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| Extensions of Reinforcement-Based Approaches to Toilet Training |
| Monday, May 26, 2025 |
| 9:00 AM–9:50 AM |
| Marriott Marquis, M4 Level, Independence E-H |
| Area: AUT/DDA; Domain: Applied Research |
| Chair: Brandon C. Perez (Northern Illinois University) |
| Discussant: Maeve G. Donnelly (Northeastern University) |
| CE Instructor: Brandon C. Perez, Ph.D. |
| Abstract: Reinforcement-based approaches to toilet training have been evaluated in the literature over the last decade (Greer et al., 2016; Perez et al., 2020). Current approaches to toilet training have focused primarily of treatment packages consisting of a) underwear, b) sit schedule manipulations, and c) differential reinforcement. Further research is warranted on the effects of these component-lean treatment packages on relevant toilet training dependent variables (e.g., urinations, bowel movements, self-initiations, and challenging behaviors) especially in other settings and with different populations. The first study extended the literature by evaluating a drop-out component analysis and examining the effects on self-initiations, specifically when the sit schedule component was removed. The second study extended the literature by replicating the Perez et al. (2020) study in a therapeutic day school with older individuals and using least-to-most prompting to target self-initiations. These two studies together progress the existing toilet training literature and provide recommendations for providers and researchers working in this area. |
| Instruction Level: Basic |
| Keyword(s): Reinforcement, Self-Initiations, Toilet Training |
| Target Audience: N/A |
Learning Objectives: 1. Identify and define the main dependent variables targeted in toilet training research.
2. Describe the common components involved in most toilet training treatment packages.
3. Describe strategies for increasing self-initiations during toilet training. |
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Evaluating the Effects of Sit Schedules on Toileting Events With Children on the Autism Spectrum |
| JOANNE LI (University of Miami), Janelle Kirstie Bacotti (University of Miami), Yanerys Leon (University of Miami) |
| Abstract: Multi-component toilet training packages and procedures for toilet sit schedule thinning often establish and maintain urinary continence (Greer et al., 2016; Perez et al., 2020). Monitoring the rate and correspondence between urinations and self-initiations (SIs) can inform decision making for toileting independence (Perez et al., 2021). This study recruited children who previously experienced a multi-component toilet training package that established in-toilet urinations (ITUs) with a dense sit schedule. They progressed to a drop-out component analysis that incorporated a sit schedule evaluation to identify if (a) urinary continence would maintain and (b) SIs would emerge without a sit schedule. We used a BAB reversal design to compare the effects of a sit schedule on urinary accidents, ITUs, SIs, and correspondence between SIs and ITUs among children on the autism spectrum. We calculated the rate of urinations to serve as the criterion for ideal SI rates. Overall, ITUs remained high with minimal accidents during a lean sit schedule and variable or no ITUs occurred without a sit schedule. Additionally, participants often exhibited higher rates of urinations relative to SIs. SIs often co-occurred with ITUs, indicating perfect correspondence. We discuss the implications of these outcomes when focusing on toileting independence. |
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An Evaluation of a Toilet Training Treatment Package in a Therapeutic Day School for Individuals With Autism Spectrum Disorder |
| SAMANTHA CAMACHO (Turning Pointe Autism Foundation), Brandon C. Perez (Northern Illinois University), Natalie Andzik (Northern Illinois University), Darcy Douglass (Northern Illinois University) |
| Abstract: Most contemporary research on toilet training in behavior analysis focuses on young children with autism spectrum disorder, typically in clinical or school settings (e.g., Cagliani et al., 2021; Perez et al., 2020). Current trends in the toilet training literature emphasize the use of reinforcement-based approaches, typically component-lean treatment packages including the manipulation of undergarments, sit schedules, and differential reinforcement. In the current study, the authors replicated the procedures from Perez et al. (2020) but with students in a therapeutic day school for individuals with severe challenging behavior. Four participants with autism spectrum disorder completed the current study and ranged in age from 8-11 years old. Three of the participants communicated using augmentative and alternative communication (AAC) devices. Additionally, the authors added a least-to-most prompting procedure to increase self-initiations. Results supported the use of this toilet training package in a novel setting to increase appropriate urinations and self-initiations. Implications for research and practice will be discussed in the current presentation. |
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