Toileting
Not a very polite topic, but more and more teens and adults with autism as well as families of individuals with autism have begun sharing concerns and thoughts about toileting issues.
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For example, one family is excited about finally helping their pre-teen son graduate from diapers to the toilet. The problem is that toilet paper doesn’t work for him, so his clothing is occasionally soiled and smelly. They have solved the problem by teaching him to use pre-moistened hand wipes to clean his bottom after a bowel movement. They have finally found inexpensive, flushable, bio-degradable, anti-bacterial wipes, so they keep a supply at home, at school, and in the car.
The families, teachers, and therapists of a number of individuals with autism, ranging from elementary-aged kids to adults, have expressed frustration and concern about their failure to toilet-train their friends with autism. This is a huge issue because it has such significant logistical implications.
The reasons behind resisting toilet-training vary greatly. Some people cannot communicate their need to use the restroom, so they have occasional accidents. Some are not motivated to move beyond the usual method of having a bowel movement in a diaper. Some individuals do not seem to notice or care if they have a toileting accident. Some people with autism strongly resist changes in routine, even if sticking with a routine results in soiled pants. Some people are being purposefully defiant, or they thrive on the attention and reaction of adults around them when they have an accident. And some people with autism with extreme auditory sensitivities avoid toilets and bathrooms at all costs because of the sudden loud noises. Even if none of the scenarios seem logical to us, we need to realize that individuals with autism do not always view the world in the same way as their more typical peers.
An articulate adult with autism shared these thoughts after being assured I would protect their identity. My friend wrote, “I know this sounds very bizarre, but the thought of sitting on a toilet is horrifying to me. I guess it is similar to a young child imagining monsters under the bed. To me, a toilet is like a loud, gurgling, bottomless pit. I feel as if I will be sucked down into oblivion if I sit on a toilet. As strange as this seems, it is easier for me to wear adult diapers, changing them as soon as I can after a bowel movement, than to tolerate sitting on a toilet.”
In order to be successful at toilet training, we need to consider all sides of the issue, then develop a strategy that (1) identifies and overcomes barriers to using a toilet, (2) avoids escalating the frustration on both sides, and (3) includes both patience and persistence.
We welcome your input – both successes and frustrations with toileting issues. Just click on the comments button or send an e-mail to talk@FAQautism.com.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me an email with your thoughts or challenging situations or innovative solution. Send email to talk@FAQautism.com And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
