Are you having a hard time getting your child or clients potty trained? I’m Dr. Mary Barbara, and today’s episode we are covering five easy steps to get started or restarted with potty training for kids with autism and toddlers with developmental delays.
We are going to cover what is in this brand-new free potty guide, available at mbarbara.com/potty (or click the link on or around this video). You’ll want to download the guide, and I am going to walk you through it because what’s in here can really make the difference—even if you’ve struggled for months or years. So, let’s get to it.
We have done a ton of potty training content over the past decade, especially since I’ve been selling courses online. But I’ve been at the potty training game since the 1980s, when I was a nurse on a neuro floor. Later, I worked in a rehab setting with head injury patients and spinal cord injury patients, where bowel and bladder problems were rampant.
When I entered the autism world in the late 1990s, after my firstborn son Lucas was diagnosed with autism, I already had all that nursing background in terms of potty training. Over time, I’ve even been called the “potty queen.” I maintain my RN license, I’m a behavior analyst at the doctoral level, and I’m a mom to two adult sons. I’ve been potty training, writing, and speaking about it for decades.
Both of my books—my newest book, Turn Autism Around, and my first book, The Verbal Behavior Approach—have potty chapters. I recommend reading the newer book, as some of the advice in my first book from 2007 is outdated. My approach now is very positive: no overcorrection, no “positive practice” (which was actually punishment). All positive, all the time.
We’re going to cover the five steps you can take, including when and how to get started. Spoiler alert: it’s never too early or too late to begin pairing the potty and making this a top priority.
Before step one, let’s review some general prerequisites. I use the term loosely, because some children with autism won’t meet all of them. Even if a child is over age five and meets very few prerequisites, we can still—and should still—potty train.
Age: Over two years old is generally best. Under two, especially with developmental delays, may be too early.
Following directions: The child should be able to follow simple instructions.
Bowel movements: Predictable, not constant or random.
Staying dry: Able to stay dry for at least 1.5–2 hours. In the meantime, keep them dry—don’t let them sit in wet diapers.
Clothing skills: Pulling pants up and down (even with help).
Responding to reinforcement: Do they smile, accept rewards, eat treats, enjoy bubbles, or engage with toys?
Sitting ability: Can they sit with you at a table to eat or engage? If not, sitting on a potty will be difficult.
Awareness: Showing discomfort with wet/soiled diapers, hiding to poop, or bringing a diaper to be changed.
None of these alone are deal-breakers. Studies show we can potty train almost any child, regardless of intellectual disability, as long as they can respond to reinforcement and their environment.
Step 1: Assessment
The first step is an assessment—not just of potty training but of the child’s overall skills. The Barbara Early Childhood Assessment (BECA) is a free tool at mbarbara.com/assessment. It scores self-care, language/learning, and problem behaviors. This baseline helps you understand if the child can sit, follow directions, or pull pants up and down.
You’ll also assess potty history: Have they ever peed or pooped on the toilet? Do they indicate when they’re wet? Have you tried before, and what worked or didn’t? Potty training is a skill, not a race. For some kids it takes weeks, for others months or years. But with the right system, it doesn’t have to take forever.
Step 2: Early Prep
It’s never too early or late to start pairing the potty with positive routines. For example, a newly turned 2-year-old with delays might not be ready for intensive training, but you can still:
Introduce sitting on the potty for short periods.
Pair potty time with songs or reinforcement.
Work on pulling pants up and down over diapers.
Practice handwashing.
Important tip: Boys should sit to pee until fully trained for both pee and poop. Standing too early often leads to poop training delays.
I recommend gradual prep, not “all or nothing” underwear-only approaches. Pull-ups can be faded out, but success should come first. Each child’s path will differ, so flexibility is key.
Step 3: Timing
Pick the right time to begin. Don’t start during a move, a family crisis, or right before a new baby. Look for a calm period when you’ll be home consistently, such as summer vacation or holidays.
Also, standardize your potty language. If one caregiver says “poo” and another says “poop,” that’s confusing for language-delayed kids. For children under five, I recommend “potty.” For older kids, use “toilet” or “bathroom.”
Step 4: Materials
Gather the right tools:
Toilet ring insert (instead of tiny potties that require transitions).
Step stool (feet should be supported, not dangling).
Potty books, visuals, and videos.
A timer (freestanding or visual).
Data sheets or calendars to track successes.
Strong reinforcers (snacks, toys, bubbles, etc.).
Easy-on, easy-off clothing (no snaps or buttons).
Constipation is a major issue in potty training setbacks. Pediatric urologists report that 90–95% of ongoing accidents or poop smearing cases are constipation-related. If your child struggles with chronic wetting or soiling, this may need medical attention.
Step 5: Team Consistency
Finally, get everyone on the same page: parents, teachers, babysitters, nannies, grandparents. Use the same terms, schedule, reinforcers, and data collection. Consistency is the only way this skill will be learned.
I’ve seen thousands of kids succeed in potty training. If your child also struggles with language, problem behaviors, or refusal to sit, don’t focus only on potty training—look at the whole child. With systematic changes, success is possible, and once you see progress, it becomes motivating for both you and your child.
Download the free potty guide at mbarbara.com/potty. You can also attend one of my free workshops—separate sessions for parents of toddlers and for school-age kids. Professionals can access CEUs as well. If you want deeper guidance, join my online course and community, where we help you tackle not just potty training but the whole developmental picture.
Don’t get lost in scattered free advice. Dive into the 7-page potty guide, put these steps into practice, and take the next step if needed. With the right system, your child or clients can become potty trained—quickly and with less stress.
