Reduction of classroom noise levels using group contingencies.
Teach caregivers the 24-step toilet-training package—three of four preschoolers with ASD/DD achieved daytime continence in weeks.
01Research in Context
What this study did
Four preschoolers with autism or developmental delay were still in diapers.
Researchers taught each caregiver a 24-step toilet-training plan.
Parents followed the steps at home while the team tracked accidents and successes.
What they found
Three of the four children were fully dry during the day within weeks.
Parents kept the gains after the coaches stepped back.
How this fits with other research
Osos et al. (2025) later trimmed the same idea to five steps and still saw success.
Their package drops punishment and adds a quick fix if a child stalls.
Perez et al. (2021) showed that once urine training works, bowel accidents and problem behavior often fall too.
Donnelly et al. (2024) pulled these studies together and gave a menu of fixes for common roadblocks.
Why it matters
You can hand families a clear, step-by-step toilet plan and expect most preschoolers with ASD or DD to reach daytime dryness fast.
If a child stalls, switch to the shorter five-step version or add a contingent sit schedule instead of starting over.
Track bowel movements and self-initiations at the same time; gains there may come for free.
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02At a glance
03Original abstract
Toileting skills are a milestone typically achieved by the age of four. For many caregivers, particularly those who have children diagnosed with autism spectrum disorder or other developmental disabilities, teaching toileting is a challenge resulting in delayed implementation. Delaying toileting increases the risk of challenges to acquiring this skill. Caregivers are fundamental and research shows that their involvement supports the maintenance and sustainability of this skill. Four caregivers were taught a 24-step toilet training program to teach toileting. Behaviors measured included urination success, urine accident frequency, and child requests for the bathroom. All caregivers learned the 24-step procedure and the toilet training package was effective in teaching three of the four children daytime urine continence.
Journal of applied behavior analysis, 2014 · doi:10.1901/jaba.1978.11-203