Potty Training Protocol

Having trouble with or feeling timid about transitioning your kiddo with autism from diapers to the toilet? Fret not! Follow the protocol below – it’s the approach that we’ve used to successfully toilet train our patients. Remember: be patient, be consistent and be your kiddo’s biggest cheerleader as he/she learns to use the washroom like a big boy or big girl. This is a modified potty protocol based on the Foxx Azrin method. The protocol can be modified still to make sure that each child gets a personalized potty protocol.

Set up:

Place salty food (pretzels, popcorn, etc.) in the bathroom. Make sure that it doesn’t go bad when left in the bathroom.
Place preferred drinks in the bathroom, making sure that they don’t go bad in there either.
Place strong reinforcers to reward successful urination in the bathroom if appropriate.
Prepare activities for the child to engage in while on the toilet. Some examples include watching an iPad, reading books, and presenting preferred educational programs.
Place a potty seat insert into the toilet (if needed).
Prepare a TV tray (for activities that require a table).
Purchase underwear for the child.
Decide what the reinforcer for successful urination will be and withhold that reinforcer for at least 3 days prior to initiating toilet training. For example, candy can be used as a reinforce, but the child needs to associate that candy with successful urination.

Day 1:

When the child wakes up, immediately have them wear their underwear.
Begin to give the child liquids.
Prompt the child to request for potty by repeating after you “I need potty” with the potty card or their individualized communication system.
Take the child to the toilet and continue giving them liquids.
Keep the child entertained with preferred activities.
Keep the child on the toilet for at least 15 to 20 minutes.
If the child urinates on the toilet before the 15 to 20 minutes are over, then provide enthusiastic verbal praise and provide their reinforcer immediately. If they do not go potty, then give them a break and let them get up from the toilet.
Whether the child has urinated in the toilet or not, let the child get up from the potty for 15 to 20 minutes. When the 15 to 20 minutes are up, have the child request for the potty and take them back to the toilet.
Require the child to remain on the toilet until they urinate or have been sitting for 15 to 20 minutes.
Continue the 15 to 20 minutes on and 15 to 20 minutes off the potty for the rest of the day.
Increase the time off the potty by around 5 to 10 minutes after 3 successful voids in the toilet without accidents.

Following 3 successful toilet experiences:

Begin gradually decreasing fluids and increase the time period in which the child is not on the toilet. Generally, this increase should be from 3 to 5 minutes each time the child successfully urinates on the toilet.
Begin gradually decreasing fluids and increase the time period in which the child is not on the toilet. Generally, this increase should be from 3 to 5 minutes each time the child successfully urinates on the toilet.

Day 2:

The child should be on a 30-to-45-minute toileting schedule by the end of day one.
When the child wakes up, immediately have them put on their underwear.
Continue snacks and liquids.
Sit the child on the toilet. If the child urinates on the toilet before the 15 to 20 minutes are up, provide enthusiastic verbal praise and provide their reinforcer immediately. If they do not go potty, give them a break off the toilet.
They should be off the potty for 30 to 45 minutes, depending on day one’s results.
After 3 successful voids in the potty, continue increasing time off the potty by 3 to 5 minutes.
By the end of day one, the child should start urinating in less than 5 minutes and should be off the potty for at least 45 minutes to 1 hour.

Day 3+:

Continue protocol above while decreasing liquid intake and increasing time off the potty. Consistency is key here.