Riddhi*, 5, lives in a house with a detached bathroom without a commode. Her communication difficulties prevented her from indicating when she needed to pee so she’d do it in her pants wherever she was or when taken to the toilet by a parent. She also had constipation, pooping every four days or so.
Here’s how her sessions progressed:
Session 1: Understanding toileting
In which we advised that her parents to:
- Address the constipation with a stool softener a fibre- rich diet.
- Make a record of every time she was taken to the toilet or peed/ pooped elsewhere.
- Take her to the washroom and encourage her to sit at least with a fun activity to improve her tolerance for sitting on the commode.
- Use Social Stories to help Riddhi understand what to do.
Session 2: Materials and schedule for trip-training
Two weeks later, we used the record to recommend that Riddi be taken to the washroom every two hours, with a potty seat, visual cards of the washroom, chocolate and the words, “Riddhi, susu time!”.
Session 3: Trip-training plan
At the third session, we shared a two-week urination trip-training plan. A week later, Riddhi was sitting to pee and poop on her own in the washroom. At the follow-up two months later, her father reported that she was going to the washroom on her own and would sometimes say “susu ” or “toilet” (for pooping). The parents have no other concerns with toileting at the moment.
Strategies that worked
Riddhi’s successful two-month toilet training incorporated some simple but effective strategies:
- Inculcating the habit: Taking Riddhi to the washroom and making her sit for some time accustomed her to sit on the commode to pee and poop.
- Using Social Stories: Autistic children are often visual learners. As pictorial media, Social Stories and visual cards helped Riddhi understand that a washroom is where we sit down to pee and poop.
- Easing the constipation: Stool softener and a high-fibre diet helped Riddhi poop every day.
Modelling language: Consistently using specific words – “susu”, “toilet” – helped Riddhi associate them with the act.