Autism and Continence Care | Toilet Training for Autistic Children

Posted by Will 01/07/2016 9 Comment(s) Kids,


Common Issues with Toilet Training and Children with Autism


Many parents of children with an Autistic Spectrum Condition (ASC) encounter challenges with toilet training. While every child learns to use the toilet at a different time, it can take longer for children with an ASC such as Asperger’s Syndrome.

While it’s not uncommon for these children to get there at a later age, there are sometimes certain difficulties that make the process harder for everyone involved. A good understanding of these points might help people understand and tackle the problem better.

We have lots of customers with autistic kids still in nappies, so it makes sense for us to try to offer some useful advice that we have picked up from parents we have spoken to.


Why Are Some Children With ASC Harder To Toilet Train?

Common Problems With Toilet Training ASC Kids:

  • Soiling
  • Smearing
  • Constipation or Withholding
  • Fear of using the toilet or different toilets
  • Bedwetting or daytime wetting


The immediate needs of a child with autism have an impact on their desire to toilet train. By this I don’t mean the care they require, but rather their desire and motivation. This child is likely to have different social priorities to other children. He or she may often have trouble both communicating that they need the toilet and having the importance of proper toileting communicated to them.

They also might not understand the social impact of soiling on those around them and why others would be unhappy with this type of behaviour.

An aspect of toilet training a child with autism that can be especially challenging to cope with is the smearing of faeces. Due to the difficulty with discussing the issue that some carers face, it is easy to see why some can feel very isolated. The sensory experience associated with smearing is something that can be redirected (for example with finger paints), but it is also possible that the child does not fully understand the need to use toilet paper.


Toilet Training Autistic Children


By paying careful attention to your child’s behaviour you can go a long way towards helping them feel more comfortable with the process of using the toilet. This might involve avoiding things that cause distress; desensitizing the toileting process or building on the security they feel through the following of a consistent routine.

This desire for a routine can be an important aspect to focus on, as it can also be used to make using the toilet fun. By combining familiar and enjoyable things with the learning process, and using careful communication such as clear visual cues, toilet training can go much more smoothly.

Unfortunately there are instances where the process can take much longer, and, depending on the level of severity that a child with an ASC is experiencing, they may never achieve full continence.

This makes the cases we have been hearing lately about the rationing of incontinence products on the NHS all the more alarming.


Getting Help With Continence Care


As always the best person to advise on your child's development will be a healthcare professional. But we know that sometimes it's not easy to get the help you need.

Incontinence of any degree can have a severe impact on a sufferer’s quality of life, and can have serious consequences on the social development of people such as children with an ASC.

You Aren't Alone - It's Not Just ASC

Bladder control problems affect around 14 million people in the UK

Bowel control problems affect around 6.5 million

Although a large number of incontinence cases are extremely treatable (and often completely resolvable), we are seeing a trend towards cutbacks in both staffing and resources such as nappies and pads.

With fewer high level continence specialists and less money for necessary products, we are seeing damage to healthcare staff morale, as well as patients supplementing incontinence products from their own pockets or in some cases completely self funding their usage because the NHS provision is not adequate.

Couple this with an ever-increasing number of patients seeking help because they refuse to suffer in silence any longer, and you are left with failures in the incontinence product supply that, as it is often determined by local policy, has created a postcode lottery that is failing many people (sufferers and carers alike).

Many providers do not even support what they deem to be “light” incontinence, although in some cases this does not matter as the supply of products is often regulated by their budget rather than what people need.


Nappies For Autistic Children


We have written a blog post about how to get free nappies here.

As we mentioned earlier, in many cases you won't need to use nappies for long as ASC children can usually be toilet trained, but it might take a little longer. In some cases ASC people will need to use nappies into adulthood.

This can be expensive if you are buying them privately, but the NHS can supply products for free in many cases.

Your local Continence Service might not be able to help because of the elligibility criteria, or the inflexibility of the continence service in the products they can supply.

The product you choose will depend on your child. Some children have very sensitive skin that will come out in a rash when certain products are used. Other children can be sensititve to noise, so a product with a crinkly plastic backing wouldn't be suitable. 

We can advise on the best product for your child if you call us on 01636 30 20 50 or email us using the link at the top of the page.


Buying Nappies for Autistic Kids from a Private Company


The reason that people buy from us is that we can offer good advice and set you up with the right product for your child.

The nappies we usually supply are extra small sized adult nappies, extra small sized adult pull-up pants, extra large size baby nappies and small size adult nappies.


Recommended Products


If you need the most absorbent product try MoliCare® Super Plus (age 9+).

If you want a nappy that's like Pampers but bigger, try Libero® Size 7

If size 7 is too small, try Abena® Abri-Form Junior XS2 or MoliCare XS


Age2 – 33 – 44 – 55 – 66 – 77 – 88 – 99 – 1010 – 1111 – 1212 – 1313 – 1414 – 1515 – 16
Waist (cm)5253.5555657586062636465.5677175
Waist (inches)20.52121.52222.52323.524.5252525.526.52829.5
Weight (Kg)11.5-13kg15kg17kg20kg22.5kg25kg28kg30kg34kg38kg43kg48kg52kg57kg
Most Suitable Nappy

Libero® Size 7

Abena® Abri-Form Junior XS2 (next size up from Libero Size 7)

MoliCare® Soft Extra Small (more absorbent than Abri-Form Junior)

Size Small Adult Nappies

9 Comment(s)

Gaynor collinson:
16/04/2019, 01:09:03 AM

Hi am looking for nappies for my 5 year old daughter who is autistic am finding it hard to get nappies to fit and to keep her dry on a night anyone help me please x

16/04/2019, 08:10:13 AM

Hi Gaynor - We've sent you an email. The most suitable nappies for a five year old would probably be the Abena Abri Form Junior XS2 - They should be a great fit.

Let us know if you'd like to try a sample!

lisa carter:
01/11/2017, 09:31:01 AM

hiya my 8 year old son is autisic and adhd he wears size 8+ but is now growing out of them and i can not find a larger size to fit him what do you recommend please

16/04/2019, 08:13:57 AM

Hi Lisa - The best nappies for an 8 year old would be either XS sizes or adult size small, depending on his size.

For a good general nappy the Abena Abri Form Junior XS2 is a good choice, however it may be a little small. For Adult Size Small nappies there are lots of choices depending on what you need.

For daytime the Abena Abri Form S2 is quite discreet but has a high capacity.

For over night you can try the same nappy but in S4 absorbency, which is a bit thicker, or for ultimate protection we would recommend the MoliCare Slip Maxi Small - this is a fully plastic backed nappy with extremely high absorbency so probably not ideal for daytime use but very effective for over night.

Give us a shout if you would like to try a sample or explore other options!

Helen fox:
28/01/2017, 12:29:06 AM

Hi, my daughter has issues with normal pull-ups saying they are tight and don't fit properly,do you have a size 7 that is softer than regular pull-ups please? What price are they? Thanks Helen

16/04/2019, 08:16:29 AM

Hi Helen - It really depends on the size of your daughter, but we do have a special Extra Small adult pull-up which will be a pretty good fit for most kids between age 6 and 12. It has super soft elastic waistbands and good capacity. The only issue is that it's much thicker than normal supermarket pull-ups so isn't suitable for smaller kids (it will look silly, too bulky, a bit too big). For older kids though it's ideal! You can see the product here:

MoliCare Mobile Children's Pull-ups

Please let us know if you would like to try a sample.

How To Potty Train An Autistic Child:
06/01/2017, 11:58:42 AM

In many cases, the condition is actually more debilitating for adults “because what you do as an adult has more severe consequences,” explains Almagor. “If you punch someone in grade two, your parents are going to work with you to stop that, but if you say something impulsively as an adult, you could lose your job.”

julie dunn:
11/07/2016, 09:20:13 AM

hi am looking for nappies for my 9 year old son with asd could you please help and also would we be able to get support with buying these as we are on benefits

11/07/2016, 12:25:42 PM

Hi JulieThe best choice of nappies for a 9 year old would probably be MoliCare Maxi Small or Abena Abri Form Junior XS2 (although they might be a little tight).Unfortunately we can't offer you any support with buying them but your GP should be able to get you a referral to your local continence team to arrange free supply, however the nappies you get from the local authority may not be as good or suitable as the ones we sell.Here is a link to the molicare maxi: for commenting!

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