Toilet training a child is never straightforward. For many autistic or additional needs children the process can often start later, take more planning, and may take longer. But it will be worth the effort in the long run.
Establishing a routine is a huge step in helping your child become toilet trained.
This record sheet ( available as a download using the link below) can help you develop a toilet routine for your child. Recording your child’s wee and poo habits for 3 ‘typical’ days helps you to identify their wee and poo pattern so you can encourage them to sit on the toilet at around that time. Your notes may also help you spot any signs of constipation that could make toilet training unsuccessful.
Let’s get started
Here is a guide to help you fill in the record sheet;
Write down the time your child has their meals, drinks, and snacks. This helps you track how long it takes between when your child eats or drinks and when he or she is wet or soiled.
It may be helpful to write down what your child drinks. You may see a pattern with the type of drink he or she has and how often or quickly they wee afterward.
Time of wee / Time of poo
Check your child’s nappy or pull up every 30 minutes for wetness or soiling.
Write down the time that any wee or poo is passed
This will help you identify your child’s wee and poo patterns. Use this information to schedule toilet time.
Type of poo
Write down the number from the Bristol Stool Chart that best describes the poo—see pictures in the Choose Your Poo table on the left.
Record the size of the poo passed as small/ medium or large
Types 1,2 and 3 suggest constipation. You should contact your child’s doctor for further advice if your child passes these types of poos.
Write down any behavioural changes you notice before or after your child has passed a wee or a poo. For example, running and hiding, jiggling around, crossing their legs, or clutching at themselves.
Recognising any behavioural changes will help you decide when is a good time to encourage your child to sit on the toilet.
Imagine being able to send your child off to school without the usual dramas, panic, shouts, and screams over lunch boxes, PE kits or homework!
Anxieties over forgotten items can be avoided with a little preparation and practice.
When children have the skills to pack their school bag independently, they can start taking responsibility for their belongings without you having to remind them all the time. This also helps them at the end of the school day when they need to know what to bring home again.
Even the youngest or most disorganised child can soon get the hang of finding and packing everything they need for school, giving them a great sense of achievement too.
Visual checklists are an ideal tool to use when helping your child learn how to get organised and become more independent.
Find the right school bag
With so many bags to choose from it is important to find one that matches your child’s needs.
The main consideration is comfort.
• Does the bag feel good to wear?
• Do the straps feel sufficiently strong?
• When filled, is the weight of the bag evenly spread about?
Choose a sturdy bag that has multiple compartments and zipped pockets. Check that all the fastenings work cleanly and it is easy to access. If you child gets frustrated finding things or struggles with fiddly zips, opt for fewer pockets and Velcro fastenings instead.
Let’s get organised
Start with an empty school bag.
Ask your child to sort out their school things into clear categories. For example, school supplies such as pens, pencils, notebook, communication book in one pile. Items that go back and forth to school like lunch boxes, water bottles and PE kit in another pile.
Assign each item to a compartment or pocket. A big compartment can be for books and their lunch box. A smaller pocket for writing equipment.
A school-home folder is ideal for any loose papers, letters, or permission sheets that need to go back to school.
Make a map
Once everything has its place, help your child draw a picture of their school bag and label what goes where. This school bag ‘map’ will help remind them where things go when they are packing up for the
Encourage your child to practice emptying their bag and putting everything back in the right place.
Keep a copy of the map in the front pocket of their school bag plus a copy at home.
Pack all the right kit
Use a simple checklist attached to their school bag listing all the things they need to remember to take to school for each day of the week. The checklist should be sturdy and easily seen. Using different coloured lists makes it easy to identify the right list for each day.
Picture cues work well for younger children or non-readers as well as older children and those with additional needs such as dyslexia, dyspraxia, autism, or ADHD.
Getting into the habit of packing the night before is a great way to avoid the last-minute panic searching for homework or PE kit in the morning when you really should be leaving the house!
Bear in mind that children may need lots of practice before they can organise and pack their school bag independently.
Give lots of opportunities to practice these techniques and make forgotten school items a thing of the past.
My autistic son Tom (the inspiration for TomTag visual schedules) struggles with changes to his routines. His autism means that he perceives the world differently to other people. For him, the world can often seem a strange, unpredictable, and confusing place. It is understandable why he craves the stability and predictability of repetitive routines and activities, and the comfort of familiar food. However, as a wise man once said, the only constant in life is change. Learning how to be flexible and less rigid about routines is a crucial life skill. It is one that Tom has developed over the years, with the help of visual supports.
Visual schedules are a great tool for teaching flexibility around changes to routines. This may seem surprising – surely a schedule means sticking to a repetitive routine? However, it’s not the visual schedule that makes changes to a routine difficult but the way it is used.
In this blog, I’d like to share with you an approach you can use with TomTag visual schedules to help your child be less rigid and more tolerant of changes to their routines.
Use a schedule
Make sure that your child understands how their schedule works and uses it regularly. If your child doesn’t understand their schedule or use it regularly then it is unrealistic to expect them to deal with changes to it.
A TomTag I am flexible tag is a great way to introduce your child to changes to routines when used alongside their normal routine tag. Using the format ‘instead of‘ … ‘I am flexible’… is a simple visual way to familarise your child with a proposed change in their routine.
Words can have a powerful effect. I am flexible is a positive affirmation that will give your child a sense of achievement and boost their self esteem.
Start with positive changes
Start with something positive, for example, a change to a preferred activity or food choice.
In the examples shown- sand play instead of inside play, fish fingers instead of pizza (go with the preferred activities/ food choices for your child!)
Start with a change that is not upsetting. This also reinforces the idea that a change does not always have to be negative.
Giving initial warnings
Although the aim is to get to a stage when you don’t have to give warnings about changes – life is unpredictable after all – you shouldn’t expect your child to immediately accept changes without doing the necessary groundwork.
Like all new skills, the best way to learn is to break the skill down into small sequential steps.
Refer to their morning schedule tag and show them the proposed change. In this example, if their morning routine shows inside play then show them the I am flexible tag with the new play activity at the earliest opportunity e.g. before breakfast.
Ask them to change the activity on their schedule to the new activity themselves. Our symbol packs include 2 copies of every symbol so you don’t have to worry about running out of symbols. Their morning schedule tag now shows the new activity.
Keep the I am flexible tag handy. Depending on your child’s level of understanding, a short verbal explanation of why the change has taken place would also be helpful.
Give another warning just before the changed activity happens. Show your child the I am flexible tag to reinforce your verbal warning. This will help them remember the change and prepare for it.
Praise and encouragement
Praise your child specifically for handling the change well using supportive positive statements like, “I like how well you managed it when we changed the schedules” or “Change can be hard, but you are doing a great job!”
Saying “You are so brave handling that change in the schedule without getting upset!” is particularly useful if your child is very anxious about change.
Try not to say “See it wasn’t so bad was it!” as this could belittle your child’s genuine feelings of anxiety about changes and make them feel anxious about having these feelings.
Fade the warnings
Once your child can manage changes to their routines with warnings, start moving the warnings nearer to the time when the actual change is going to happen.
So in the example tags I have used above, you could move the warning about the change of play activity to later in the morning.
Make sure that your child’s schedule is always accurate.
Being prepared makes changes to routines so much easier to manage. It also keeps the schedule consistent so your child knows they can rely on it.
I hope you find this approach useful in helping your child learn to accept and manage changes to their routine.
Want to make your own schedules, routines and I am flexible tags like the ones shown in the examples here or need more advice before getting started on introducing routines or changes to routines? Take a look at the resources below or get in touch with Clare via our contact page.
Getting dressed independently is an important life skill for autistic children. Teaching dressing skills to my autistic son required a lot of time, practice, and patience.Putting on clothes in the right order, fastening buttons and zips and tying shoelaces involves mastering many skills. Add sensory triggers into the mix and it is easy to see why it took him longer to develop dressing skills compared with other children his age.
However, it is worth the effort. Being able to get dressed by themselves gives autistic children confidence to function independently at school and it’s one less thing for you to worry about in the mornings!
Now is the perfect time for your autistic child to start developing their dressing skills. With schools closed, there’s no pressure to get everyone fed, dressed and out of the front door in the morning so there’s plenty of time to practice at your child’s own pace.
Getting dressed takes a lot of motor skills that autistic children may need time to develop. Balance and co-ordination of movements are needed to get their limbs in all the right places. Fine motor skills help them deal with many types of fastenings.
Improving motor skills does not have to be boring! Here are some activities you can do at home with your child to make practice fun.
Practice balance by making a line on the floor and step with one foot in front of the other like “tightrope walking”. You could make it more interesting by pretending that they are walking a tightrope across a river full of snapping crocodiles!
Work on fine motor skills with a hidden treasure hunt. Fill a tub with rice or another pulse and hide small objects such as cars, or small figures and ask your child to find them. Sand play and messy play are also activities which practice fine motor skills.
Therapy putty is ideal for developing the hand strength needed to manipulate clothing and fastenings.
Use a TomTag visual list to help your child choose their preferred activity. Our new Early Years Activities sticker pack has lots of activities that make fine motor skill practice part of playtime.
Once you’re ready to practice dressing try ‘backward chaining‘ . This method lets the child feel accomplished every time. They start with the last step then work backward from there.
Little changes can make a big difference in reducing your child’s frustrations while dressing. Here are some things you can do to make things easier for them.
Choose trousers or skirts with elasticated waists where possible and opt for loose fitting items with velcro or large buttons which are easier to put on than tight fitting ones.
Use a simple visual checklist like TomTag showing what order each item of clothing should be put on. You could also lay the clothes out in the shape of a body to help with visualisation.
Offer a choice, “ you can wear the blue shirt or the red shirt”.
Lay out clothes the night before, making sure they are the right side out.
Organise the wardrobe separating play clothes, school clothes and ‘going out’ clothes
Begin with large, short socks that slip more easily over the feet.
Show your child how to scrunch longer socks up first before pulling them on
Socks with colored heels make it easier to get them the right way round. We love the brightly coloured Ez Socks from Special Kids Company that also have handy pull up loops.
Try Little Grippers school socks for socks that stay on – and up! – all day long.
Having a designated place for shoes will save valuable time spent hunting for them
Teach shoe tying with a step by step approach. The ‘bunny ears’ is a popular method and YouTube is an excellent resource for demonstrations of this and other tying methods.
Start practising with different, larger types of coat.
If the sleeve by sleeve approach isn’t working try this flip flop over the top method wonderfully described by Connectability.ca – you might want to stand well back until they get better at this one though!
Attach a zip pull or a key ring to the zip to help with gripping the tab and make zipping easier.
Don’t forget to give plenty of praise to your child for their efforts at each stage and consider using a star chart to help them establish their routine.
Sensory and developmental issues
If your child is sensitive to clothing consider how to reduce their sensory triggers .
Check for labels and seams that might cause irritation and cut them out where possible. Wash clothes several times before wearing to help soften them.
The Sensory Smart Store started by a mum of an autistic boy with sensory processing disorder has a great range of clothes to help sensitive and sensory children and adults. Whilst EcoOutfitters offer school clothing made from 100% pure organic cotton.
Dressing in front of a mirror provides important visual cues that can help a child with sequencing, body planning and body awareness. If your child continues to have difficulty with dressing, a qualified occupational therapist should be able to help.
Have you any tips or experiences to share about teaching dressing skills? We’d love to hear from you in the comments below.
This year’s World Autism Awareness Week takes place against the backdrop of a global pandemic. With a third of the global population under lockdown our daily lives have been dramatically changed. Forced to remain in our houses and adapt to new circumstances, many of us will be feeling bewildered, frustrated and anxious.
Sweating it out!
The anxiety many of us are now experiencing around these unprecedented changes gives us an insight into how many young people with autism, like my son Tom, experience an unwanted change of plan – it’s fraught with worry, it’s out of anything we could have predicted and it’s not what we wanted.
Our ‘new normal’ in these strange and unsettling times is very much how he feels all the time. Imagine having to deal with that level of anxiety every single day!
So, given everyone’s heightened levels of anxiety how can you manage autism and anxiety in a lockdown?
We’d like to share some daily strategies which we are using to support Tom’s mental health during this lockdown period. We’ve called it the SWEAT approach – let’s sweat this one out!
Socialise – maintain social connections
Tom misses his dad, grandparents and college friends. Thankfully technology makes it relatively easy to keep connected. However, just as in normal social situations, we’re careful not to put demands on him to socialise virtually either. We offer him a choice of how he stays connected and how often he wants to have contact.
Work – provide structure and routine
Routines and rituals help establish stability and order for children and young people with autism like Tom.
Like many young people with autism Tom struggles with flexible thinking. That means he finds it difficult to adjust and readjust to changes in his routine and this can cause him anxiety. A useful strategy has been to highlight what has stayed the same and what has changed. This reassures him that even with all the uncertainty some things, like his college work, mealtimes and bedtime routines, remain the same.
Keeping familiar routines going as much as possible is therefore important to provide structure and reassurance. Tom accesses his college work and sessions with his speech therapist, English tutor and German teacher online. A simple written visual schedule shows him what to expect each day and can help navigate these confusing times. You can also create symbol-based home visual schedules quickly and easily with TomTag.
However, it’s important not to set the bar to high! Be mindful that there will be days when the ‘home-schooling’ isn’t done and instead it is just a day of being together. An example of this was during the recent warm weather when we abandoned the schedule and went for a family walk.
Emotions – share worries and concerns
Set aside time each day to talk about worries and concerns. Try to contain your own anxieties around the current situation because this anxiety gets transferred to our children. Now more than ever our autistic children need patience and support from the people they love.
Tom, like all of us, is naturally worried about events and this is amplified by worries about whether he is catching or spreading the disease.
We keep news coverage to a minimum and explain things in a clear and consistent manner using language appropriate to his level of understanding.
Making a wish list, where we write down all the things we want to do after the pandemic has passed, is also working well – though at the moment, it mostly revolves around football and Swiss trains!
Active – encourage physical activities
Keeping active is good for both our physical and mental well being. Tom has a daily fitness programme and he’s set up an exercise challenge with his speech therapist.
Focusing on activities and encouraging him to do some chores – like washing the car and helping his sister deliver essential shopping to his self-isolating grandparents and other vulnerable members of the community – provides positive reinforcement that is so vital to keep up his self-esteem, confidence and sense of purpose.
Time alone – relax with special interests
Build in lots of down time, together with time to indulge special interests. With all the family thrust together it’s important for mental well being that we all carve out some time for ourselves.
It’s a difficult time for all of us particularly for children with autism and anxiety. Hopefully by following these strategies we can sweat out this lockdown period.
What tips can you share that make this lockdown period more manageable and less stressful in your house?
Depending on your child’s developmental age, sit down each evening and try and plan out a rough schedule for the next day. Decide which activities for the day or part of the day you want to show. Choose the length of the schedule that you think will be appropriate for your child and adjust as necessary.
A simple daily visual schedule could include some education, fun activities and chill time (for them and you!) to help give some meaning and purpose to the day. If you’re interested in creating or using educational resources have a look at Twinkl and Education.com.
Try to replicate some elements of your child’s typical day. For example, encourage them to get dressed, brush their teeth, eat breakfast, etc. You could use a mini schedule to target these specific skills by breaking down a single activity into smaller steps.
Make sure the schedule includes things like bedtime, time for exercise and meals. You could also consider giving children a chore or job to do to help them feel useful. This could be as simple as clearing the table or putting away their clothes.
Setting aside time every day to do a family activity that you know helps everyone in times of stress is also important. This could be watching a movie or playing a game.
Worried about challenging behaviour?
Try starting with activities that your child usually does willingly. It makes sense to structure the day so that harder tasks are done first when children are likely to be more rested. After schoolwork or chores are complete you can follow with easier tasks as a reward for accomplishing the harder tasks.
A home visual timetable or schedule doesn’t have to be complicated– a simple written, maybe colour-coded, chart pinned on the wall so your children can see it and refer to it will do the trick.
With this month playing host to Safer Internet Day we’ve some tips on helping our kids stay safe in the home, looking at both online and physical safety.
With an almost daily diet of stories about the negative impact of the internet and new technology on children and young people, it’s easy to forget the positive aspects: the ability to learn, to connect with others, to be creative.
Safer Internet Day (February 11th) offers an ideal opportunity for parents and carers to start a conversation with their children about online safety. By teaching children to understand and navigate the risks you can help them to have a safer and more positive experience online.
Start by reading these tips for parents from the UK Safer Internet Centre and explore the many other fantastic resources on the site.
This article from the Guardian takes a interesting look at how the internet can be a great learning tool and includes some really simple ideas for changing how we approach our children’s use of it.
Drawing up a family agreement that all the family sign up to is a useful way to help everyone make better decisions and display appropriate behaviour. Here’s a great example from Digizen.org.
You can also find a wealth of information and advice on the subject from CEOP’s ThinkuKnow website.
Safe at home
Of course, we’ve all been consciously protecting our children from harm from the moment they were born but we have a responsibility to teach them the skills to keep themselves safe too.
Talking about potential dangers as part of everyday conversation and using games to teach what to do will really help to prepare your child for emergency situations without scaring them.
Play the ‘What if’ game
What if … the smoke alarm sounded?
What if … you cut yourself badly?
What if … someone came to the house when no-one else was home?
You’ll get a feel for how your child would react in a real emergency and can guide them to how they might deal with it.
Using some of the blank stickers you’ll find in each TomTag sticker pack, draw or write a list of safety rules and apply each sticker to a blank button. Put the buttons into a TomTag holder and hang or stick it up (eg. on the fridge) where it will be seen every day.
Hold a scavenger hunt
Once you’ve played the What If game and discussed ideas about how to deal with different situations, does everyone in the house know where to find the things they might need to deal with an emergency? Where’s the first-aid kit, keys to open doors, fire blanket, emergency phone numbers? Give each child a TomTag with some items on it that they need to find and let them race to be the first to find everything on their list.
Teach your child how to use what’s in the first aid kit too to treat minor injuries. The British Red Cross have a great web resource to help children aged 6-11 learn life saving first aid.
Make an escape plan
Every household should have an emergency escape plan in case of fire. Hopefully you will never need to use it but having a plan will prevent delay and help you to escape faster if you need to. Anyone can ask for a free Home Fire Safety Check from their local fire service.
Don’t forget that a weekly test of your smoke alarm is the simplest and easiest way to help prevent fire emergencies.
Give your child a clip-board and pen and let them pretend to be a safety inspector. Ask them to look around the house for safety features and hazards and let them help you fix any deficiencies.
Know your numbers
Make sure everyone knows the number for emergency services and try role-playing a call so that they know what they might be asked.
Teach children their home address and telephone number so that they can give it if they need to call the emergency services (also useful if they get lost when out of the house!).
Keep a list of names and numbers of friends, neighbours, family doctor, etc. by the door or telephone in case of emergencies, particularly if your child is old enough to be left at home alone.
Dyslexia is most commonly understood as a condition that causes difficulties with reading. It is less well known that dyslexia can also impact on organisation and time management skills, which is sometimes referred to as executive functioning.
What are the signs?
A child with dyslexia who has executive functioning issues may have difficulty:
remembering to take to school everything they need for the day
being organised and preparing their kit in advance
sticking with an activity and not being distracted
understanding what day of the week it is and what different things they need to do each day
remembering their routine and prioritising the tasks needed to get ready for school
What can you do to help?
There’s lots you can do to help a child with these issues. Here’s just a few ideas:
Get into a regular routine and stick to it. Children who struggle with time management often feel more secure and less anxious with a familiar routine.
Make checklists to break down a task or routine into smaller steps. Visual prompts work better than verbal reminders as they are constant and consistent.
Use calendars and planners – colour-coding often works really way to identify regular activities and highlight special events.
Encourage development of organisational skills with lots of repetition, reminders and practice.
How could TomTag help?
TomTag is ideal for all children with dyslexia as the picture symbols we use are easily recognisable and don’t rely on a child’s ability to read for TomTag to be effective.
Make morning and evening routine reminders for tasks that need to be completed and the order they should be done using an I know what to expect – morning and evening minikit or for more varied options try these kits I can do it self care skills or I know what to expect at home
Create a school bag packing checklist using the I can do it pack my bag for school kit that will remind them exactly what they need to take to school each day, and bring home again.
Take advantage of TomTag’s colourful tags by colour-coordinating checklist and routine reminder tags with any planners, calendars or charts that you’re also using.
It’s often the simplest things that have the biggest impact.
A seemingly simple thing that gets forgotten, ignored or left unnoticed can cause a big problem down the line. Simple ideas, simple tools, simple changes might be all that’s needed to solve a problem or do a better job than a complex solution.
A Share how I feel tag, with its thermometer-style colour faces scale, has to be one of the simplest uses for the TomTag system but since introducing it less than nine months ago has become our best selling product. It can be used in lots of different ways which is perhaps one of the keys to it’s success – we’ve given some ideas in this free download guide.
Having recommended in our guide that using a feelings diary can help to identify patterns of emotions or behaviour and the triggers that could be causing them, we decided to make our own!
My TomTag Feelings Notebook
Keeping a diary gets you into the habit of noticing and naming how you feel in different situations throughout the day or at times when you feel most anxious or worried.
There’s a scale for rating the strength of your feelings and a guide to help build up a vocabulary to describe your different feelings and emotions.
By making notes about what happened during the day or at key points you can start to build up a picture over time which helps you to see patterns and identify the common triggers or stressors. Quite often these might be simple things that go unnoticed day to day but are easier to spot once patterns emerge.
It’s often the simplest things that have the biggest impact.