Special Paper Session: Toileting becomes clinically important the moment a team has to turn good intentions into reliable action inside case conceptualization, intervention design, staff training, and literature-informed problem solving. In Toileting, for this course, the practical stakes show up in stronger conceptual consistency and better translational decision making, not in abstract discussion alone.
Provider: BehaviorLive — via Florida Association of Behavior Analysis
Take This Course →Including ethics, supervision, and topics like this one. New live CEU every Wednesday.
Join Free →Evaluating the Effects of Sit Schedules on Toileting Events with Children on the Autism Spectrum - Multi-component toilet training packages and procedures for toilet sit schedule thinning often establish and maintain urinary continence (Greer et al., 2016; Perez et al., 2020). Monitoring the rate and correspondence between urinations and self-initiations (SIs) can inform decision making for toileting independence (Perez et al., 2021). This study recruited children who previously experienced a multi-component toilet training package that established in-toilet urinations (ITUs) with a dense sit schedule. They progressed to a drop-out component analysis that incorporated a sit schedule evaluation to identify if (a) urinary continence would maintain and (b) SIs would emerge without a sit schedule. We used a BAB reversal design to compare the effects of a sit schedule on urinary accidents, ITUs, SIs, and correspondence between SIs and ITUs among five children on the autism spectrum. We calculated the rate of urinations to serve as the criterion for ideal SI rates. Overall, all participants exhibited high and stable ITUs with a sit schedule, and most participants exhibited variable or no ITUs without a sit schedule. Additionally, most participants often exhibited higher rates of urinations relative to SIs. SIs often co-occurred with ITUs, indicating high correspondence. We discuss the implications of these outcomes when focusing on toileting independence. Extending the efficacy of component-lean toilet training procedures to children who exhibit self-exploratory behavior Urinating in the toilet is an early developmental milestone (American Academy of Pediatrics, 2018). Component-lean procedures have been efficacious with increasing in-toilet urinations and decreasing accidents among young children on the autism spectrum (Perez et al., 2020). Additionally, nontargeted behavior such as bowel movements and self-initiations have increased, and challenging behavior has decreased when urinary continence emerges (Perez et al., 2021). However, it is unknown if self-exploratory behavior (i.e., self-touching "private" anatomy) during toilet sits is a common nontargeted behavior. The current study evaluated the effects of component-lean procedures on establishing urinary continence among young children on the autism spectrum who exhibit self-exploratory behavior. We also assessed if urinary continence maintained when switching from a 30- to 90-min toilet sit schedule. To date, we have recruited two children on the autism spectrum attending an early intensive behavioral intervention clinic who exhibited self-exploratory behavior upon referral. Both participants experienced a baseline that included (a) wearing pull-ups, (b) a 30-min sit schedule, and (c) praise plus a snack for in-toilet urinations. One participant exhibited an increase in in-toilet urinations, decrease in accidents, and decrease in self-exploratory behavior during baseline, with these improvements maintaining with a 90-min sit schedule and underwear. The second participant exhibited variable in-toilet urinations, accidents, and self-exploratory during baseline. In-toilet urinations increased, and accidents decreased with underwear and these improvements maintained with a 90-min sit schedule after incremental thinning procedures. These preliminary findings suggest idiosyncratic outcomes for children who exhibit self-exploratory behavior, and implications for intervention and maintenance procedures.
| Certification Body | Credits | Type |
|---|---|---|
| BACB® | 1 | General |
| COA | 1 | — |
| FL MH/PSY | 1 | — |
Joanne Li is a programs manager at the University of Miami-Nova Southeastern University Center for Autism and Related Disabilities (UM-NSU CARD) – Applied Research and Behavioral Training Division. She is part of the research support staff for the Learning and Behavior, Research and Training Clinical Research Site at the University of Miami. Joanne earned her Master of Science in Psychology with a concentration in Applied Behavior Analysis from the University of Miami and her Bachelor’s in Psychology with minors in cognitive science and statistics from the University of Central Florida. Joanne has gained experience participating in diverse research areas. Joanne’s interest areas include early learner skill development and refinements in function-based treatments.Financial: Ms. Li is employed by UM CARD. Conference registration has been paid. Non Financial: None
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.