Standardized to Individualized Behavior Analytic Toilet Training Package for Autistic Preschoolers
A five-step, punishment-free ABA toilet package works for most autistic preschoolers; add a contingent sit schedule or brief tweak if needed.
01Research in Context
What this study did
The team tested a five-step toilet-training package on five autistic preschoolers.
They used a preference assessment, request training, praise for staying dry, underwear, and a sit schedule that started short and grew longer.
No punishment, no extra fluids, no intensive 30-minute sits.
What they found
Three kids reached full daytime dryness with the standard plan.
Two kids needed a quick tweak: a brief sit right after an accident.
Four kids kept the skill after the schedule was faded.
How this fits with other research
Perez et al. (2020) used the same ideas but kept kids on 30-minute sits. Osos cut sit time and still saw success, so shorter sits can work.
Whitehouse et al. (2014) taught parents to run a 24-step plan at home and got similar wins. Osos shows clinic staff can get the same result with a leaner five-step list.
Perez et al. (2021) looked back at old data and found that once urine training worked, bowel accidents and problem behavior dropped too. Osos adds fresh proof that the urine package is a good first move.
Why it matters
You can start toilet training with a short, simple package: underwear, praise, and a sit schedule that grows. If accidents continue, add a quick contingent sit instead of jumping to longer, stricter plans. This keeps therapy fun and saves you time.
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02At a glance
03Original abstract
ABSTRACTAutistic children often have difficulties learning to transition out of diapers and controlling continence. Due to this, children on the spectrum may require a more systematic toilet training protocol than what parents may use with typically developing children. Most published toilet training procedures with this population include some form of punishment as a component of the treatment package, which may raise ethical concerns. Thus, the purpose of the present investigation was to examine the effects of a standardized behavior analytic toilet training package without a punishment that included the following components: 1) preference assessment, 2) request training, 3) differential reinforcement for staying dry, 4) underwear, and 5) progressive sit schedule on the successful urinations in the toilet by young children with autism. For students who did not meet mastery criteria with the standardized training package, we implemented a contingent progressive sit schedule followed by the individualized interventions when necessary. Three of the five participants successfully learned how to urinate in the toilet with the standardized toilet training package alone. One participant required a contingent progressive sit schedule phase, and one participant required an individualized intervention to reach mastery. Four of the five participants maintained responding when the package was faded out over a 4‐week period.
Behavioral Interventions, 2025 · doi:10.1002/bin.70006