Changing Diapers

This discussion about the words we use when talking to our children with autism came to mind when a mom said to her 6-year-old daughter, “Let’s go change your diaper” as the youngster and her classmates were gathering for a field trip.

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I’ve known mom for many years, and realize she would never purposefully say anything to embarrass her daughter. And, in reality, this 6-year-old was probably not embarrassed by her mom’s mention in a public forum of her wearing diapers. The youngster is very bright, and has excellent expressive and receptive language, but she does not spontaneously interact with her classmates, and she does not seem to be particularly aware of the conversations or opinions of other people.

In spite of diligent, systematic efforts by parents, teachers, and behavior specialists, this 6-year-old is not yet toilet trained, so diapers are required at this point. The family has always used the phrase “Let’s go change your diaper” since she was a toddler. But the time is probably long past to change to a more age-appropriate phrase.

In a private conversation, Mom and I brainstormed about some alternative phrases. Our criteria were:
(1) To use more age-appropriate, discrete words.
(2) To clearly communicate that the youngster needed to go into the bathroom, take care of toileting, and change her diaper.
(3) To introduce a phrase that would be appropriate for teens and adults should the youngster resist toilet training for a number of years.

This family now says, “Hannah, let’s go freshen up.” Specifically stating her name captures her attention. “Let’s go” translates to “walk with me now.” Saying “freshen up” indicates they will go into the bathroom without mentioning in what ways she will freshen up. Some kids need more specific directions, so some families use phrases like, “Robert, walk with me now,” or “Samuel, please come with me now.”

TIP FOR THE DAY: The idea is to avoid the words diaper, bathroom, toilet, and other task-specific words. This is done not out of modesty, but out of respect for your friend with autism as well as the people around them. The ultimate goal is to help each youngster become independent in this area, but, meanwhile, we need to avoid words and phrases that bring attention to their need to wear a diaper.

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NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism.

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