Toileting

Toileting (an issue with toileting may be related to maturity, proprioceptive, tactile and gross motor difficulties, below are some general strategies)

  • Be aware of bathroom lighting levels and reduce any loud noises
  • Some teenagers may benefit from a definite time limit to the task e.g. wash hands for 1 minute. Others may find this heightens anxiety.
  • Provide a visual or symbol so they can indicate they need bathroom
  • If they are unaware of when they need to ask for the bathroom, think about habit training (having set times for bathroom visits)
  • Provide options for cleaning e.g. moist toilet wipes and toilet tissue or paper towels, fabric towels, anti-bacterial gel and blow dryers for hand hygiene.
  • Use their preference for routine to your advantage
    • Teach the whole routine from communicating need to go to washing hands afterwards
  • Keep sequence the same each time
  • Use visual cues to support the routine (e.g. Check schedule- enter bathroom-undress-sit on toilet- wipe-flush-dress- wash and dry hands – return to class)
  • Reward appropriate toilet behaviour
  • Visual schedules should be in the bathroom / dressing area
  • Social Stories that teach students about how to behave in certain situations, can be effective to teach variety of skills, including toileting and personal care. Useful books include:
    • Taking Care of Myself: A Hygiene, Puberty and Personal Curriculum for Young People with Autism, by Mary Wrobel, 2003, Future Horizons Incorporated, Arlington, USA.
    • Hygiene and Related Behaviors for Children and Adolescents with Autism Spectrum and Related Disorders, by Kelly Mahler, 2009, Autism Asperger Publishing, USA.

Useful videos:

To reduce accidents the following strategies are recommended

  • Having set times for bathroom visits may be helpful
  • Provide an alarm/ visual reminder of times for bathroom visits.
  • Use preference for routine to your advantage
    • Teach the whole routine from communicating need to go to washing hands afterwards
  • Keep sequence the same each time
  • Use visual cues to support the routine (e.g. Check schedule- enter bathroom-undress-sit on toilet- wipe-flush-dress- wash and dry hands – return to class/downstairs etc.)
  • Reward appropriate toilet behaviour
  • Visual reminders of appropriate toilet behaviour should be in the bathroom
  • Social Stories that teach children about how to behave in certain situations, can be effective to teach toileting and personal care skills:
    • Taking Care of Myself: A Hygiene, Puberty and Personal Curriculum for Young People with Autism, by Mary Wrobel, 2003, Future Horizons Incorporated, Arlington, USA.
    • Hygiene and Related Behaviors for Children and Adolescents with Autism Spectrum and Related Disorders, by Kelly Mahler, 2009, Autism Asperger Publishing, USA.
Example of social story for toileting:
  • Sometimes I need to pee
  • Sometimes I need to poo
  • Mum might ask me if I need to pee or poo
  • When I need to pee or poo I go to the bathroom.
  • I close the door.
  • I can use my timetable and pictures to help me
  • I will pull down my pants and sit on the toilet
  • I can pee in the toilet
  • I can poo in the toilet
  • When I am finished I will wipe my bottom and wash my hands

 

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