Toilet training individuals with developmental delays: A comprehensive review
Acquisition of toileting skills is of vital significance for children with developmental disabilities (DD) because individuals with DD are often delayed in or fail acquiring these skills. The purpose of the study is to comprehensively review the studies demonstrating the effectiveness of toilet training for children with DD between 2009 and 2019. In this literature search, four databases (ScienceDirect, EBSCOhost, Wiley Online Library and SpringerLink) were searched by using eight keywords and a total of 1360 studies were identified. The studies were evaluated in terms of eligibility criteria and 23 studies were included in the review. Authors examined the studies by the demographic, methodological and outcome characteristics. The review highlighted that toilet training programs, packages or protocols are developed according to researchers’ preferences and participant characteristics, as such, there is still no agreement on a common toileting program in literature. Directions for future research are also discussed.
Ardic, A., & Cavkaytar, A. (2014). Effectiveness of the modified intensive toilet train-ing method on teaching toilet skills to children with autism. Education and Training in Autism and Developmental Disabilities, 49(2), 263-276.
Axelrod, M. I., Tornehl, M., & Fontanini-Axelrod, A. (2016). Co-occurring autism and intellectual disability: A treatment for encopresis using a behavioral intervention plus laxative across settings. Clinical Practice in Pediatric Psychology, 4(1), 1. doi: http://dx.doi.org/10.1037/cpp0000131
Brown, F. J., & Peace, N. (2011). Teaching a child with challenging behavior to use the toilet: a clinical case study. British Journal of Learning Disabilities, 39(4), 321-326. doi: https://doi.org/10.1111/j.1468-3156.2011.00676.x
Byra, K. L., White, S., Temple, M., & Cameron, M. J. (2018). An Approach to Cleanliness Training to Support Bathroom Hygiene among Children with Autism Spectrum Disorder. Behavior Analysis in Practice, 11(2), 139-143. doi: https://doi.org/10.1007/s40617-017-0205-9
Call, N. A., Mevers, J. L., McElhanon, B. O., & Scheithauer, M. C. (2017). A multidisciplinary treatment for encopresis in children with developmental disabilities. Journal of Applied Behavior Analysis, 50(2), 332-344. doi: https://doi.org/10.1002/jaba.379
Carr, J. E., Austin, J. L., Britton, L. N., Kellum, K. K., & Bailey, J. S. (1999). An assessment of social validity trends in applied behavior analysis. Behavioral Interventions: Theory & Practice in Residential & Community‐Based Clinical Programs, 14(4), 223-231.
Chang, Y. J., Lee, M. Y., Chou, L. D., Chen, S. F., & Chen, Y. C. (2011). A mobile wetness detection system enabling teachers to toilet train children with intellectual disabilities in a public-school setting. Journal of Developmental and Physical Disabili-ties, 23(6), 527-533. doi: https://doi.org/10.1007/s10882-011-9243-3
Cicero, F. R., & Pfadt, A. (2002). Investigation of a reinforcement-based toilet training procedure for children with autism. Research in Developmental Disabilities, 23(5), 319-331. doi: https://dx.doi.org/10.1016/S0891-4222(02)00136-1
Cocchiola, M. A., Martino, G. M., Dwyer, L. J., & Demezzo, K. (2012). Toilet training children with autism and developmental delays: An effective program for school set-tings. Behavior Analysis in Practice, 5(2), 60-64.
Cox, D. J., Morris Jr, J. B., Borowitz, S. M., & Sutphen, J. L. (2002). Psychological differences between children with and without chronic encopresis. Journal of Pediatric Psychology, 27(7), 585-591. doi: https://doi.org/10.1093/jpepsy/27.7.585
Dalrymple, N. J., & Ruble, L. A. (1992). Toilet training and behaviors of people with autism: Parent views. Journal of Autism and Developmental Disorders, 22(2), 265-275. doi: https://doi.org/10.1007/BF01058155
Doan, D., & Toussaint, K. A. (2017). A parent-oriented approach to rapid toilet training. International Electronic Journal of Elementary Education, 9(2), 473-486.
Drysdale, B., Lee, C. Y. Q., Anderson, A., & Moore, D. W. (2015). Using video modeling incorporating animation to teach toileting to two children with autism spectrum dis-order. Journal of Developmental and Physical Disabilities, 27(2), 149-165. doi: https://doi.org/10.1007/s10882-014-9405-1
Francis, K., Mannion, A., & Leader, G. (2017). The assessment and treatment of toileting difficulties in individuals with autism spectrum disorder and other developmental disabilities. Review Journal of Autism and Developmental Disorders, 4(3), 190-204. doi: https://doi.org/10.1007/s40489-017-0107-3
Greer, B. D., Neidert, P. L., & Dozier, C. L. (2016). A component analysis of toilet‐training procedures recommended for young children. Journal of Applied Behavior Analysis, 49(1), 69-84. doi: https://doi.org/10.1002/jaba.275
Holcombe, A., Wolery, M., & Gast, D. L. (1994). Comparative single-subject research: Description of designs and discussion of problems. Topics in Early Childhood Special Education, 14(1), 119-145. doi: https://doi.org/10.1177/027112149401400111
Henriksen, N., & Peterson, S. (2013). Behavioral treatment of bedwetting in an adolescent with autism. Journal of Developmental and Physical Disabilities, 25(3), 313-323. doi: https://doi.org/10.1007/s10882-012-9308-y
Hyams, G., McCoull, K., Smith, P. S., & Tyrer, S. P. (1992). Behavioural continence training in mental handicap: a 10‐year follow‐up study. Journal of Intellectual Disability Research, 36(6), 551-558. doi: https://doi.org/10.1111/j.1365-2788.1992.tb00573.x
Joinson, C., Heron, J., Butler, U., von Gontard, A., & Avon Longitudinal Study of Parents and Children Study Team. (2006). Psychological differences between children with and without soiling problems. Pediatrics, 117(5), 1575-1584.
Keen, D., Brannigan, K. L., & Cuskelly, M. (2007). Toilet training for children with autism: The effects of video modeling. Journal of Developmental and Physical Disabili-ties, 19(4), 291-303. doi: https://doi.org/10.1007/s10882-007-9044-x
Kircaali-Iftar, G., Ulke-Kurkcuoglu, B. & Kurt, O. (2014). Otistik çocuklar için davranışsal eğitim programı II (OCIDEP) [Behavioral Intervention for Autistic Children I]. Ankara: Anı Yayıncılık.
Kircaali-Iftar, G., Ulke-Kurkcuoglu, B., Cetin, O., & Unlu, E. (2009). Intensive daytime toilet training of two children with autism: Implementing and monitoring systematically guarantees success!. International Journal of Early Childhood Special Education, 1(2), 117-126.
Kroeger, K. A., & Sorensen-Burnworth, R. (2009). Toilet training individuals with autism and other developmental disabilities: A critical review. Research in Autism Spectrum Disorders, 3(3), 607-618. doi: https://doi.org/10.1016/j.rasd.2009.01.005
Kroeger, K., & Sorensen, R. (2010). A parent training model for toilet training children with autism. Journal of Intellectual Disability Research, 54(6), 556-567. doi: https://doi.org/10.1111/j.1365-2788.2010.01286.x
Kurniawan, R., Purnamasari, W. M., Rakhmawati, R., & Jalaputra, D. P. E. (2018). Development of Game for Self-Help Toilet Learning for Children with Autism. CommIT (Communication and Information Technology) Journal, 12(1), 1-12.
Leader, G., Francis, K., Mannion, A., & Chen, J. (2018). Toileting Problems in Children and Adolescents with Parent-Reported Diagnoses of Autism Spectrum Disor-der. Journal of Developmental and Physical Disabilities, 30(3), 307-327. doi: https://doi.org/10.1007/S10882-018-9587-Z
Lee, C. Y. Q., Anderson, A., & Moore, D. W. (2014). Using video modeling to toilet train a child with autism. Journal of Developmental and Physical Disabilities, 26(2), 123-134. doi: https://doi.org/10.1007/s10882-013-9348-y
Levato, L. E., Aponte, C. A., Wilkins, J., Travis, R., Aiello, R., Zanibbi, K., ... & Mruzek, D. W. (2016). Use of urine alarms in toilet training children with intellectual and developmental disabilities: A review. Research in developmental disabilities, 53, 232-241. doi: https://doi.org/10.1016/j.ridd.2016.02.007
Lott, J. D., & Kroeger, K. A. (2004). Self-help skills in persons with mental retardation. Behavior modification for persons with developmental disabilities: Treatment and supports, 2, 33-63.
Mannion, A., & Leader, G. (2013). Comorbidity in autism spectrum disorder: A literature review. Research in Autism Spectrum Disorders, 7(12), 1595-1616. doi: https://doi.org/10.1016/j.rasd.2013.09.006
Matson, J. L., Horovitz, M., & Sipes, M. (2011). Characteristics of individuals with toileting problems and intellectual disability using the Profile of Toileting Issues (PO-TI). Journal of Mental Health Research in Intellectual Disabilities, 4(1), 53-63. doi: https://doi.org/10.1080/19315864.2010.531443
McLay, L., Carnett, A., Van Der Meer, L., & Lang, R. (2015). Using a video modeling-based intervention package to toilet train two children with autism. Journal of develop-mental and physical disabilities, 27(4), 431-451. doi: https://doi.org/10.1007/s10882-015-9426-4
Mruzek, D. W., McAleavey, S., Engel, S., & Smith, T. (2016). A novel enuresis alarm for toilet training students with intellectual disability: an initial evaluation in a school setting. Journal of Special Education Technology, 31(4), 217-227. doi: https://doi.org/10.1177/0162643416673915
Ohtake, Y., Takahashi, A., & Watanabe, K. (2015). Using an animated cartoon hero in video instruction to improve bathroom-related skills of a student with autism spectrum disorder. Education and Training in Autism and Developmental Disabilities, 50(3), 343-355.
Ozcan, N., & Cavkaytar, A. (2009). Parents as teachers: Teaching parents how to teach toilet skills to their children with autism and mental retardation. Education and Training in Developmental Disabilities, 44(2), 237-243.
Ozkubat, U., & Toret, G. (2014). Zihinsel Yetersizliği Olan Çocuklara Gündüz Tuvalet Kontrolü Becerisi Öğretiminde Anneleri Tarafından Sunulan Geleneksel Gündüz Tu-valet Kontrolü Öğretimin Etkililiği (Effectiveness of a Toilet Training Program for Children with Intellectual Disabilities Provided by Their Mothers). Pamukkale Üniversitesi Eğitim Fakültesi Dergisi, 35(35), 61-84.
Rinald, K., & Mirenda, P. (2012). Effectiveness of a modified rapid toilet training workshop for parents of children with developmental disabilities. Research in Develop-mental Disabilities, 33(3), 933-943. doi: https://doi.org/10.1016/j.ridd.2012.01.003
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 921-929. doi: https://doi.org/10.1097/CHI.0b013e318179964f
Sonmez, N., & Aykut, Ç. (2011). Using mother delivered simultaneous prompting for teaching independent toileting skills to a child with developmental disability. Journal of Human Sciences, 8(1), 1151-1171.
Suppo, J. L., & Mayton, M. R. (2012). A portable potty plan for children with autism. Young Exceptional Children, 15(4), 3-16. doi: https://doi.org/10.1177/1096250612451758
Sutherland, J., Carnett, A., van der Meer, L., Waddington, H., Bravo, A., & McLay, L. (2017). Intensive toilet training targeting defecation for a child with Autism Spectrum Disorder. Research and Practice in Intellectual and Developmental Disabilities, 5(1), 87-97. doi: https://doi.org/10.1080/23297018.2017.1360153
Szyndler, J. (1996). Toileting problems in a group of children with autism. Child Psy-chology and Psychiatry Review, 1(1), 19-25. doi: https://doi.org/10.1111/j.1475-3588.1996.tb00004.x
Unlu, E. (2019). Parent implemented program for teaching toileting skills for children with developmental disabilities. International Journal of Early Childhood Special Edu-cation, 11(2), 92-104. doi: https://doi.org/10.20489/intjecse.640348
Van Der Wal, M. F., Benninga, M. A., & Hirasing, R. A. (2005). The prevalence of en-copresis in a multicultural population. Journal of Pediatric Gastroenterology and Nutri-tion, 40(3), 345-348. doi: https://doi.org/10.1097/01.MPG.0000149964.77418.27
Van Oorsouw, W. M., Duker, P. C., Melein, L., & Averink, M. (2009). Long-term effectiveness of the response restriction method for establishing diurnal bladder con-trol. Research in Developmental Disabilities, 30(6), 1388-1393. doi: https://doi.org/10.1016/j.ridd.2009.06.006
Wolery, M., Ault, M. J., & Doyle, P. M. (1992). Teaching students with moderate to severe disabilities: Use of response prompting strategies. Longman Publishing Group.
Copyright (c) 2020 International Journal of Early Childhood Special Education
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
I accept that the Owner of International Journal of Early Childhood Special Education, the Editor, Associate Editors, Reviewers and the Editorial Board cannot be hold responsible regarding the scope, the findings, the discussion and conclusion of the manuscript submitted.
I declare to the editorship of International Journal of Early Childhood Special Education that the manuscript is original and has not been published anywhere else or is not under evaluation process for any other journal.
I approve that I grant International Journal of Early Childhood Special Education as the sole and exclusive right and license to publish for the full legal term of copyright of my manuscript concurring with article 5846 / 22-23-25 while I retain copyright in the work.