Occupational therapy: taking new NDIS and Support at Home clients now, with no waitlist. OT: no waitlist NDIS → Support at Home →
Occupational Therapy September 2026 7 min read

Toilet Training Children With Autism or Developmental Delay: OT Tips for Parents

Toilet training is a big step for any family. For children with autism, developmental delay or sensory differences, it often takes longer and needs a different approach. Here's how occupational therapists help.

Why toilet training can be harder

Many children are toilet trained during the day somewhere between 2 and 4 years. Children with autism or developmental delay often need more time and that's okay. Common barriers include:

  • Body awareness: difficulty noticing the signals of a full bladder or bowel (called interoception)
  • Sensory sensitivities: the flush is too loud, the seat feels cold, the bathroom smells or echoes
  • Changes to routine: nappies are familiar and the toilet is a big change
  • Communication: difficulty telling you they need to go
  • Motor skills: managing clothing, balancing on the seat and wiping
  • Constipation: common in children with restricted diets and it makes toileting uncomfortable

Check with your GP first: if your child has constipation, pain, blood in their stool or wetting after being dry, see your GP before starting a toileting program.

Signs of readiness

  • Stays dry for an hour or two at a time
  • Shows awareness of a wet or dirty nappy
  • Can sit on a chair for a short activity
  • Can follow a simple routine with visual support

OT strategies that help

Make the bathroom comfortable

  • A child-size seat insert and footstool so feet are flat and supported
  • Delay flushing until your child has left the room or use noise-reducing headphones
  • A soft seat cover, warm lighting and a favourite toy or book

Build a predictable routine

  • A visual schedule showing each step: pants down, sit, wee, wipe, flush, pants up, wash hands
  • Regular sits at predictable times, such as after meals and before bath
  • Short sits of a minute or two, with a timer if helpful

Build the skills

  • Practise pulling pants up and down with easy elastic-waist clothing
  • Body awareness games and simple language for body signals
  • Social stories or picture books about using the toilet

Keep it positive

  • Celebrate small steps, like sitting on the toilet with clothes on
  • Stay calm and neutral about accidents
  • Use a reward your child really values, straight after success

How an OT supports your family

A paediatric OT looks at what's getting in the way for your child, whether sensory, motor, communication or routine and builds a step-by-step plan that fits your home. We coach parents and carers and can share the plan with kinder or school so everyone is consistent.

Get help with toilet training

Exercare's occupational therapists visit children at home, kinder or school across north-east Melbourne and beyond, with no waitlist. One NDIS intake form gets you started.

NDIS intake (EP or OT)Call 0413 827 232

Funding

If your child has an NDIS plan, paediatric OT is usually funded from Capacity Building – Improved Daily Living Skills (Category 15). For children younger than 9, families usually start with an NDIS early childhood partner. We can also complete a self-funded functional capacity assessment to support an NDIS application. The National Continence Helpline (1800 33 00 66) also offers free advice.

Evidence referenced in this article

Written by the Exercare allied health team. This article is general information only and is not a substitute for individual medical advice. Exercare provides mobile exercise physiology and NDIS occupational therapy across south-east and eastern Melbourne.

Frequently asked questions

When should I start toilet training my autistic child?

Look for readiness signs such as staying dry for an hour or two and noticing a wet nappy, rather than a specific age. Many autistic children train later than their peers.

My child is scared of the flush. What can I do?

Delay flushing until your child leaves the bathroom, try noise-reducing headphones and gradually build tolerance with play and preparation.

Should I see a GP first?

Yes, especially if your child has constipation, pain or wetting after being dry. Treating constipation often makes toilet training much easier.

Can an OT help with night-time wetting?

Night-time dryness develops later and is often medical or developmental. Start with your GP; an OT can help with routines and practical strategies.