A Comparison of Caregiver or Mediator Implementation to Teach Both Urination and Bowel Movement Skills

Principal Investigator(s):
Natalie Croteau
Grant Type:
Graduate Research
The Chicago School of Professional Psychology
Chicago, Illinois
Year Awarded:
Behavior, Emotions, Mental Health


Toileting skills are a developmental milestone important for all children to achieve. However, children with autism spectrum disorder (ASD) often experience challenges in the acquisition of this milestone. Caregivers often delay the implementation of this skill due to these challenges and uncertainty about how to overcome them (Smeets, Lancioni, Ball, & Oliva, 1985). This grant aims to assess the effectiveness of a toilet training package designed to teach daytime dryness to children with ASD. Additionally, this study will compare outcomes and efficiency in the implementation of the skill across two groups of participants in different environments: caregivers in home and behavior technicians in the center. Participants will include two sets of child-adult dyads. The first set will be three to four children with ASD, between the ages of 2.5 and 8 years old, along with their caregivers. The second set will be three to four children with ASD, between the ages of 2.5 and 8 years old, who are receiving applied behavior analysis (ABA) services in a center-based program, paired with their behavior technicians. The toilet training package to be assessed is comprised of five components that include: diaper removal, requesting, scheduled bathroom visits, sitting on the toilet, and consequences. The comparison between groups aims to identify the effectiveness of caregivers as mediators. Dependent variable measures include correct implementation steps of the toilet training procedure by caregiver and behavior technician, correct urination and defecation in the toilet, and the number of sessions required to meet mastery criteria of 180-minutes for daytime dryness. It is hypothesized that the toilet training package will be effective in teaching children both urination and defecation voids in the toilet. The toileting skills developed will potentially have long term effects by providing a foundation for further independence with self-care skills, as well as increased opportunities for participation in social activities.

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