Toilet Training Readiness

This is from TOILET TRAINING FOR CHILDREN WITH SEVERE HANDICAPS - A Field Manual For Coordinating Training Procedures Across Multiple Community Settings, by Dunlap, Koegel, and Koegel, distributed by Autism Training Center, Marshall University, WV

Prior to the start of training, the child's physician should be consulted in order to make sure that there are no medical conditions or problems that would make training inadvisable. The physician may also comment on the child's physical development and age (most children with handicaps should be at least two years of age). This step can usually be accomplished with a phone call. 

There are some behaviors that may be positive indicators for he child's participation in the program. For example, if the child displays the ability to retain urine for extended periods of time (12 hour to an hour), such control may facilitate training. Such a child may learn appropriate retention and elimination skills more easily than a child who displays constant, poorly controlled elimination ("dribbling", etc). 

The child's general mobility skills may be important. Being ambulatory in terms of independently standing up, sitting down, and walking to and from the bathroom is helpful, as such skills are part of the set of appropriate toileting behaviors. However, our field-testing has demonstrated that with minor program adjustments, non-ambulatory children can also demonstrate success with the present program. Relatedly, in order for the child to be totally independent, some dressing skills are important (such as being able to pull pants up and down, manipulate zippers, buttons, snaps, etc). The child's grasping ability and fine motor coordination are important for such behaviors, as well as others, such as wiping, etc. 

If necessary, the child can be provided with some pretraining on these skills, in order to facilitate progress in the toileting program. However, it should be pointed out that the above-discussed behaviors should not be considered as absolute prerequisites to training with a child. A great deal of training on these behaviors will naturally occur in the course of the toilet training program. Also, it may be possible to circumvent difficulties that may be associated with some dressing skills, such as buttoning and/or sipping. For example, pants with elastic waistbands can be used to make the raising and lowering easier to accomplish.
Again, it should be stressed that while the presence of some of the above behaviors may be positive indications of success in the program, they should not be used as criteria for exclusion from training. Rather, they are areas that should be evaluated with respect to their possible effects on the child's participation in the program, and provisions for dealing with them should be made accordingly.

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