A parent training model for toilet training children with autism.
Parents can copy Azrin & Foxx's intensive toilet plan at home and get kids with autism fully trained within ten days.
01Research in Context
What this study did
Xenitidis et al. (2010) taught two moms and dads how to run Azrin & Foxx's fast toilet program at home. The kids were boys with autism who still wore diapers.
Parents got one hands-on demo, then coached their child all day for about a week. The team watched via video and gave tips.
What they found
Both boys stayed dry during the day after just one to two days. They walked to the toilet, pulled pants down, and wiped without help within five to ten days.
Three years later the skills were still there—no diapers, no accidents.
How this fits with other research
Somers et al. (2024) used the same parent-coach idea over Zoom to teach kids with autism to use a water flosser. Their success shows the model works even through telehealth.
McLay et al. (2019) also sent parents home with ABA plans, but for sleep problems instead of toileting. Both studies saw quick gains, proving moms and dads can run solid behavior plans.
Niemczyk et al. (2019) found that about one in six kids with autism in clinics still wet themselves. Xenitidis et al. (2010) gives a clear fix for that common problem.
Why it matters
You can hand families a short, intense toilet plan and expect fast results. No need for clinic hours—parents do the work and kids keep the skill for years. Try packaging Azrin & Foxx steps in a single parent meeting; check in daily by video. If sleep or other self-care is the goal, the same coaching style works there too.
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Give parents the Azrin & Foxx step sheet, demo the first round, and schedule daily five-minute video check-ins.
02At a glance
03Original abstract
BACKGROUND: Azrin & Foxx pioneered an intensive toilet training protocol for individuals with intellectual disability living in a residential setting. Since the development of the Rapid Toilet Training (RTT) protocol, many have replicated the efficacy, most notably in educational and outpatient treatment settings, but often training over longer periods of time. This study presents data from a parent training model that replicates Azrin and Foxx's results and training time. METHOD: This multiple baseline across subjects design study employs an ABA design where two boys diagnosed with autism were toilet trained using a modified Azrin & Foxx intensive teaching protocol. The first subject, a 4-year-old boy, did not have a history of attempted toilet training. The second subject, a 6-year-old boy, demonstrated a history of failed toilet training attempts in both the home and school settings. The trainings were conducted in the home setting where a novel parent-training approach was implemented. RESULTS: Participant 1 was continent at the end of the second day of training, and completely toilet trained (including initiation and communication) by day 10 of the intervention. Participant 2 was continent after day 1 and completely toilet trained by day 5 of the intervention. CONCLUSIONS: Long-term follow-up demonstrates maintenance of skills 3 years post training. Social validity via parent satisfaction was assessed. Limitations to the current study and recommendations for future research were discussed.
Journal of intellectual disability research : JIDR, 2010 · doi:10.1111/j.1365-2788.2010.01286.x