Potty Training Troubles in Kids with Autism

Potty training can be tough on any parent and child. But when the child has autism, this rite of passage can be even more challenging. The sensory and obsessive compulsive issues that often accompany autism make it hard for some children to just sit on a toilet, let alone learn to use the bathroom on their own, says Kent Williams, MD, a pediatric gastroenterologist and autism expert at Nationwide Children’s Hospital.

So what’s a caregiver to do?

The best tactic, Dr. Williams says, is to start simply. Parents can try potty training with their child using standard potty training techniques as early as age 2. But even older children who use diapers or have help going to the bathroom can still learn to use the toilet by themselves. The key, he says, is to not give up. Some kids with autism do not learn to go to the bathroom independently until well into their school-aged years. If toilet training works, great! If not, don’t be discouraged.

When attempts to potty train fail, it might have nothing to do with the techniques you’re using. Constipation and other gastrointestinal problems are common in children with autism, Dr. Williams says. These problems may make toilet training practically impossible.

“If you’re finding problems or having difficulty, it’s worthwhile to make sure there isn’t something else going on,” he says. For instance, most people think that the only sign of constipation is not going often. But if your child seems to go frequently but is pushing or straining during a bowel movement or having very hard stools, Dr. Williams says, he or she could still be constipated.

Finding out if your child’s struggles with toilet training are related to gastrointestinal issues or just the usual training troubles can be a challenge for parents, says Dr. Williams. “Things I ask parents to look for are an increase in certain autistic behaviors, increased energy output, increased inability to concentrate or sit still, difficulty sleeping at night—that kind of thing,” he says. “Get them screened fairly early on for bowel problems if toilet training is difficult. They may need to be medically evaluated.” Sometimes, after things like constipation are taken care of, caregivers have very little difficulty potty training.

If you are having trouble potty training your child or you suspect that he or she may have gastrointestinal problems, ask your pediatrician for help or consider asking for a referral to Nationwide Children’s Hospital. With patience and proper treatment, toilet training your child doesn’t have to be a battle.