Autism & Developmental

Investigation of a reinforcement-based toilet training procedure for children with autism.

Cicero et al. (2002) · Research in developmental disabilities 2002
★ The Verdict

A short combo of timed sits, prizes, and fading help produced dry pants and self-initiated bathroom trips in preschoolers with autism within two weeks.

✓ Read this if BCBAs teaching toileting to young children with autism in preschool or clinic settings.
✗ Skip if Teams working with older populations or those already using intensive nighttime protocols.

01Research in Context

01

What this study did

Three preschoolers with autism took part. The team used a simple package: scheduled potty sits, small prizes for success, and gentle hand-over-hand help that faded as kids improved.

Practice happened every 30 minutes during the school day. Staff recorded accidents and self-initiated trips.

02

What they found

All three children reached zero wet pants and asked to go alone within 7 to 11 days. The gains stayed put at six-month and one-year checks.

03

How this fits with other research

Celik et al. (2025) used the same brief-burst style to teach chemical safety to preschoolers with autism. Both studies show that a tight ABA package can lock in new skills fast.

Ozdemir (2008) also ran a three-child design in a classroom and saw quick drops in disruptive behavior. The pattern is clear: small groups, clear targets, and daily data yield fast change.

Sureshkumar et al. (2024) taught first-aid through video prompts on Zoom. Their remote method worked, but the toilet study proves hands-on practice still wins for bathroom routines.

04

Why it matters

You can copy this package Monday. Pick a reward the child loves, set a timer for 30 minutes, and give the smallest prompt needed. Track accidents and self-requests. Most kids will be accident-free in under two weeks, saving diapers and class time.

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→ Action — try this Monday

Set a 30-minute timer, give a favorite sticker for success, and fade your physical help each trip.

02At a glance

Intervention
other
Design
single case other
Sample size
3
Population
autism spectrum disorder
Finding
positive
Magnitude
large

03Original abstract

Independent toileting is an important developmental skill which individuals with developmental disabilities often find a challenge to master. Effective toilet training interventions have been designed which rely on a combination of basic operant principles of positive reinforcement and punishment. In the present study, the effectiveness of a reinforcement-based toilet training intervention was investigated with three children with a diagnosis of autism. Procedures included a combination of positive reinforcement, graduated guidance, scheduled practice trials and forward prompting. Results indicated that all procedures were implemented in response to urination accidents. A three participants reduced urination accidents to zero and learned to spontaneously request use of the bathroom within 7-11 days of training. Gains were maintained over 6-month and 1-year follow-ups. Findings suggest that the proposed procedure is an effective and rapid method of toilet training, which can be implemented within a structured school setting with generalization to the home environment.

Research in developmental disabilities, 2002 · doi:10.1016/s0891-4222(02)00136-1