Response by Candace Fugazy, MA, BCBA, behavior consultant at Washington County Mental Health Services and adjunct professor at Johnson State College.
When thinking about toilet training adults, clinicians may consider the same principles used when training young children with a more age appropriate focus.
In the beginning you will want to focus mostly on trip training and potentially start in the individual’s home setting, as this is where he or she might be most comfortable. You will want to have scheduled bathroom trips (e.g., once per hour) where you can prompt the individual to urinate on the toilet and can offer reinforcement for successful voids.
When determining what to utilize as reinforcement, think about more age appropriate activities such as watching a movie or listening to some favorite music. It helps to greatly increase fluids and/or offer high fluid foods (e.g., watermelon, popsicles) to increase the chances of the individual having a full bladder and thus increasing the prevalence of urinating on the toilet. If the individual has a hard time sitting, you may offer high preference magazines or a video if that would make sitting more reinforcing.
Only engage in reinforcing activities when in the bathroom to ensure that the bathroom does not become an aversive place. If an accident occurs it is important not to shame but rather inform the individual that he or she had an accident and then provide support as needed with changing clothes. Also, consider your prompting methods. If you need to physically touch the person consider explaining what you are doing and when you are going to prompt so he or she can be prepared.
Another support to add is the use of a wet alarm. This will help the individual become more knowledgeable of when he or she is actually urinating, and can also assist with teaching initiations to use the bathroom.
Take care to use age appropriate language, use the phrase “going to the bathroom” rather than “going potty.” Use actual labels for body parts rather than child friendly terms (e.g., wee-wee).
I think as long as you are respecting the dignity of the adult and using both age appropriate and cognitively appropriate visual and prompting supports, you can use the same training methods as with children.
References
Wright, B.W. (1998). Toilet training procedures for individuals with developmental
disabilities. Retrieved from http://dcs-cde.ca.gov/rsc/toilettraining.pdf
Wilder, D.A., Higbee, T.S., Williams, W.L., Nachtwey, A. (1997). A simplified method of
toilet training adults in residential settings. Journal of Behavior Therapy and
experimental Psychiatry, (28)3, 241-246.
When thinking about toilet training adults, clinicians may consider the same principles used when training young children with a more age appropriate focus.
In the beginning you will want to focus mostly on trip training and potentially start in the individual’s home setting, as this is where he or she might be most comfortable. You will want to have scheduled bathroom trips (e.g., once per hour) where you can prompt the individual to urinate on the toilet and can offer reinforcement for successful voids.
When determining what to utilize as reinforcement, think about more age appropriate activities such as watching a movie or listening to some favorite music. It helps to greatly increase fluids and/or offer high fluid foods (e.g., watermelon, popsicles) to increase the chances of the individual having a full bladder and thus increasing the prevalence of urinating on the toilet. If the individual has a hard time sitting, you may offer high preference magazines or a video if that would make sitting more reinforcing.
Only engage in reinforcing activities when in the bathroom to ensure that the bathroom does not become an aversive place. If an accident occurs it is important not to shame but rather inform the individual that he or she had an accident and then provide support as needed with changing clothes. Also, consider your prompting methods. If you need to physically touch the person consider explaining what you are doing and when you are going to prompt so he or she can be prepared.
Another support to add is the use of a wet alarm. This will help the individual become more knowledgeable of when he or she is actually urinating, and can also assist with teaching initiations to use the bathroom.
Take care to use age appropriate language, use the phrase “going to the bathroom” rather than “going potty.” Use actual labels for body parts rather than child friendly terms (e.g., wee-wee).
I think as long as you are respecting the dignity of the adult and using both age appropriate and cognitively appropriate visual and prompting supports, you can use the same training methods as with children.
References
Wright, B.W. (1998). Toilet training procedures for individuals with developmental
disabilities. Retrieved from http://dcs-cde.ca.gov/rsc/toilettraining.pdf
Wilder, D.A., Higbee, T.S., Williams, W.L., Nachtwey, A. (1997). A simplified method of
toilet training adults in residential settings. Journal of Behavior Therapy and
experimental Psychiatry, (28)3, 241-246.
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