Caregiver-implemented toilet training procedures for children with autism spectrum disorder

Children with Autism Spectrum Disorder often exhibit deficits in daily living skills, including toileting skills. Previous studies have evaluated components of common toilet training practices, including differential reinforcement, sit schedules, fluid loading, underwear, and wet alarms. The purpose of this study was to replicate and extend previous work by delivering all coaching remotely. Three caregiver-child dyads participated in this study. A researcher coached caregivers on the implementation of the protocol using a modified behavioral skills training approach via telehealth. Caregivers submitted daily toileting data and weekly audio recordings for treatment integrity checks. The sit schedule fading was individualized to meet the needs and preferences of each family. All caregivers implemented the protocol with high integrity. Two participants met the mastery criteria at the 90-min sit schedule and maintained performance at the 1- and 6-week maintenance follow up probes. The third participant, despite an interruption of treatment, also reached mastery.