 Authors: Judith Coucouvanis, AAPC 2008
Reviewed by Maureen Bennie
Director, Autism Awareness Centre Inc.
Parents of children with autism or other special needs frequently
struggle with toilet training their child. Toileting a child with
special needs is more difficult because there are often additional
challenges such as communication difficulties, sensory issues,
behavioral concerns, resistance to change, inability to generalize a
newly learned skill, and the need for routine. Using traditional toilet
training books and methods are not always helpful because the autism
population does not think the same way a neurotypical child does. The
child with autism may not care about pleasing parents or receiving
verbal praise. Because there may be significant developmental delays,
the toileting process may not be started until after the age of 4.
Using a diaper to eliminate has been the routine for several years and
this can be hard to change. Children’s books to introducing toilet
training may not be appropriate because the child is too big for a
potty chair or using the potty chair then transitioning to the toilet
becomes yet another change and obstacle in this process.
All of these concerns may feel insurmountable and overwhelming when
making the decision to begin toilet training. Judith Coucouvanis has
come to the rescue with her new book The Potty Journey: Guide to Toilet
Training Children with Special Needs, Including Autism and Related
Disorders
that empowers parents and professionals with practical information to
make this journey a success. I would recommend reading the book in its
entirety first before starting toileting because Ms.Coucouvanis equips
the reader with a plan and presents the overall picture for this
process. She uses the concept of a journey/trip and all the things one
would need to do to make the trip a successful one. It is these
planning tips and manageable steps that make toileting “do-able”.
One of the biggest quandaries parents face is not knowing
when to start toileting. Ms.Coucouvanis outlines considerations when to
begin toileting in the second chapter. She discusses mental age which
is not the same as chronological age, the ability to remain dry for 1 –
2 hours at a time, and being over the age of 4 when bodily functions
are more mature. It is also important that you as the parent are
emotionally ready for this commitment which takes several weeks, and
that there are no additional life stressors such as a move, divorce,
job change, or major illness.
One key to successful toileting is using a team approach.
Everyone who spends time with that child should be involved in the
toileting process. Children with autism don’t generalize from one
situation to the next so for success to occur there has to be a
consistent toileting routine and approach throughout the child’s day
which may unfold in several places.
Ms.Coucouvanis introduces the Daily Progress Record (DPR)
in chapter 3 which is the foundation of the toileting process. She
provides lots of examples and a template in the appendix. She teaches
how to practice toileting, use rewards, and supports the child’s
learning with visual examples. She dedicates two chapters to
troubleshooting problems. The book is peppered with thoughts from
parents and professionals who have gone through this journey. Their
comments offer positive support and encouragement. The final chapter is
dedicated for stories from those who have completed the toileting
journey.
Ms.Coucouvanis also writes about creating independence
with toileting – how to fade prompts and your presence in the bathroom.
She also discusses bathroom use in other locations such as the school
and public restrooms. The hidden curriculum rules for boys and girls
public bathroom use are outlined. Most mothers are not aware of how
different a men’s public bathroom is from a women’s.
There is a helpful appendix at the end which includes
charts for determining toileting readiness, the Daily Progress Record,
records for your team members (known as the travel crew), a checklist
to prepare for this journey, suggested rewards, Sitting Practice
Record, and a visual breakdown of the toileting steps.
On a personal note, I toilet trained my 9 ½ year old son
with autism in the summer of 2006. There was very little literature on
this subject and nothing that I could find on the internet to guide me
on how to train the older child with autism. My husband and I devised
our own plan and experimented with different ideas. A book like this
one would have been a gift for us, providing support and
troubleshooting ideas. We got the job done, but it was a six week
struggle.
The
Potty Journey: Guide to Toilet Training Children with Special Needs,
Including Autism and Related Disorders book takes parents and
professionals through the toileting journey which is a challenge but
well worth the effort. Toileting with independence and confidence is a
life-long skill; without this skill, a person’s choices are limited and
they are dependent on someone else for one of their most basic needs
Visit Autism Awareness Centre's Bookstore to purchase The Potty Journey
[added June 6, 2008]
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