Teaching an Adult with ASD Independent Toileting Skills
An 11-week intensive package (alarm, schedule, praise, edibles, staff BST) erased daytime accidents and created independent toileting in a young learners with autism.
01Research in Context
What this study did
A team worked with one young learners man with autism. He still wore pull-ups and had several wetting accidents each day.
over the study period staff ran an intensive toilet plan. They used a urine alarm, 30-minute bathroom trips, candy and praise for dry pants, and quick checks every few minutes. Staff also got hands-on training so they did every step the same way.
What they found
Accidents dropped to zero by week five. The young man began asking to use the bathroom on his own. Daytime pull-ups were gone before the program ended.
Nighttime training took longer, but wet nights also fell. Parents and staff no longer had to remind him to go.
How this fits with other research
Matson et al. (2013) showed that brief mentoring helps older adults with ID join club activities. McQuaid et al. (2024) now show that the same careful coaching can teach a basic life skill to a younger adult. Together they prove behavior plans work across age groups when staff follow a script.
Lin et al. (2011) warned that most programs are not ready for adults with ID who age early. The toilet study gives those programs a ready-made package they can copy.
Dembo et al. (2023) looked at babies with Down syndrome and mapped early delays. Their work reminds us to start plans early, while A et al. show it is never too late to add a missing skill.
Why it matters
Many BCBAs still see toileting as a child-only goal. This case shows you can reach the same milestone in adults with autism if you bundle alarm, schedule, reinforcement, and staff training. Copy the package in day programs, group homes, or vocational sites. One clear protocol can remove diapers, cut laundry, and give the adult dignity that lasts the rest of his life.
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02At a glance
03Original abstract
<b>Background:</b> Independence with the toilet is an important life skill. Individuals with Autism Spectrum Disorder (ASD) may present with several deficits that impair their ability to independently use the toilet and often individuals with ASD require more support than is provided in typical toilet training methods, including behavioral toilet training methods. This current study is a demonstration of the use of an intensive toilet training procedure with one eighteen-year-old adult male with ASD and below-average levels of adaptive functioning to successfully void in the toilet and reduce accidents. <b>Methods</b>: A package of behavioral toilet training procedures was implemented for 11 weeks in a school setting. This package included intensive toilet training, a urine alarm, a toileting schedule, verbal praise, edible reinforcement, and dry pants checks. School staff were trained to implement this procedure with behavioral skills training (BST). <b>Results</b>: Intensive toilet training was effective in eliminating the number of accidents while increasing the number of successes, thus increasing his independence with toileting. <b>Conclusions</b>: Increasing independence with toileting is an important life skill and can increase the likelihood that an individual would be accepted by an adult services placement.
, 2024 · doi:10.3390/healthcare12232374