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Toileting Part 2: Why Isn’t It Working?
Jun 15th, 2016

North Shore Pediatric BlogPlay Pals North Shore BlogMadison Pediatric Blog

So you’ve created a “bathroom routine.” You have a time schedule of timed sittings on the toilet. You have candy ready for that moment your child voids in the toilet…but that time still hasn’t come. It can be incredibly frustrating when you’ve created an intervention that isn’t producing successful results. Don’t lose hope! It may just take some adjusting of variables for your child to be successful in toilet training. Here are some tips for easy changes you can make to your routine:

  1. Adjust timing/duration of sit sessions – Adjusting frequency and duration of bathroom trips can have a big impact on success in the bathroom. Maybe the trips aren’t frequent enough, maybe the duration isn’t long enough, or maybe your child feels they are sitting too long and having shorter but more frequent trips would be a better option. This is sometimes a trial by error process that may need to be adjusted to find the right balance.
  2. Re-evaluate your reinforcers – It could be possible that the items you are providing aren’t reinforcing enough or at all in comparison with the effort your child is putting forth. Often times, children have a revolving list of items that may be motivating for them on a particular day. One option is to provide your child access to a variety of items beforehand, and then use whichever items they select as their sit toy or reinforcer. The key, as always, is to only have that reinforcer available for bathroom trips to avoid satiation and increase motivation.
  3. Re-evaluate what behaviors are being reinforced – It could also be possible, if your child has little to no success on the toilet, that they are not contacting reinforcement frequently enough for using the toilet to be motivating. Another option is to have one reinforcer for sitting on the toilet, such as an iPad they can use during the entire sit session. Then have a separate reinforcer, such as a small candy or cookie, available only when they void in the toilet. This way, your child is being reinforced both for exhibiting appropriate bathroom behavior and voiding in the toilet, so in case they do not void often they are still contacting reinforcement. This can help trips to the bathroom to remain motivating to the child.
  4. Video Modeling – YouTube is your friend! There are many bathroom-related animated or pretend play videos available to play just before or during your child’s trip to the bathroom. Since many children with Autism Spectrum Disorder learn better visually, actually seeing someone or something else carrying out the routine might make the whole process make sense. There are many videos available with well-known characters, such as Elmo and Dora. Including a video with an accompanying song can always make the process more fun too!

It may take a little adjusting and investigating, but remember – it’s possible and you can still do this!

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