Toilet Training: A Fluid Process | BCBA CEU | Learning | 1 Hour

In this presentation, Dr. Shannon Arthur discusses the social significance of toilet training and the contributions of applied behavior analysis (ABA) to this area. She frames toilet training as a behavior with broad implications for access to daycare, preschool, vocational settings, community participation, and quality of life. She notes risks associated with delayed training, including teasing, stigmatization, limited opportunities, and safety concerns when individuals require bathroom assistance during adolescence or adulthood.

The talk reviews developmental readiness (e.g., bowel and bladder control emerging around 24–30 months; average training age 27 months for typically developing children and closer to 4 years for children with autism spectrum disorder) and discusses commonly cited prerequisites, while questioning whether all are necessary to initiate training.

Dr. Arthur summarizes seminal and contemporary research, including Azrin and Fox (1971), later modifications, rapid toilet training, and alternative procedures. She reviews common evidence-based components such as reinforcement, scheduled sits, overcorrection, video modeling, hydration, and stimulus control manipulation. She also discusses component analyses (e.g., Greer et al., 2016; Perez et al., 2020), noting findings that underwear and package treatments showed improvement, whereas differential reinforcement alone did not.

Finally, she highlights collaboration, feasibility, social validity, and future research directions, including clearer mastery criteria and expanded targets such as bowel continence and self-initiation.