Standardized to Individualized Behavior Analytic Toilet Training Package for Autistic Preschoolers

Abstract

Autistic children often have difficulties learning to transition out of diapers and controlling continence. Due to this, children on the spectrum may require a more systematic toilet training protocol than what parents may use with typically developing children. Most published toilet training procedures with this population include some form of punishment as a component of the treatment package, which may raise ethical concerns. Thus, the purpose of the present investigation was to examine the effects of a standardized behavior analytic toilet training package without a punishment that included the following components: 1) preference assessment, 2) request training, 3) differential reinforcement for staying dry, 4) underwear, and 5) progressive sit schedule on the successful urinations in the toilet by young children with autism. For students who did not meet mastery criteria with the standardized training package, we implemented a contingent progressive sit schedule followed by the individualized interventions when necessary. Three of the five participants successfully learned how to urinate in the toilet with the standardized toilet training package alone. One participant required a contingent progressive sit schedule phase, and one participant required an individualized intervention to reach mastery. Four of the five participants maintained responding when the package was faded out over a 4-week period.