Autism Potty Training – When to Start and Steps to Take

Whether your child is 2 or 20, with autism or without, potty training is a critical life skill. As a part of my classic rebroadcast series, I’ve brought back episode 34 originally recorded in 2019. I share signs of readiness, stress-reducing strategies for toilet training, steps to take, and solutions for common issues and mistakes. 

When to start potty training?

If you’re considering beginning potty training you may want to look for simple signs of readiness such as…the child is aware and dislikes being in a wet or dirty diaper, the child is interested in the bathroom and handwashing, the child is interested in dressing and undressing themselves. Sometimes, a child may even hide during a BM in their diaper. These are not all guaranteed signs the child is ready to potty train, but they can be an indication to start.

Consistency is crucial. Try starting potty training when your child will be home for an extended period, such as Christmas or summer break. If you’re going to train during school be sure that parents and other professionals involved with the child are all on the same page, collaboratively working on this skill. Also, get clear on the language you’re going to use. Will you say potty? Bathroom? Toilet? Poop? Pee? Decide the terms you’re going to use, and keep those consistent and not flip back and forth. 

As with teaching any new behavior, reinforcement is key. Find something super motivating as a high reinforcer when a child pees or poops on the potty. For some families, this can be candy or stickers; others may require more creativity. But remember, a reinforcer isn’t only working if it makes the child smile, the behavior has to go up too. 

How long does it take to potty train?

Potty training can take days, weeks, or even months depending on the child…but never years. If your child isn’t ready, that’s okay. There is some pairing you can do to get your child moving in that direction. One crucial tip is to start exposing your child as early as possible to the bathroom, signing or saying the word bathroom or potty, sitting on the toilet periodically, and keeping them clean and dry as often as possible throughout the day.

I cover a lot more in this episode regarding possible medical issues, underwear vs pull-ups, peeing sitting down for boys, and other really important information. When you are listening to this podcast and other free content please remember that this is always for informational purposes, only a professional who has seen and observed your child can offer true guidance and advice. For more information, you check out my online potty toolkit. 

As always with the classic rebroadcast series, I will be back next week answering the top 5 questions related to this very important topic!

Classic Rebroadcast: Autism Potty Training - When to Start and Steps to Take

YOU’LL LEARN

  • Why is potty training an important life skill?
  • Common issues, mistakes, and troubles in potty training.
  • Simple tips, advice, and steps to take for potty training.
  • What age should you potty train?
  • How long should potty training take?
  • Can medical issues affect potty training?
  • How to pair the bathroom and potty with your child.
Want to get started on the right path and start making a difference for your child or client with autism? SIGN-UP FOR DR. MARY BARBERA'S FREE TRAINING

RESOURCES

Mary Barbera – Turn Autism Around Podcast Transcript

Transcript for Podcast Episode: 210

Classic Rebroadcast: Autism Potty Training - When to Start and Steps to Take

Hosted by: Mary Barbera

Mary: You are listening to the Turn Autism Around podcast episode number 210. Today I'm bringing you a rebroadcast, a classic podcast, which has, I think the number one downloads. It's been downloaded many, many times since it was first broadcast back as podcast 34 in 2019. I am both a registered nurse and a behavior analyst. I also have some expertise in potty training. There is a chapter of both of my books dedicated to potty training. I have a free potty guide at MaryBarbera.com/potty. Just a very important issue for our kids and that is why this podcast is being rebroadcast and next week for a podcast 211. I am answering the top five questions I get about potty training. It is such an important topic for our kids on the spectrum and for toddlers and preschoolers just showing signs they can tend to impact school placement and just a whole host of other issues. So let's get to this very important topic of potty training.

Intro: Welcome to the Turn Autism Around podcast for both parents and professionals in the autism world who want to turn things around, be less stressed, and lead happier lives. And now your host, autism mom, behavior analyst and bestselling author Dr. Mary Barbera.

Mary Barbera - Expertise, Experience, and Information on Potty Training

Mary: So many of you know that in addition to being a board certified behavior analyst, I'm also a registered nurse and I have a Ph.D. and I'm the mom of Lucas and Spencer. And Lucas recently turned 23 years of age. So I just celebrated, quote unquote, celebrated 20 years in the autism world. But since this episode is all about potty training, I do want to just clarify that this is not medical advice. It's not behavioral advice. All of my content, my free content, podcasts, video blogs, even my online paid courses are for informational purposes only as professionals out there that are listening understand that it is not ethical or legal for me to give medical or behavioral advice to individual clients who I have not observed. I have not reviewed any videos. So this is all for informational purposes only and only a trained professional who evaluates your child can really give you guidance and professional advice. But I do think that my mission is to help turn autism around. And people say, what does that mean, turn autism around? It means to have each child reach his or her fullest potential and continue to reach his or her fullest potential. So I am all about that. And if you have party problems, no matter if you have a two year old or a 20 year old potty, issues are going to definitely affect the child and the family's quality of life. And we're going to get all into that and hopefully give you some great strategies if you have any issues with toileting. So I'm not just a registered nurse. My whole career in nursing was with neurologically impaired patients, such as patients with strokes, head injuries, spinal cord injuries, brain tumors. And I also worked, in addition to working at the University of Pennsylvania Hospital, I worked at Magee Rehab, where I worked with multidisciplinary teams like speech pathologists, PT's, and OT's. And we had team goals. And our main goals there were to increase independence, to teach people how to learn to talk again, how to learn to walk again or feed themselves, and so on. And toileting was a large part of what we did as well. So I do think that because of my nursing background, the daunting task of toilet training, potty training my two boys was not a huge deal. I mean, it was hard. It was hard to toilet train. Lucas and I waited a while because nobody was really giving me guidance on potty training him. They were telling me to wait until I had better instructional control and he had better language and ability to understand and so forth. So I waited until he was four and a half and I toilet trained basically. Spencer. And Lucas at the same time. Spencer was three, just turned three, and Lucas was four and a half when I potty trained both of them. I also had waited because Lucas was going to get his tonsils out, and so there was a couple of months there where I just thought, Let me wait until his tonsils are out and then I will tackle potty training. So after I potty trained both my boys I'm bad with math, but you know, say 2000, 2001. Then I went on to become a board certified behavior analyst in 2003. And so I was working with kids who needed to be potty trained. And really, my whole career has involved potty issues. In 2007, when I wrote my book, The Verbal Behavior Approach, I dedicated a full chapter, chapter number 11 to potty training, and it still holds true. There are a couple of things in the chapter that if I were writing it today, I would take out, positive practice, which I'm going to talk about a little bit. But besides that, I think the chapter is still a really good compilation of how I trained Lucas and the basics of how I've gone on over the past 15 years to train other kids, to use the toilet and to tackle these lingering potty issues that are a problem. So I don't have a standalone potty workshop or potty training course. And at this point at least and we're talking it's now the summer of 2019. I'm not saying that that will never happen. That definitely might happen. But I believe that if you have a toddler or preschooler who needs to be potty trained and you're having some problems, it is one of the many problems you're having if you have a newly diagnosed child or child who's showing signs of autism. Potty training is one of the ten big things that you're worried about that you're trying to teach your child. And so I believe and then if you have an older child, we had one of my participants in my online course. She took my toddler preschooler course for her younger son, and then she took my verbal behavior bundle for her older 11 year old son. And she told me that after 11 years, her big win for that day was that he had his first bowel movement on the toilet in 11 years. And so that's why I don't really think a standalone potty training course is what you need if you're struggling. Because for an 11 year old who's not potty trained, who has his first bowel movement on the toilet, which is awesome, there are lots of other areas and everything is really intertwined, you know, problem behaviors and compliance and language and understanding and working through task analysis to wash your hands and pull up your pants, dressing, fine motor. There's so many things that are part of potty training and dealing with toilet issues that I would suggest that if potty training is one of the many issues you're struggling with, that you consider joining my online courses and communities, and you can start by just attending a free online workshop at MaryBarbera.com/workshop. But today I am going to give you the advice. I do have two bonus videos on potty training. One is on the basics of potty training, and another bonus video within my online courses is called Almost Potty Trained for lingering problems that a lot of kids face once they're potty trained. So we're going to talk about that. I'm going to give you some free resources to get you started and then we'll go from there. So we all probably understand that I'm going to use potty training, toilet training very interchangeably. You know, when kids get older, the tendency is to call it toilet training versus potty training. But I find that searching for potty training is much higher than toilet training. So I kind of use potty training more now these days. So we all know why potty training is important, that, you know, wedding and soiling diapers results in a significant amount of time,energy, and resources. It does impact school placement options and access to child care. You know, it's really tough to get a babysitter that's willing to change a diaper for a five year old, let alone a 15 year old. And it can interfere with social acceptance, I know for my family, even even though Lucas was toilet trained pretty much by four and a half, five for urine, and then he had some bowel movement issues where he would, you know, have bowel movements in a pool or hide behind the sofa and and have a bowel movement in his underwear. I mean, those kinds of things that if a child is pooping in the pool, that's embarrassing and that's not embarrassing to Lucas. Lucas doesn't understand embarrassment, but it's embarrassing to me. It's embarrassing to his brother and to his father. So it's, you know, a health risk. That's the other thing is like because of my nursing background, I understand how body fluids, urine and bowel movements contain. It's not sanitary. It is a big deal if someone is pooping in their pants. It is a big deal. And I've heard horror stories of professionals kind of blaming it on the parents or like. Potty training is a home thing and just kind of needs to be collaborated. It's a bodily function that happens all day and all night. And, you know, it's not a home or school job. We need to work together to get each child to reach their fullest potential, which includes collaborating with potty training. And I'm going to give you some tips on how to do that. So determining readiness, are there really prerequisites? Yes and no. We do need to consider the child's chronological and developmental age. So if somebody joins my online course and starts talking about a two and a half year old that's, you know, got all these issues, not talking, not imitating, won't sit at the table and not potty trained. Well, they're two and a half chronologically and developmentally. They seem very young, like nine months old, 12 month old, you know, those kinds of functioning levels. So potty training for two and a half year old or even three year old who is very delayed, I wouldn't recommend it. I wouldn't recommend tackling potty training as your first thing.

Potty Training Signs of Readiness

Mary: However, there are other prerequisites like or not really prerequisites, but readiness. Is your child noticing when their diapers are wet or soiled? Is there an interest in the bathroom on the toilet and handwashing and dressing? Does a child move away or hide to have bowel movements? That's actually a pretty good sign because it's not just like they're just going and oblivious to the whole thing and the child's. It would be better if the child has regular bowel movements and does not soiled their diapers through the night. I know some children with autism have major GI problems and have diarrhea and constipation, and we're going to talk about that as well in a little bit. So these are some of the you know, if they don't soil at night and they have regular bowel movements, preferably every day, twice a day would be even better. It's not ideal if the child is constipated.

Potty Training Books

Mary: So let's talk about a couple books that I read very early on that most behavior analysts here listening would be like, Yeah, that's what we do. That's the book I read and that's what we do. So the book is called Toilet Training in Less Than a Day, and it's by Richard Fox. Well, it's actually by Nathan Azrin and Richard Fox. And it is a 1974 book. It sold over 2 million copies, at least in this edition, which I bought many years ago. So it's probably in higher millions of copies sold. And for those of you that don't know about Dr. as Ryan and Doctor Fox are both behavioral analysts, Ph.Ds, they're, you know, really spearheaded a lot of the toilet training literature. This is not a book for children with autism. This is a book using ABA principles, behavior modification principles, because it was back in the seventies to train mostly, typically developing kids quickly in a day. So a couple of the issues are that this is back in the seventies when this was written. You know, the idea is that you put a child in underwear only. You kind of hoist up their shirt so that you can see if they have an accident or not. And we use this approach for Lucas. We use this approach pretty much when training Lucas. But now we're, you know, two decades almost after training Lucas And I'm a behavior analyst and I'm a nurse. And times have changed. I've seen public school staff who have taken this book and said, okay, we're going to, you know, toilet train Joey, who's eight years old in a public school classroom. And he's going to be in underwear only and he's going to be partitioned off. And, you know, having an eight year old walking around a room, even with some privacy barriers in a public school setting is just not really appropriate anymore. You know, looking at their underwear, certainly touching their underwear to see if it's wet. I mean, we have so many issues, right, with that whole thing. So kids in public schools and even private schools, you know, you can get advocates, other parents, other kids going home, telling their parents that Joey was in his underwear. So that is something that's changed over the past two decades. That's just so that that is kind of out for older kids. If you're potty training in the home with a three year old and you know, very you may it might work, but I see a lot of problems with that. The other big thing in the book is a procedure called Positive Practice, which I talk about briefly. That's how we got Lucas potty trained for bowel movements after I called Dr. Fox on the phone because I had met him early on and he recommended that we do positive practice and it is a punishment procedure. It involves having the child have the accident and then taking them back and forth to the potty as a punishment that is not allowed. Punishment procedures are not allowed in public schools, at least in my state. And again, it can just get us into a bind. And now newer studies have shown that you can potty train without positive practice. So my procedures are definitely different from Dr. Fox and Azrin not to say that they were wrong. That is a you know, this is the book Toilet Training in less than a day is the book that most behavior analysts follow. But my thought is we need to progress with the times now and we need to consider all the factors and especially with punishment procedures and wearing underwear and focusing on any negativity. So that is a big thing. The other book that I read was recommended several years ago, but I would already consider myself a potty training expert for sure. And then somebody told me to read this book. So this book is called It's No Accident, and it is by Dr. Steve Hodges, who's an M.D. and he's actually a pediatric urologist. So urologists, pediatric urologists deal with urine issues, but it's no accident is basically Dr. Hodges talks about how it is all the constipation holding of stool and pee accidents, poop accidents. It is all caused by our diet, our Western diet, and being fiber deficient. And he also blames potty training too early and irrational demands and priorities. So in a lot of preschools to get into a three year old class, you need to be potty trained and that is a barrier or daycare to move up to preschool B potty training is a requirement. So there's a lot of demands put on kids, even typically developing kids. But when you have autism, then the stakes are even higher. So he has a clinic down south somewhere in North Carolina. This is an excellent book. It's No Accident. And he was saying that 90% of kids that come to his clinic, the parents fill out the form. They say the child is not constipated and 90% of the time they are actually constipated if they are having poop problems, pee problems, nighttime wetting, holding stool, not going for five days in a row, needing, you know, medicine to go, they are most likely fully impacted and constipated. And so this is a great book. He does recommend a medicine, over-the-counter medicine called Miralax to clean kids out to keep them clean. Some of the clients that I've worked with, again, this isn't medical advice. It's just like he's recommending Miralax, which is over the counter. One of my clients who felt that Miralax was kind of toxic for her daughter found a supplement that is similar to Miralax called Aloe Verocks. That, again, is over-the-counter. So you have to work with your doctor or whoever is the recommending health care practitioner in order to recommend something like doing an X-ray to see if the child is impacted and not just saying, no, they're not constipated. So that's another reason why I don't agree with positive practice, is you could be doing a punishment procedure. Meanwhile, the child is impacted with stool. It's never their fault, accidents or holding or anything. But it is quite medical and I think behavior analysts who read a 1974 book and are just, you know, determined that that's the protocol they're going to use probably need to get up with more of the current research.

Common Potty Training Issues and Steps

Mary: So prior to potty training, say you have a two and a half year old who is not ready for potty training, but you can do a couple of things prior to potty training to get your child kind of more ready, and that is to keep their diapers clean and dry frequently. So you want to be checking them every hour to make sure they're not sitting in wet diapers or sitting in stool. You can comment. You're very wet and you could and should, I believe, put your child on a small potty or on a toilet with a ring seat so they don't fall in. I would put them there in the morning at bath time at night, a couple of times a day just to pair it up so that this is where we pee and poop. What happens sometimes with kids with autism is like people say, well, they're not ready. So we're putting that little potty away. And then when they are ready, say, at three and a half, four, four and a half, then you get out the little potty and then it's like World War Two has erupted because the child won't sit. The body's not paired. And so I believe that even little babies who can set, you know, 18 month olds or one year olds even to put them on a little potty, just to pair it up, just to be like, oh, this is where we pee is fine. The other point that is a mistake I see frequently is that boys are often taught to stand to pee. And then then when they get to pooping, it's like World War Two to make them sit. So I strongly advise that boys need to sit to pee, at least until they're fully bowel trained. This is a mistake. I see a lot. And this is the number one thing when you have an 11 year old who pees on the toilet but poops in his pants or in a diaper because they are not taught to sit. And if you're not taught to sit and relax, then a lot of times the bowel movements happen by accident and this is a problem.

Mary: So okay, say your child is ready and you're going to try to tackle this. I do have a tool kit that I produced years ago. I hopefully will update it in the near future. But if you go to MaryBarbera.com/potty, you can get this tool kit for free. But you want to select a good time to initiate training. Usually bladder control, your urine comes first to get trained. And the newly diagnosed period, as I said, is not really ideal. And you want to look for it, preferably at home. So you say you're going to tackle this in your parent or even if you're in an autism school and you're going to tackle it at school first and then generalized to home, which is totally fine, you want to pick like a two week chunk where child's not going to be like if it's at home, the child's going to be off. So maybe summer time or a week or two over Christmas break, something where you're going to get some momentum and you can definitely train at school and at home. But it just needs to be collaborative. You also want to look ahead to the next couple of months, maybe two or three months if you're moving, if you're having another baby, if the child's getting his tonsils out like Lucas was, it might not be worth it to start and stop. And maybe many of you listening have had a lot of false starts with potty training and a lot of, you know, we tried it didn't work. You know, I've worked with kids that are 16 and not potty trained at all. And when I tried to investigate, like, was this ever attempted, it's just like a lot of false starts. So you want to make a plan so that it's not just a false start, you actually can follow through. So as I said, home is usually more ideal than school, but if it's going to be done at both home and school, I suggest that, you know, we need to communicate and that there's a toilet training training manager, especially if there's multiple environments. So really ideal. Say you're in a private school for kids with autism and you're going to, you know, do this at school and say Amy's the teacher or the person that's going to basically take charge of it at school. Maybe Amy could then visit the home and talk about the steps that mom can take at home and how this is going to work. Consistency is the key. The team needs to agree on words to use. You know, it's just so simple. Like, are we going to use the potty or are we going to use the toilet or bathroom? I know we have people from all over the world listening, whatever, you know, words people use. Are we going to say pee pee or urine or poop or poo? These words need to be discussed and decided so that everybody's consistent. We need to decide. Decide on a schedule. Most kids are schedule trained before there's any spontaneity in requesting. We need to decide on reinforcers. You know, some people give an M&M, some people they don't want to talk about food and bathroom at the same time. You know, some kids are really tough. I remember I had a 12 year old that I was trying to potty train and, you know, he was just really he had no language. He had really few skills and really few reinforcers. So I'm like, you know, what could we do? Just have him sit on the party or if he peed, you know, what could we what could we reinforce with? Is there anything that he kind of goes really happy about? And I remember the staff sitting around and whispering, Well, no, no, don't tell her that. Don't. I'm like, What is it? What is it? I need to know reinforcers. And they said, Well, when it rains, when people bring in their umbrellas or put up their umbrellas, he gets really excited. I'm like a travel umbrella. That's perfect. You could open it up and twist around three times and that's his reinforcement for peeing on the potty. And then the little travel umbrella could be kept in the bathroom. So nothing is off the table. And we sometimes need to be really creative. And if it can be liquid reinforcers, like an ice pop or four ounces of juice, that's even better because that kind of goes with one of our other steps, which is extra drinks. So before we get into extra drinks, though, if the child can pee and then consume them where we're kind of getting two for one there. Okay. So before we get to the extra drink step, sometimes we can use books like I used to use this book and it came with a video too. It was called Once Upon a Potty for him, and I think they have it for her. And they had this little doll, which I mean, Lucas didn't really understand the doll, but he liked the book and he liked the video. And so then, you know, the part that Lucas really liked about the video was, you know, they had this little character boy jumping around and going pee on the potty and whatever. And then after the character cartoon, everything was over. Then they had this doctor, come on, he's like, I'm Dr. Smith. Potty training is the most important, you know? And Luke is like that part, like the boring doctor talking, which was crazy when we're talking about there's also some potty apps now which back two decades ago there was no such thing as a cell phone, so I couldn't use that. But there's a See Me Go Potty app. There's other apps that are totally great. There's an app, I forget the name of it where, you know, you had like you would push the button. Like, Oh, Johnny went pee. And then it would be like an automated person like this person was face timing you. Great job going potty, you know. So there's a lot more things you can do now with your cell phone and apps and potty training. So the umbrella can't be like, Oh, I got to go outside the classroom. I got to, you know, find an umbrella. Like it needs to be immediate. It usually needs to be tangible and, and it has to be rewarding to the child like. And the only way to really tell if it is enough of a reinforcer is if the behavior goes up, not if the child smiles like. People jump too quickly to like sticker charts or whatever for peeing. It's like that's probably not going to do it. Even if the child smiles. If the peeing on the potty is not going up, it's not enough of a reinforcer. So remember that. Diapers, pull-ups, underwear. What should we use like so in Dr. Fox and Azrin's book Toilet Training in less than a day they were like very clear that a had to be a had to be underwear and once the child initiated a one time, there was no going back to any diapers or Pull-Ups. But I have found as a parent and as a consultant in homes and as schools, that it's just not realistic to have kids peeing and pooping on sofas and on chairs and on bean bag chairs. It's a mess and it's not sanitary. As a nurse, there's E coli, there's if the child has any hepatitis or AIDS or anything, you should not be taking bodily fluids lightly. Right. So I am not really a big proponent of going with underwear on day one. If you do, if you can kind of quarantine the situation where you're in the kitchen with gates and the child's in their underwear and they're in the safety of their home, and, you know, you can do it for like a two hour chunk of time where you put the child in the, you know, sometimes putting your child in underwear and having them wet themselves is all it takes to to make it be like, oh, I don't like that feeling. I'm going to, you know, go on the potty. But I am okay with underwear, with pull ups on top or waterproof pants, especially if you want to try to take the child out somewhere. You do not want to be dragging your child around in underwear, and then you'll have to clean up the car seat and the couch and you'll have to get new rugs. It's just a mess. So I am not against using other things as you toilet train and it might take a little bit longer, but it will be less stressful. Either way, you want to make sure that the pants that a child wears during potty training can be easily taken down by them. No buttons or snaps or anything that is that is cumbersome. Getting to the extra drink. So you want to get a child on a schedule, you want to do extra drinks because we'll be working on potty training for like a two or four hour period usually is what I recommend. And you want to have a consumption of four ounces of fluid an hour or if the child's bigger. I mean, you can't just load a small little child with a ton of fluid, but you want to have extra drinks so that you have more practice trials, more practice, more need for pottying and then more, you know, awareness if there is an accident. And the schedule, I think, should be 1 to 2 times an hour. Tell the child it's time to go to the party or the bathroom. Use the word bathroom when training a child. I usually recommend over five if you're starting the training because transitioning from potty to bathroom is sometimes hard and then have them say the word potty or bathroom if they can, or sign it with a fist up with a thumb through the fist. So that kind of it doesn't really get them to initiate. But if you say it's time to go potty, say potty or sign potty, and you give them a sign, then it's almost like you're practicing, manding or initiating for that potty too. And the child should be heavily reinforced if he urinates or has a bm certainly some children just need reinforcement to pair up the party to go in the bathroom, to sit down. I mean, if you get screaming when a child enters the bathroom, then you can even attempt to potty train until you get the situation repaired. And that's going to cause a lot of desensitization. Again, that's covered in my online courses, my verbal behavior bundle. So if you have a child that's screaming or having aggression in the bathroom or peeing and pooping in his pants or in a diaper, and they're older, then you've got other issues that also need to be tackled. So I would highly recommend that you visit MaryBarbera.com/workshop. Learn more about my online courses and community. You want to do whatever you do when you're doing the schedule whether it's just reinforcing them for sitting, reinforcing them for peeing, and that can change. You know, initially you might be just reinforcing them by sitting and trying. Then you're going to reinforce them more strongly, use differential reinforcement. So if they do sit and pee, they get more reinforcement. If they sit and poop, they get, you know, a lot more reinforcement because we want to use that differential reinforcement that is so powerful. And then in addition to schedule training, extra drinks, we want to, if possible, take some kind of data. And this could be, you know, if you're at home alone and it's just you and your child and you're a parent, it could be keeping data on a calendar, which I have a video blog about how to do that. It could be as simple as just on a loose leaf. How many times have you gone? How many times did he actually pee? The other thing, even if you're not ready for bowel movement training, it is a good idea to start writing down the times of bowel movements, whether they're in a diaper or potty or wherever they are, because we want that to be consistent. If the child is constantly pooping after dinner, we want to take advantage of that when it is time. There are two re reflexes the orthocolic reflex and the gastrocolic reflex that are important for bowel movements. Usually people have a bowel movement after the first thing in the morning after they wake up. So ortho, upon standing and then the other time is after a meal. That's the gastrocolic reflex. And so if you're going to try to get the child toilet trained for bowel movements, then we're going to have to be aware of when that is happening and if there is any problem with constipation or even if you think they're not constipated. I would totally read this book. It's no accident. It really was a game changer for me, even as a potty training expert. And you'll you know, if you're at a clinic or a school, I would highly encourage you to take really good data, graph the data do phase change lines because when when parents and professionals get like, oh, this isn't working, but if you graph out the data, you can show them actually it is working or it's not working. Okay, let's come up with a different plan. As I said, I have two bonus videos within my verbal behavior bundle. One is on the basics and one is on almost potty training, which covers four lingering issues that a lot of older kids with autism face. The first issue is not being fully trained for bowel movements. They're they're waiting or requesting a pull up or diaper. And even if you're going to potty train during the day, a lot of times we don't tackle nighttime training, so until later. So the child will get a diaper and then they'll poop. Like some kids ask for diapers and you, you know, I get requests or, you know, questions. Well, should I give him the diaper and you know, it's not like a quick oh, just give him a diaper because they're eight or they're 11. Like, we need to work on this. But as not your behavior analyst, I can't really tell you what to do. But in the bonus video with my course, I go over more. One of the ways to prevent not being fully trained for bowel movements is to have boys sit on the toilet to pee. Number two, failure to.... So say you're listening and you're like, I have an 11 year old who stands to pee and doesn't poop. On the potty, on the toilet. So now I'm you know, I'm already down the path. Now, how do I do it? So in that respect, I would have them pee. And then I would, especially at those high probability times, have them sit on the potty, maybe set a visual timer for 5 minutes, or have it be part of the routine. Like after dinner, they're going to sit on the potty they can pee standing up because that's what they're used to. And then they sit at the party for 10 minutes while they have their iPad and try to poop. And then you can, you know, start incorporating that. Start making it, like, really high reinforcement if they do poop. Okay. So not fully trained, failure to wipe, which I cover in this bonus video as well, failure to initiate request potty and not independent with the whole routine. So again, this is short. It's getting to be a long podcast, but we can't cover all of the issues. But those are the most common issues for older kids that are basically toilet trained but still have lingering issues. And then nighttime training is like a whole different animal that sometimes takes systematic work. Sometimes you can get it for free and it all works out.

How Long Should Potty Training Take?

Mary: But how long should this whole process take? It should take days, weeks or months, but not years. And if you are having false starts or you're having lingering problems or maybe there's a regression with toilet training, you need to go back, assess, make a plan and collaborate with home and school to get the child back on track, to get them fully potty trained. Because I do believe that being fully potty trained and independent with toileting is one of the really important skills in life. And it will make the child's life better and it will make the family's life better if we can get this issue tackled as soon as possible. So if you would like more information about potty training, I do have a free resource at MaryBarbera.com/potty. And if you would like to learn more about joining my online course and community, go to MaryBarbera.com/workshop for a free workshop. I hope you found this podcast helpful. This is episode number 32 (210). So if you want to refer anybody to listen to this episode, have them go to MaryBarbera.com/32 (MaryBarbera.com/210) to listen to this podcast and hopefully it will will help you whether you're a parent or professional tackle these issues and get children to reach their fullest potential, which is totally my goal. So have a good one and I will talk to you next week.

Mary: If you're a parent or an autism professional and enjoy listening to this podcast, you have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a brief online workshop at MaryBarbera.com/workshop where you can learn how to avoid common mistakes. You can see videos of me working with kids with and without autism, and you can learn more about joining my online course and community at a very special discount. Once again, go to MaryBarbera.com/workshop for all the details. I hope to see you there.