Toilet Training in Individuals with Angelman Syndrome

Quick Overview

Toilet training can be a challenge for individuals with special needs, but with a gradual and positive approach, progress can be made. It’s important to address any medical considerations, such as constipation or urinary tract infections, before starting a toilet training program. A team approach, involving family, school team members, therapists, and healthcare providers, works best. Establishing a routine and using visual supports, such as schedules and social stories, can be helpful. Rewards and reinforcers should be toilet-specific and problem-solving strategies can be used for any challenges that arise. Bedwetting can also be addressed with strategies such as addressing constipation, managing fluid intake, and using alarm therapy. Remember, toilet training is a marathon, not a sprint, and progress can be made with patience and persistence.

Hello, my name is Terry Katz. I’m a psychologist in developmental pediatrics at Children’s Hospital Colorado, and I’m here to talk with you today about toilet training.

Challenges in Toilet Training

Toilet training individuals with special needs, such as Angelman Syndrome, can present unique challenges. It is important to consider any medical conditions that may affect toilet training, such as constipation, urinary tract infections, and voiding dysfunction. Addressing these medical considerations is crucial before implementing a behavioral approach to toilet training.

Key Components of a Successful Toileting Program

A successful toileting program requires a team approach, involving the family, school team members, therapists, and healthcare providers. It is important to take small steps and establish a routine. Collecting data on eating, drinking, and toileting habits can provide valuable information for developing an individualized program. Consideration should be given to an individual’s specific strengths and challenges, including communication skills, motor skills, anxiety levels, sensory issues, and ability to generalize skills.

Medical Considerations

Medical considerations, such as constipation and urinary tract infections, can impact toilet training. The Bristol stool chart can help identify signs of constipation, with types 3 and 4 being ideal. Voiding dysfunction can also be related to constipation, as a stretched colon can put pressure on the bladder. Collaborating with medical providers is essential to address any medical concerns before implementing a behavioral approach.

Establishing a Routine

Establishing a routine is important in toilet training. Consistent toilet times, consistent cues, and gradual steps can help individuals feel more comfortable and confident in using the toilet. Visual schedules and social stories can be helpful in guiding individuals through the steps of toileting. Rewards and positive reinforcement play a crucial role in motivating individuals to use the toilet.

Addressing Challenges

Common challenges in toilet training include refusal to sit, fear of flushing, playing in the water or with toilet paper, poor aim, wiping difficulties, and the need to use diapers. Each challenge requires problem-solving and individualized strategies. Gradual exposure and desensitization techniques can help individuals overcome fears and anxieties associated with toileting.


Bedwetting is a common issue that may require separate strategies. Addressing constipation, fluid intake, and bladder irritants can help reduce bedwetting. Strategies such as wet alarms and practicing retention control can also be effective in managing bedwetting.


Toilet training individuals with Angelman Syndrome may require patience, a gradual approach, and individualized strategies. With a team approach, consistent routines, and positive reinforcement, individuals can make progress in toilet training. It is important to remember that each individual is unique, and progress may vary.

Talk details

  • Title: Toilet Training in Individuals with Angelman Syndrome
  • Author(s): Terry Katz
  • Author(s)’ affiliation: Children’s Hospital Colorado
  • Publication date: 2020-12-31
  • Collection: 2020 FAST Educational Summit