Gast, D. L., Lloyd, B. P., & Ledford, J. R. (2018). Multiple baseline and multiple probe designs. In J. R. Ledford & D. L. Gast (Eds.), Single case research methodology: Applications in special education and behavioral sciences (3rd ed., p. 270). London: Routledge. MacDuff, G. S., Krantz, P. J., & McClannahan, L. E. (1993). Teaching children with autism to use photographic activity schedules: Maintenance and generalization of complex response chains. Journal of Applied Behavior Analysis, 26, 89–97. https://doi.org/10.1901/jaba.1993.26-89. Personally I try to do my PECs cards in bulk one evening so I can sit cutting them out in front of the telly, it always takes longer than I think it will. Velcro for PECs cards Schum, T. R., Kolb, T. M., McAuliffe, T. L., Simms, M. D., Underhill, R. L., & Lewis, M. (2002). Sequential acquisition of toilet-training skills: A descriptive study of gender and age differences in normal children. Pediatrics, 109(3), e48–e48. The child should be given the basic needs communication board and taught how to use it, by showing them all the different symbols and when they should use them. The child will be able to use the board to communicate:

Can the child pull down his/her pants and underwear and pull up pants and underwear with little to no assistance?

Video modelling

The steps to toilet training are much the same for all children. But autistic children might need extra support and strategies adjusted to suit their needs. Once your child is toilet trained at home,you will want to teach them to use toilets when out. When visiting new places, show your child where the toilets are and use the same routine as you do at home. Use the same picture and toy or book they may have for toileting at home. Go over the schedule with your child 2-3 times a day. Everyone who does toileting with your child will need to know and follow the schedule. This way, training will be consistent.

distributing them throughout particular environments,egobjects and areas in the classroom and at home could be labelled These findings provide preliminary support for consistently pairing trips to the restroom with prompted communication for initiation. Participants did not initiate all trips to the restroom, but the percentage of self-initiated restroom trips may have been appropriate for this age of students since students in early elementary years are often taken to the restroom regularly throughout the day as a preventative measure. Additionally, these findings suggest that ITT programs are effective in the classroom setting as long as enough staff are available to support the student. School systems may consider providing short term classroom support (e.g., 1–2 weeks) for the initial days of toilet training before a reasonable sit interval is attained (e.g., 60 min between trips to the restroom). Finally, teachers may be more likely to approach toilet training with students still in diapers, but they should consider removing diapers before toilet training or as part of the intervention (Greer et al. 2016). As noted by the final participant, James, diaper removal was sufficient for increasing continence and on-toilet voids. Future Research During the Planning Phase, it is essential to gather all the essentials materials needed for a positive experience. Below is a list of the top 10 items needed before beginning the toilet training process. Wheeler, M. (2007). Toilet training for individuals with autism or other developmental issues: A comprehensive guide for parents & teachers. Arlington: Future Horizons. Singh, B. K., Masey, H., & Morton, R. (2006). Levels of continence in children with cerebral palsy. Pediatric Nursing, 18(4), 23.Watson, P. J., & Workman, E. A. (1981). The nonconcurrent multiple baseline across-individuals design: An extension of the traditional multiple baseline design. Journal of Behavior Therapy and Experimental Psychiatry, 12, 257–259. https://doi.org/10.1016/0005-7916(81)90055-0. Whether children with autism are verbal or non-verbal, it is important to teach them how to communicate when they need to use the restroom.Before the child enters the bathroom, prompt him/her to communicate that he/she needs to use the bathroom. There are many verbal and non-verbal ways to prompt children with autism to communicate that they need to use the toilet. Make going to the toilet part of your everyday routine. For example, ask your child to sit on the toilet at the same times each day. Foxx, R. M., & Azrin, N. H. (1973). Dry pants: A rapid method of toilet training children. Behaviour Research and Therapy, 11(4), 435–442. https://doi.org/10.1016/0005-7967(73)90102-2. Encourage the child to stay dry and tell him/her that the pee and poop go the toilet. Use simple positive language like, “Good staying dry,” and “Pee in potty, poop in potty.” Show the child the items in the reinforcement bin and explain that he/she gets those items when the pee and poop in the toilet.

Autistic children generally show the same signs of readiness for toilet training as typically developing children. But these signs might appear when autistic children are older, and the training might take longer. Sometimes autistic children who are toilet training can behave in challenging ways. For example, they might be afraid of the toilet, go in places other than the toilet, fill the toilet with paper and other materials, continually flush the toilet, smear poo on the wall and other places, or refuse to poo. American Academy of Pediatrics. (1999). Toilet training guidelines: Day care providers—The role of the daycare provider in toilet training. Pediatrics, 103(Supplement 3), 1367–1368.Ivy, a female kindergarten student, was 6.2 years of age at the start of the study. She had an educational eligibility of ASD. Ivy’s VB-MAPP scores were 60.5 out of 170 on the Milestones assessment, 41 out of 96 on the Barriers assessment, 29 on the Transitions assessment, and 72 on the EESA. Academic goals for Ivy included expressive identification of letters, numbers, letter sounds, common objects, shapes answering personal questions, rote counting‚ and counting using 1:1 correspondence. Prior to the study, Ivy communicated using two-to-three-word phrases and was taught to initiate bathroom trips by saying “potty” and/or exchanging a picture of a toilet with model prompts. Dan They do not like the feeling of a wet or soiled diaper or pull-up and will show it by taking off the wet or soiled diaper/pull-up, and they vocalize displeasure in being wet of soiled and want to be changed. Pre-baseline represented the classroom procedures prior to the onset of the study. These data were collected daily to communicate with families and provide a routine around using the restroom. During this time, all participants wore diapers (sent by their caregivers) under their clothing throughout the school day. Researchers took students to the restroom every 60–90 min. Researchers gave students the opportunity to sit on the toilet if they initiated but did not require them to sit. If the participant had soiled their diaper, the researcher used graduated guidance (MacDuff et al. 1993) to prompt the participant to complete the steps to remove soiled clothing and replace with clean clothing. If the participant voided on the toilet the researcher simply said, “Good job going potty” and returned to the classroom activities. Preference Assessment