Toilet training tips

This page on toilet training tips is divided into three steps. Step 1 gives you some general advice on preparing to begin toilet training. Step 2 talks you through some things to remember when you start toilet training. Step 3 looks at some of the common difficulties parents have when toilet training.

Step 1: Preparation

Consider a good time to start toileting​

  • For children​, make sure there is no big change coming up, like starting pre-school or primary school​.
  • For parents, allow enough time for the toilet-training. It may be helpful to begin over annual leave or holidays.

Start documenting your child’s urination/ bowel habits​

  • Keep a toileting diary/chart​.
  • Keep note of when your child has done a pee/poo in their nappy.

Start introducing the potty/ toilet to your child using:​

See here for examples of a social script, visual schedule, visual aid, and social story from the ERIC website (Children's Bowel and Bladder Charity)

Involve your child, so they can:

  • Pick out their new underwear​
  • Choose a potty with their favourite colour​
  • Add fun stickers to their potty
  • Use a social story involving the child​
  • Include your child’s interests/ what they are motivated by. 

Get yourself set up well ​

  • Your child’s clothes​: an elasticated waist/ loose fitting trousers which are easy to pull up/down​
  • Equipment​: Potty seat​, toilet insert​, toilet step ​
  • Location​: The potty is ideally kept in the bathroom, as children learn by association​ (bathroom = wee/poo)​. Place items needed within reach​.
  • Keep the visuals near the child. See these examples below from the NHS Greater Glasgow and Clyde website.

 

Step 2: Starting the process

Take off the nappy and use underwear

Avoid pull-ups, if possible​. It may be helpful to have incontinence sheets in bed/ car seat.​

Create a typical daily routine to take your child to the bathroom

Look at the toileting diary/ chart you created. Usual times would be: ​

  • when waking up​
  • before and after naptime​
  • before and after a new activity​
  • after a meal​
  • before leaving the house​
  • before bedtime.

Ensure a calm environment

The key is to relax not distract the child. Consider the following:​ 

  • Singing potty songs (for example, sitting on the potty)​
  • Toileting books​
  • Visuals​ (see example below)
  • Rewards Chart ​
  • Blow Bubbles/ Tap on in the background​
  • Toilet toys​ (keep all toilet toys in the bathroom so child can develop an association between them and going to the toilet).​

  Autism Little Learners

Source: Autism Little Learners (Home - Autism Little Learners), from their Free Toileting Sequence

 

Toileting needs to be a positive experience:

Praise and rewards are helpful. Think of what would work best with your child.

  • If using a Star chart​, introduce it when you have a routine established.
  • Make sure the reward caters for child (for example, entering the bathroom may be enough for a star)​. You may need to try a variety of rewards to find the one your child best responds to. Keep rewards specific to the task and to the child. Rewards should be given immediately with positive specific feedback​.

An example of a reward chart

Toileting reward chart

Accidents happen:

  • Keep a calm tone in your voice, for example, ‘let’s try again’​. Keep language minimal​.
  • Clean the child in the bathroom with minimum of fuss. ​It is useful to have an ‘accident pack’ containing new underwear, wipes, rubbish bag, to hand. ​
  • Get the child to help mam or dad to bring soiled/ wet clothes to the washing machine.

 

 

 Step 3: Common difficulties your child may have when toilet training

Common difficulties 

   What can help
Difficulty with understanding the steps of toileting ​
  • Simplify your language, for example, say: ‘Time for potty’ v’s ‘Do you need to use the potty now?’​
Difficulty with verbally letting you know when they need to go
  • Pay attention to your child’s gestures or body language (for example, rubbing their tummy, becoming upset, leading you to the toilet, rubbing their bum).​
  • Model language if you see a gesture (for example, pulling at their underwear, say ‘time to go potty’)​.
Difficulty with reaching back to wipe after doing a poo
  • Bottom wiping: See this NHS information sheet for examples of bum wiping games and activities 
  • Use the long mirror in bathroom to self-check​.
  • Backward chaining​
    • The adult starts the task and the child finishes off the very last part. To teach the child to wipe their bottom after using the toilet, the adult would do most of the wiping and the child would complete the last, “check it’s clean” wipe themselves.
    • Gradually encourage the child to start earlier and do more of the task as they get better at it.
Difficulty with hand dexterity and hand strength to flush the toilet and/or manage their clothes (pull back up their underwear and pants)
  • Use hand-over-hand assistance and slowly move to verbal prompting over time.
    • Hand-over-hand assistance is where the adult places his or her hand on the child’s hand to guide them in completing a task. It is often used for teaching children how to acquire a skill, such as self-care skills, like holding a toothbrush or, in this case, toileting. The goal of hand-over-hand assistance is to fade it out as the child develops a better grasp on the skill. 
Unable to coordinate both hands to manage clothing and hand wash.
  • Use hand-over-hand assistance and slowly move to verbal prompting over time.
Doesn’t like the noise of the flush
  • Don’t force the child to stay in the room when flushing​.
  • Shut the lid to reduce the noise of the flush.​
  • Let them stand just outside the door while you flush and gradually get them to stand closer until they can do the flush. ​
  • Show the workings of the toilet so they can understand what is making the noise​.
  • Use ear plugs/ ear defenders to block the noise of the flushing. This would be helpful in public. ​

Likes the noise of the flush too much

  • Physically cover toilet handle to remove it from sight.
  • Give them something else to hold and manipulate. ​
  • Use a visual sequence to show when to flush (after replacing clothing, for example).
  • When it’s time to flush, give your child a sticker that matches to a sticker on the toilet handle​, as a visual prompt that they are now allowed to flush the toilet.
  • Most toilets have an easy to turn valve under the toilet tank which can be used to turn off water supply in extreme situations.

Doesn’t like the sensation of the toilet paper

  • Try alternatives for example, a wet sponge, wet wipes then toilet paper to dry.​

Doesn’t like the strong smells in the bathroom 

Doesn’t like the sensation of poo

  • Use rubber gloves for wiping​.
  • Consider messy play activities – sand; water; finger painting etc.​
  • Social stories/ videos about how poo is made​. This promotes an understanding of the body
    • Labelling/modelling intereoceptive awareness, for example, what is ‘hot/ cold’; feeling thirsty; or Mummy has a scratchy throat, it’s hard to talk. In the case of toileting that might be:
      • For the child: if they are pulling at their underwear: ‘does ​poo need to go into the toilet?”’
      • For the parent​: ‘When mummy needs to use the toilet, her tummy feels tight, mummy needs to push”’.
  • External strategies​, such as:
    • Alarms​
    • Routines (e.g. we sit on toilet first, then football).

May be going to the toilet in inappropriate spaces ​

  • A social story about where we go to the toilet​.

Becoming very distressed and anxious when needing to toilet​ (toileting anxiety)

  • Use of a visual schedule: routine and predictability can help reduce anxiety​.
  • Consider the sensory environment, removing unpleasant items for your child.​
  • Use of rewards.

Not going to the toilet in school/ public spaces​ (holding)

NHS Seating position

Source: NHS

Wanting the sensation of wee or poo in their nappy or pants as it gives increased tactile experience

  • Look at options to increase their tactile (touch) sensory input in other ways, for example wearing tightly fitting clothing or fiddle toys.

Wanting the sensation of wearing a nappy (as it may be providing deep pressure).

  • Allow the child to wear tight fitting pants, leggings or shorts.
  • Provide deep pressure in other ways, for example, weighted lap-pads or blankets, massage or tight clothing
  • Gradually reduce the tightness of the nappy as the child gets more confident.

 

Further information