pulled up for her.

Mine was like that initially - sat on the potty, nothing doing, five minutes later there would be an accident.
The breakthrough was realising that she did want to in principle, but something (possibly subconscious) was holding her back (I don't know about others, but I'm like that when needing to collect a urine sample). I said to her "when you go on the potty, it doesn't go all down your legs like when you have an accident". It turned out that was her worry, and she suddenly relaxed and could do it.

My son is 5 and non verbal, still not ready. I do believe it varies and depends on the child when they genuinely feel ready/not want to wear nappies anymore

My son was 5.5 and we had tried from about 3 onwards. He knew exactly what to do etc but I just don't think his brain was getting the signal he needed to go. He would look down in shock when pee started coming out (when we had nappies off trying to train him). Since 5.5 he's been dry day and night. I think from what you've said your child is similar and it's to do with the signals.

He’s not ready and that’s okay 😊

If he's not ready he's not ready. Leave it for a few months or until he's showing lots of signs of being ready.

On the other hand my DS with autism self trained ,early, by looking at what his dad/brother did. Might be a good idea to just stop trying to actively train but just let him see dad/other male relative wee. My DS never sat down to wee, he was happier standing, having copied others. Once he got the hang of weeing, he started to sit on the toilet to poo, he never used a potty either. He clearly thought that was gross.

Every child like this will be different.

Our little girl, now almost 5 showed absolutely no awareness whatsoever of toileting needs until she was well over 4, but progressed to being out of nappies and dry at night in an astonishingly quick couple of weeks that we weren't expecting.

Problem now is she's a bit of sensory seeker and very independent, so won't tell anyone she's been, and likes to splash in the contents of her potty 😐

I had to take communication completely out of the equation with my son. Very early on I started taking him to the toilet at closely timed intervals, and gradually stretched out the time. Eventually he started telling me when he needed to go, but it must have been around the age of 4.5-5yo

We did something similar - we used a digital timer and sent DS off once an hour. Gradually we stretched the time intervals. No accidents after 3y11m but actually self initiating (which was always running straight to the loo, never telling us) came a fair few months later tbh.

Try to remember a lot of children with ASD don't actually recognise the feeling of needing the toilet. So will have accidents because they can't recognise they need to go.

My son, we basically put him in the garden naked and every time he did a wee he could see it and feel it so ended up linking the two together. That the feeling meant he needed a wee. Also you'll have to prompt them a lot.

My ASD DS2 has just almost finished training and he’s 5. We were working on it from about 4.5 lots of support from school and continence team. We were told that it’s highly likely that he doesn’t feel / understand the need to go which is while children with SEN and ASD can train later. He still doesn’t quite have poo mastered.

personal experience says don’t push it if they’re not ready and reach out for supply form GP / children’s health services & your paediatrician

People with autism and adhd often have sensory processing difficulties and this can include difficulties with introception. Introception means knowing what is happening/ what you feel inside your body. If somebody has difficulty with introception this can include difficulties knowing when their bladder is full or when they need a poo.

Other signs someone has problems with introception could include:
Not recognising feelings of hunger/ thirst, or not recognising feelings of being full
Having a high or low pain threshold
Not feeling hot/ cold (eg: not dressing appropriately, happy wearing no coat in winter or a jumper in summer)
Not responding as expected when unwell (eg: vomits with no prior warning that they felt sick, has a high temperature but still bouncing around the house where you’d expect them to be in bed)

If your son has issues with introception, which is very common with both autism and adhd and so likely, then he is going to find it harder to recognise when his body need a poo/ wee than for a NT child. It is very common for children with autism/ adhd to be later to toilet train than NT peers and to have bladder/ bowel issues in childhood (eg: constipation, bedwetting). At 3.5 your son is probably on the lower end of the age range for which a neurodiverse child is successfully toilet trained so I really wouldn’t worry at this point, it is likely to take a lot longer for him than it did your NT and it may be that he is just not ready yet.

I would probably put him in pull-ups for a few more months so you can keep taking him to the toilet and working on all the skills around using the toilet like pulling up pants etc but where accidents also won’t matter and look at getting into a routine that he can remember, so for example always using the potty after breakfast, before lunch etc. For some neurodiverse people who struggle with introception going to the toilet regularly as part of a routine is easier than waiting to feel the signals from their body, especially as sometimes by the time their body gives them the signal they need to go it is already an urgent need which might not leave enough time to actually make it the toilet. If you’re using things like sticker charts I wouldn’t focus on him recognising when he needs to go, as this might literally be something he cannot feel/ recognise in his body yet, but instead focus on him remembering to go at the right point in the routine, so remembering that after breakfast that before he goes to play he needs to go to the toilet first. Hopefully if you get into a routine this will reduce accidents until the point at which he learns to recognise the signals in his body.