Autism and Incontinence: Potty Training Tips for Parents

Children with autism often experience incontinence due to common delays in potty training. Here are some tips and ideas to help parents manage incontinence in their little ones.

Growing up, children are expected to overcome many challenges, from learning how to walk to potty training. However, children with autism spectrum disorder (ASD) overcome these hurdles at a different pace. For them, one common challenge can be incontinence, which affects 85% of children with ASD.

Known as the lack of voluntary control of urination or defecation, children with autism often experience incontinence due to common delays in potty training. Video games and other engaging activities can be a distraction for autistic children, so much so that they don’t feel the need to urinate until it’s too late.

What’s more, some individuals may experience urge incontinence, which is where they feel the urge to urinate unexpectedly and their bladder contracts when it shouldn’t. Additionally, children with autism who are nonverbal may have trouble communicating when they need to go to the bathroom, leading to unintended accidents.

Making a plan for managing your child’s incontinence may seem like a strenuous task at first. However, with the right toilet training practices and daily routines, there are proven ways to set them up for success.

Managing incontinence symptoms

Some of the first symptoms of incontinence include bladder leakage, delayed toilet training, and nocturnal enuresis, also known as night-time incontinence. If your child is exhibiting any of these symptoms, it’s recommended to visit the pediatrician to determine if the incontinence is caused by developmental delays or another medical condition and to develop an effective treatment plan.

Being supportive and understanding as a parent is the first step to managing your child’s incontinence. Although this may seem like a given, reassuring your child that their bladder leakage is not a bad thing will further boost their ability to handle bouts of incontinence.

As a next step, start keeping track of your child’s normal bathroom routine. You can do so by monitoring their bathroom schedule or keeping a Bladder Diary, which will allow you to keep track of when during the day they tend to have the most accidents.

If you’re aware of their bathroom schedule, you can remind them to use the restroom when they typically feel the urge to go. It’s encouraged to have your child use the bathroom every two to three hours in order to get them into a solid routine.

A healthy diet and a good amount of fluids will also go a long way in improving your child’s incontinence symptoms. If your child does not drink enough water, this can lead to constipation and potentially worsen incontinence symptoms.

Constipation can cause abdominal bloating, which puts pressure on the bladder and increases the risk of leakage. Eating vegetables and fruits that are high in fiber can also help ease constipation and reduce instances of incontinence. If your child’s stomach is swollen, they go a full week without a bowel movement, or experience continuous pain that does not respond to medication, it’s important to see their doctor.

Lastly, being prepared every time you and your child leave the house is imperative to managing incontinence. Make sure to pack a bag with extra incontinence supplies and clothing so you’re covered in the event of an incontinence episode.

In situations where your child does not want to interrupt what they’re doing to take a bathroom break, reminding them that they can always come back to the activity they’re doing will help avoid any potential meltdowns and prevent a situation where your child has any bladder leakage.

Introducing a new toilet training schedule

When you’re ready, and when you think your child is ready, another more time-intensive solution to managing incontinence is introducing a new toilet training schedule. It’s recommended to train your child to adhere to this new schedule for a full two weeks to give them enough time to get comfortable with the changes to their routine—whether it’s trying a new method of toilet training or working to use pull-ups less.

Sensory triggers are important to consider when creating a successful bathroom routine. Children with autism can be deterred from using the bathroom if they are triggered by certain aspects, such as a toilet flushing or how the toilet seat feels. To minimize these triggers, parents can try waiting to flush the toilet until they leave the bathroom, or trying out different types of toilet seats to find the most comfortable one for their child.

If the end goal is transitioning from diapers to regular underwear, the best products to use are interval continence care products such as training pants (a diaper with a cloth-like texture meant to mimic regular underwear) or pull-ups. Pull-ups, otherwise known as protective underwear, are the recommended incontinence products as they are designed to look and feel like regular underwear.

Not only are they discreet, but they also secure your child with absorbency and odor protection. They are also best when addressing sensory triggers, in cases where it’s important for products to be soft and non-irritating to the skin.

Stay positive, and don’t give up!

Every child with autism is unique, which is why it can take some trial and error before you figure out what is best for your child and their specific needs. From learning their bladder training schedule and sensory triggers when going to the bathroom, to watching what continence care products you’re using and how their diet impacts leakage, all these ways may help you and your child better manage their incontinence.

Establishing effective toilet training practices will not be immediate. However, with these steps and a lot of patience and understanding, you can work to overcome this temporary challenge in their life.