1. Tips for Making Toilet Training Successful Mia Caccavale, B.S. University of Houston-Clear Lake

2. Objectives Making sure the child is ready Materials needed Setting the sit schedule What the routine looks like If accidents happen

3. How do I start? Make sure the child can ▫Sit for at least 3-5 min Other indicators the child is ready ▫Awareness that he/she has a dirty diaper ▫Self-help skills* Make sure there are no medical problems Gather all materials needed Choose a bathroom and put all materials needed there

4. Materials Needed

5. Materials Needed (con’t)

6. Communication You will want to determine a mode of communication for the child to tell you he/she needs to go to the bathroom ▫Speech ▫Picture Exchange Communication System (PECS) ▫Sign Language ▫Voice Output Device (VOD)

7. Sitting Schedule Time-based Initially very intensive Stick to the schedule LevelScheduleLevelSchedule 110 min on toilet, 5 min off toilet 75 min on, 1 hr off 210 min on, 10 min off85 min on, 1.5 hr off 35 min on, 15 min off95 min on, 2 hr off 45 min on, 25 min off105 min on, 2.5 hr off 55 min on, 35 min off115 min on, 3 hr off 65 min on, 45 min off125 min on, 4 hr off

8. Sitting Time/Rewards

9. Drinking Schedule Decrease liquids as you increase through the levels LevelScheduleFluid Intake 110 min on, 5 min offPrompt every 5 min 210 min on, 10 min offPrompt every 10 min 35 min on, 15 min offPrompt every 15 min 45 min on, 25 min offPrompt every 30 min

10. Routine 1.Prompt the child to communicate they need to use the restroom 2.Walk to the bathroom 3.Undress 4.Sit on toilet (according to schedule or until they go) 5.Void in the toilet Provide praise and reward 6.Wipe 7.Get dressed 8.Flush toilet 9.Wash hands

11. What If Accidents Happen?

12. Pay attention and check for wet underwear/pants or supplement with a urine alarm Catching him/her in mid-urination ▫Interrupt the child from continuing to pee ▫Take them immediately to the bathroom ▫Give the child about 1 min to finish urinating  Urinate in toilet  Does NOT urinate in toilet  Positive Practice Child has already had the accident ▫Use Positive Practice

13. Positive Practice Take the child to where the accident occurred Tell the child “no wet pants” Take the child to the restroom Have the child sit on the toilet Have the child stand up and dress Take the child back to where the accident occurred You will repeat this process 5 times Then, you will have the child change clothes and resume the previous activity

14. Self-help Skills Involved Undressing Dressing Wiping Self Washing Hands

15. Important Things to Remember Make sure the child can sit for at least 3-5 min Have all materials ready before starting Initially, provide liquids to help give the child opportunities to use the restroom Stick to the sit schedule to avoid accidents Practice going to the restroom in other settings Provide the highly preferred reward for voiding in the toilet Say “No wet pants” only during positive practice/or once time when sitting him/her on the toilet after an accident

16. References LeBlanc, L., Carr, J. E., Crossett, S. E., Bennett, C. M., & Detweiler, D. D. (2005). Intensive outpatient behavioral treatment of primary urinary incontinence of children with autism. Focus on Autism and Other Developmental Disabilities, 20, 98-105.

17. Thank You! Any Questions?