Asperger's syndrome, an autism spectrum disorder, ranges greatly in severity. Some children with Asperger's syndrome exhibit developmental delays, which may prolong or delay the toilet training process significantly. In some cases, children with Asperger's may still be potty training when they enter grade school.
Language and Change
The two main characteristics that impede toilet training in kids with Asperger's are language difficulties and resistance to change. Children with Asperger's syndrome typically have difficulty using and understanding language. These language barriers often persist in older children. Thus, they may not understand toilet training instructions and they may be unable to tell a caregiver when they need to use the toilet. Also, children with Asperger's generally do not like to change their routines, so adding toilet use to their daily routine may be difficult.
Caregivers must plan carefully before beginning the toilet training process with a child with Asperger's syndrome and they must carry out plans consistently. Careful planning will help to ensure that the caregiver clearly implements toilet training methods. Consistency helps children with Asperger's because they prefer strict routines with little variation. Variation in routines may lead to a tantrum. Older children with Asperger's typically require routine even more than their younger counterparts.
Before beginning a toilet training program with a child with Asperger's, caregivers should be aware of the child's normal daily routine. Autism-help.org suggests that caregivers track a child's daily food intake, fluid intake, wet diapers and soiled diapers. This information can be used to determine when the child typically urinates and defecates and how long after eating and drinking each occurs. Then, use these conclusions to plan the best times for taking the child to the bathroom.
A Tailored Approach
Children with Asperger's syndrome need visual reminders of routines and task. The need for visual aids persists in older children with Asperger's. For this reason, caregivers should use visual aids to show the steps of properly using the toilet, explaining the steps exactly the same way and with the same pictures each time. Maureen Bennie, the director of Autism Awareness Centre Inc., and author of "The Trials of Toilet Training: Training the Older Child" in Austim/Asperger Digest, 2007, also asserts that directions should be expressed in simple language. In addition, caregivers should use positive reinforcement to reward children when they use the toilet. Positive reinforcement may include anything the child enjoys, like food items, special drinks or small toys. Bennie adds that the chosen reward should only be used for toilet training reinforcement and not for reinforcement of any other non-related behaviours. Even older children with Asperger's still enjoy certain toys. Often times, children with Asperger's become obsessed with one type of toy such as Hot Wheel cars or Legos. Such toys would make good reinforces if the child likes them.
Caregivers may be tempted to rush the child in order to have them potty-trained before a certain age or before entering grade school, but some children may just not be ready to until an older age. According to Autism-Help.org, toilet training for children on the autism spectrum may take a year. Maureen Bennie suggests that if a child with Asperger's syndrome does not respond at all to toilet training after three weeks, then the caregiver should try new methods.
Some children with Asperger's may have an aversion to the bathroom all together. In this case, toilet training may take longer. To conquer this aversion, begin by rewarding the child for going in the bathroom. Next, reward them for standing near the toilet. Next, encourage the child to sit on a closed toilet and finally sitting on an open toilet before actually working on using the toilet. Even older children with Asperger's may have aversions or fears associated with the bathroom. Children with Asperger's syndrome often have increased anxiety when forced to do something for which they have developed a serious aversion.
Children with Asperger's need to exhibit readiness before starting a toilet training program. Readiness may not occur at the typical potty-training age of 2 or 3. Children with Asperger's may not be ready until reaching an older age. Starting a toilet training program before children exhibit readiness symptoms will most like result in stress for both the child and the caregivers.
Readiness signs include awareness of wet or dirty diapers, desire to remove wet or dirty diapers, staying clean and dry during the night and ability to imitate actions.
Toilet training may occur at both home and school; however, the same methods should be used in both places. Use the same directions and the same visual aids in all environments. Also, in the beginning it may be necessary for parents to spend a week at home with the child to give full attention to toilet training.
Do not ever punish a child with Asperger's syndrome for toilet accidents. Instead, calmly tell the child what has happened and that he needs to use the toilet instead. Also, it may be helpful to take the child to the toilet right after an accident has occurred and sit him on it for a minute or less and reward him for sitting there, as a reminder.
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