Toilet Training Tips for Children with ASD, ADHD, and Neurodivergent Needs
Shauni Snow COTA-L
What does it mean to be neurodivergent:
According to the pediatric summit on pelvic floor health the term Neurodivergent
acknowledges the adversity of the human mind, the infinite variation in neurocognitive
functioning within our species (Dwyer 2022). According to the DSM-5 Autism, ADHD and
intellectual disabilities are a few diagnoses that fall under the neurodivergent umbrella.
Successful toilet training requires patience, understanding, and flexibility
regardless of diagnosis. Here are some tailored strategies to support your
child through this important milestone:
1. Create a Routine:
• Consistency is Key: Establish a regular schedule for toilet breaks, such as after
meals, naps, and before bed.
• Visual Schedules: Use visual schedules or charts to outline the steps of using the
toilet. Pictures and symbols can be very effective.
2. Use Visual and Sensory Supports:
• Visual Aids: Provide clear, step-by-step visual instructions on how to use the toilet.
• Sensory Considerations: Be mindful of sensory sensitivities. Choose a toilet seat
that is comfortable, and consider using sensory-friendly wipes or toilet paper.
3. Make It Fun and Engaging:
• Incentives and Rewards: Use a reward system that motivates your child, such as
sticker charts or small treats.
• Games and Books: Incorporate toilet-themed games or books to make the process
more engaging.
4. Gradual Introduction:
• Familiarization: Start by introducing the toilet in a non-threatening way. Let your
child explore the bathroom and sit on the toilet with clothes on before expecting
them to use it properly. Here are some fun ideas:
o Make potions in the toilet with blumbing friendly ingredients including food
coloring, glitter, or Cheerios. Use your imagination and make toilet time
playful and fun *
• Small Steps: Break down the process into manageable steps, such as sitting on the
toilet for a few minutes, even if they don’t go.
5. Communicate Clearly:
• Simple Instructions: Use clear, concise language and consistent phrases when
talking about toilet use.
• Social Stories: Create or find social stories that explain toilet training in a relatable
way.
6. Adapt the Environment:
• Accessibility: Ensure proper toileting positioning to improve your child’s ability to
relax their pelvic floor. Consider using a step stool or potty seat if needed.
• Comfort: Ensure the bathroom is a comfortable space. Minimize loud noises or
bright lights that might be distracting or upsetting.
7. Address Accidents Calmly:
• Positive Reinforcement: Encourage your child even when accidents occur. Avoid
punishment or negative reactions, or power struggles. Remember your child is in
control of their body not you. Allow them their autonomy.
• Problem-Solving: Discuss any issues calmly and look for creative solutions. For
example, if your child is afraid of the flushing sound, you might need to find ways to
make it less startling. Keep it playful and fun.
8. Collaborate with Professionals:
• Consultation: Work with your child’s occupational therapist or other specialists to
tailor the approach to their specific needs.
• Family Involvement: Engage all caregivers in the training process to ensure
consistency and support.
• Modeling: Children learn well by observing others. Consider allowing your child to
watch peers or parents using the toilet.
9. Be Patient and Flexible:
• Adapt as Needed: Recognize that each child is unique. Be prepared to adjust your
strategies based on your child's responses and needs.
• Celebrate Successes: Celebrate small milestones and successes to build
confidence and motivation.
10. Foster Independence:
• Encourage Self-Care: As your child becomes more comfortable, encourage them
to take more responsibility for the process.
• Skill Building: Gradually introduce skills such as wiping and hand washing, using
positive reinforcement to encourage these steps.
Remember, every child is different, and progress may vary. With patience, empathy, and
these tailored strategies, you can support your child in achieving successful toilet training.
For further assistance, consult with our occupational therapists who are ready to help you
through this process.
*make sure you teach your child what is appropriate to flush down the toilet and what is
not.
Dwyer P. The Neurodiversity Approach(es): What Are They and What Do They Mean for
Researchers? Hum Dev. 2022 May;66(2):73-92. doi: 10.1159/000523723. Epub 2022 Feb
22. PMID: 36158596; PMCID: PMC9261839.
Biofeedback Training & incontinence solutions Tiffany Ellsworth Lee and Jane Kaufman
2023