Intensive Toilet Training

Before beginning intensive massed practice toileting, ensure that your child is ready for potty training. Your child should have some bowel control, indicated by extended periods of dryness and should be willing to sit on the toilet. Intensive toilet training is a technique that can be used for most children, with and without disabilities. It is sometimes called massed practice or the Azrin technique. For typically developing children, a variation is also called “Potty training in a day”. Intensive toilet training for young children with disabilities takes several days and your full devotion. It requires you and the child to remain close to the restroom for the entire period and the training should not be interrupted for any reason. Be sure that you have no other obligations for the training period. Intensive toilet training involves increasing your child’s liquid intake, frequent trips to the potty, and following a standard set of procedures for successes and accidents.EBIP_toilet training_1

Before beginning, you should collect the following materials:

  1. Data collection sheet
  2. Timer
  3. Salty snacks (pretzels, popcorn, crackers)
  4. Your child’s favorite drinks (water, juice)
  5. Reinforcers (identified by PA-videos, candy, toy)
  6. Lots of extra underwear, clean clothes

The following steps are for prepping your toilet training sessions:

  1. Place your child in underwear and pants that are easy to pull up and down
  2. One hour before the first toilet session, give your child one cup of a moderately preferred drink
  3. 30 minutes the first toilet session, allow the child to drink up to a cup of a moderately preferred drink
  4. Right before the first session, allow him or her to again drink more liquid
  5. If at any time the child refuses a drink, do not force them, but have it available to consume at any time.

Now your child is ready to begin. The follow steps will inform you how to conduct the training:

  1. EBIP_toilet training_15Have child sit on toilet for 5-10 minutes
  2. If the child urinates, praise the child and provide high quality reinforcement. Remember that this should be a highly preferred item or activity that is only given for potty successes. If it is a food, allow them to finish it. If it is an item or activity, set a timer for 2 minutes and end the activity when the timer sounds.
  3. If child does not go, say “Remember we go pee in the potty” and allow them to get off after the sit time is over
  4. Check child every 5 min for dryness, set a timer! Give praise for being dry. Keep the child near the toileting area. For example, set up a chair in the bathroom or right outside the bathroom and stay with him or her there. Feel free to engage with the child with moderately preferred toys.
  5. Allow the child to have free access to liquids and salty snacks, which will make them thirsty.
  6. Bring child to the toilet every 15-20 minutes for 5-10 minutes. And repeat the previous mentioned steps. Make sure to record the data for each dry check and potty sit.

If at any time the child has an accident, use the following corrective procedure:

  1. Say “No wet pants”/”We don’t pee in our pants”
  2. Have child sit remove soiled clothes and put on clean clothes
  3. If child refuses to remove clothes, use graduated guidance to assist them. Gently use hand over hand prompting to assist them, and make moment to moment decisions as to how much help the child needs.
  4. Continue to check the child every 5 minutes for dryness and provide fluid and snacks when off the toilet
  5. Continue the routine and take the child to the potty every 15-20 minutes

The following are some general guidelines you may find helpful during the procedure:

  • If the child refuses to sit on the potty, place gentle pressure on their shoulders
    to still them. Remind them, “If you go pee in the potty, you can get off.”
  • Remain close to the restroom for the entire day.
  • Continue intensive training until the end of the day, then place child in diapers for bedtime and continue with intensive training the next day.
  • When the child has a success, increase the amount off of the toilet by 5 minutes. After another success, increase it again by 5 minutes. Do this until the “off” time is about two hours, or until the training is complete
  • Toilet training is considered complete when a child has three successes with no accidents between AND when they initiate using the toilet with success, without prompting.

Considerations:EBIP_toilet training_2

Intensive toileting takes time and space. If you choose this practice, ensure that youand your child have no concurrent activities that would impede you from carrying out the training. Even meals should be given near the restroom. During this intervention, your child may exhibit some resistance, especially in the beginning of the training. You should always remain calm, and carry out the intervention as planned, unless you deem it unsafe for the child. The practice has been successful for a variety of children and is considered the fastest way to potty train a child.

Data Sheet:
Intensive Toilet Training: Data Sheet

To cite this page (APA 6th edition):

  • Harbin, E.R., Ledford, J.R., & Chazin, K.T. (2016). Intensive toilet training. In Evidence-based instructional practices for young children with autism and other disabilities. Retrieved from http://vkc.mc.vanderbilt.edu/ebip/intensive-toilet-training