Classroom Based Intensive Toilet Training for Children with Autism Spectrum Disorder

Abstract

The purpose of this study was to investigate the effects of an intensive toilet training program on continence and self-initiation for elementary children with autism spectrum disorder (ASD). Researchers used a non-concurrent multiple baseline design (Watson and Workman in

Resolving Barriers to Continence for Children with Disabilities: Steps Toward Evidence-Based Practice

“…Although it is important for children to be well-hydrated, the additional fluids offered during toilet training may result in increased accidents. Both Cagliani et al ( 2021 ) and Doan and Toussaint ( 2016 ) observed increases in accidents correlated with the provision of additional fluids. Doan and Toussaint reported eventual decreases in accidents, and Cagliani et al discontinued additional fluids when accidents did not resolve after several sessions.…”

“…Nine studies meeting criteria for inclusion in this review illustrate support for removal of diapers as a component of BATT. Cagliani et al ( 2021 ) exchanged diapers for underpants as a component of a toileting baseline phase, along with a 90-min toileting schedule, graduated guidance following accidents, and differential reinforcement for continent voids. Following these simple manipulations, one participant’s accidents decreased to zero.…”

“…Finally, adding a supplemental toilet sit is an alternative to setting one inter-sit interval for the entire training day. Cagliani et al ( 2021 ) observed ongoing morning accidents despite the participant’s experiences with positive reinforcement, so they scheduled an extra bathroom trip to occur in the morning without requiring more frequent toileting visits throughout the day. The percentage of voids occurring in the toilet increased to 100%.…”

“…For example, Johnson et al ( 2021 ) reviewed the literature and found that total toilet training hours ranged from 17.5 hr to 1,848 hr across studies and participants, with a mean total duration of 373.3 hr. Other researchers have described their toilet training packages as “Intensive Toilet Training” (e.g., Cagliani et al, 2021 ) or “Modified Intensive Toilet Training Method” (e.g., Spencer & Ello., 2021 ). Components of each package vary, but these interventions are identifiable by their conceptual basis in the principles of behavior as well as their inclusion of several, if not all, components of the seminal Azrin and Foxx ( 1971 ) procedure.…”

An Evidence-Based Guide to Toilet Training in the Early Childhood Classroom

“…Progressive sitting schedules do not require extended time in the restroom or loss of instructional time (Frank et al, 2020). Several research teams evaluated the effectiveness of progressive sitting schedules in the school setting and found this intervention to be effective for 3- to 7-year-old children with IDD (Cagliani et al, 2021; Cocchiola et al, 2012; LeBlanc et al, 2005). The initial interval between scheduled sits can range from 5 (LeBlanc et al, 2005) to 30 min (Cocchiola et al, 2012).…”