Strategies for toilet training a child with autism

I currently have an 8 year old child with autism in my class who has neither urinated or defecated in the toilet before. He is an energetic, non verbal child who has an understanding of when we is doing a wee or poo and so, this made me eager to help him get him out of nappies as soon as possible. To start with, I made him the following visual schedule, which I made using free symbols from the website Visual Aids for Learning (see my post on free symbol resource websites here).

toilet visual schedule

When we regularly take him to the toilet, we refer him to the visual schedule, so he must look at the symbol and then follow through that action. To begin with, this was with a physical prompt from the supporting adult. The physical prompts were then gradually reduced to verbal and gestural prompts as the child began doing more himself. We are 4 weeks in and he is doing these steps with mostly no physical prompts and just a simple verbal or gestural prompt for each step. We have been taking him to the toilet at very regular (every 45 minutes) intervals throughout the day (on his visual timetable) and he has access at all times to a toilet symbol to request to use the toilet. This same routine is happening at home and he has the exact same visual schedule which is being used at home. Good communication and consistency between home and school is very important for toilet training.

This is all very positive, however the child is yet to wee or a poo in the toilet. In fact, he is holding it in all day and over the last 4 weeks he has urinated in his pants only about 3 times. This is most likely because he has been so used to doing a wee and poo in his nappy and now that the nappy has gone, he is holding it in. My next plan of action is to show him some more visuals of using the toilet and hopefully catching a wee in the toilet soon. An update will shortly follow!!

1 month on update:

It has been 1 month since I wrote this post and 2 months since we started toilet training and I am happy to say that the child is now urinating in the toilet and also requesting to use the toilet through symbol or sign! Yay!

The consistency of undergoing the same process of using the visual symbols and waiting for the child to do each step as well as modelling key signs and language have been a great help. He has yet to poo in the toilet but we will keep working on this.

How has your experience of toilet training been? Please post a comment!

How to structure a lesson or activity for pupils with autism

Structuring a lesson or activity by breaking it down into small parts with visual prompts can make the lesson/ activity manageable for autistic children because it enables the pupils to know what they will be doing now, next and when the activity is coming to an end. Here is an example of visual symbols used in a physical education lesson.

visual symbols for p.e.

At the beginning of the lesson, I would say “what’s first?” and take the first symbol to show all the children individually so they can say, sign, read or point to the symbol. In this case it is ‘warm up’ so we would then do the warm up. When the warm up is finishing, I would count down from 5 and say “warm up has finished”. In a P.E. lesson I usually ask the children to “sit on the bench” before referring them to the visual symbols and removing the warm up symbol whilst again saying “warm up has finished”. I would then say “whats next?” and again individually show the children the next symbol. This process is repeated for each small activity of the lesson. This gives a clear structure and routine to the lesson which the children learn and can feel comfortable with. When it is time for ‘cool down’, the children can clearly see the lesson is coming to an end as there is only 1 symbol left.

Here is a similar example of how I’ve structured a music lesson using a similar routine. I have used the SCERTS model (green and red board- green for what is coming up and red for finished).

visual symbols for music lesson

 

There is a similar pattern with how I’ve structured this lesson. The lesson is broken down into smaller activities and each has a visual symbol to show the children what is next. When an activity has finished, I move it to the red finished area and say “what’s next?” before showing all of the children individually the next activity for them to say, sign, read or point to.

Don’t forget this structure can benefit all children and can make mainstream activities more inclusive by enabling the children that can understand symbols to know what is happening next and how many activities to go before the session is finishing. This type of structure could also be used with photos for children who understand photos but perhaps not symbols, objects of reference for children at that level and words for more able children who are confident at reading.

Also, do remember that a symbol programme like the one I have used to make symbols is also not necessary. Symbols like these can be replaced by pictures simply found on the internet, photos you have taken or by simply drawing a picture!