Toilet training and behaviors of people with autism: parent views.
Toilet training in autism can take years and commonly involves urination accidents, constipation, and fecal smearing—plan for extended parent coaching.
01Research in Context
What this study did
Rasing et al. (1992) mailed a survey to 100 parents of children with autism.
They asked about toilet training start, length, accidents, and any scary or messy behaviors.
Parents wrote in their own words how toileting went for their child.
What they found
Most families began training before anyone said "autism."
Training dragged on for months or years.
Many kids still had wet pants, hard stools, or smeared feces.
How this fits with other research
Schertz et al. (2016) and Tomeny (2017) used similar parent surveys. They show child autism signs raise parent stress and stigma.
Rasing et al. (1992) gives the concrete reason: toileting accidents last far longer than typical.
Guillon et al. (2022) and Howlin et al. (2006) asked parents about service satisfaction. Parents want clear guidance and short waits.
Rasing et al. (1992) hints that parents start training alone because no guide was offered. Together the papers say: give families early, hands-on help and the whole journey feels lighter.
Why it matters
Toilet training can take years in autism. Plan for it in your initial parent chats.
Build a slow, step-wise protocol. Track accidents, constipation, and smearing.
Offer monthly check-ins so parents feel guided, not judged. A calm plan today saves stress, stigma, and maternal burnout tomorrow.
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02At a glance
03Original abstract
Individuals with autism often present with toileting problems, yet there is little information about the nature of these problems. This investigation surveyed 100 parents of people with autism of a mean age of 19.5 years. Results indicated that lower cognition and lower verbal levels were significantly correlated with age of accomplishment of bowel and urine training; some subjects were not trained at the time of the study. The average duration of urine training was 1.6 years, bowel training 2.1 years. On the average, training started more than 2 1/2 years before the average age of diagnosis of autism. Fifty-six percent of the sample had to be taught to self-initiate, 42% were taught to ask to use the toilet, and 49% were taught using a schedule. Reinforcement was used by 78% of the parents of males and by 100% of the parents of females. Punishment, primarily scolding was used by 37% of the parents. The most common problems reported were urinating in places other than the toilet, constipation, stuffing up toilets, continually flushing, or smearing feces. More fears related to toileting were noted for verbal subjects.
Journal of autism and developmental disorders, 1992 · doi:10.1007/BF01058155