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How do I go about potty training a special needs child?

I am potty training a 3.5 year old boy on the spectrum. He is very high functioning and very smart. He follows instructions, is verbal, and has the ability to control urine. Our problem is peeing into the toilet/potty/anything other than a diaper. He screams and refuses to let go until it starts to drip and just comes out. I feel that he is ready. Do you have any advice on how to control the screaming on the potty?

Elizabeth Walenz | Pediatrician

Elizabeth Walenz

For the screaming on the toilet issue, I may recommend several approaches.

First I would try timed voids. I would make sure that you take the child to the toilet every 2 hours to urinate. If the child is comfortable urinating in a diaper, first I would teach him to urinate sitting down and I would have him sit on toilet in diaper or pull-up to urinate. Praise for a positive urination on the toilet. 

Second, I would either pull the pull up or diaper down the child's legs, the comfort of the diaper is still there, but the child actually urinates in the toilet. If the child is not ready for this step, you certainly can cut a hole in the diaper so the child urinates in the toilet, again positive praise for urinating in the toilet, gradually, we move the diaper away and only to underwear with scheduled voids every 2 hours. 

A behavior chart for urinating in the toilet may be helpful as well with an agreed upon prize for 5 days of urinating in the toilet.

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