Dear Readers,
Many of the UNIT Chapters in my book, KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker, have an added APPENDIX with more perinate information for you. Therefore, the next few BLOGS will introduce you to them.
UNIT 3 – What Is Most Concerning? CH. 1 – Gross & Fine Motor Skills PART 2 – Toilet Training, APPENDIX A – Toileting & APPENDIX B – Wandering.
Many of the UNIT Chapters in my book, KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker, have an added APPENDIX with more perinate information for you. Therefore, the next few BLOGS will introduce you to them.
UNIT 3 – What Is Most Concerning? CH. 1 – Gross & Fine Motor Skills PART 2 – Toilet Training, APPENDIX A – Toileting & APPENDIX B – Wandering.
UNIT 3 – What Is Most Concerning?
CHAPTER 1 – Gross & Fine Motor Skills PART 2 – Toilet Training
APPENDIX A – Toileting
Nunez, A. (2025) answers the question – Can a child with autism be potty trained?
Children with autism can be toilet trained as long as they don’t have any medical issues that prevent them from urinating or having a bowel movement. Some signs that would indicate a child is having discomfort or other problems would be –
Before beginning the toilet training process with children with autism, it is recommended a pediatrician confirm with a physical exam there are no medical issues.
< My Thoughts > “…no medical issues.”
Neurological conditions, like autism, can make toileting very difficult. Along with that, certain medications cause urination, constipation, and diarrhea problems. Persons with autism have more gastrointestinal issues than most people in the general population.
Nunez, A. (2025) continues, "There is no specific age to begin toilet training children on the autism spectrum because every child has different needs and different skills."
Instead of focusing on age, focus on the child’s skills. Below is a list of five questions that determine whether children with autism ready to start toilet training.
1. Does the child have the fine & gross motor skills to carry out a toileting routine?
2. Can the child pull down his/her pants & underwear & pull up pants & underwear with little to no assistance?
3. Can the child imitate actions? (i.e., sitting on the toilet, wiping, etc.)
4. Can the child identify where the bathroom is located in his/her house?
5. Can the child sit on a toilet with a potty-training seat or sit on a transitional potty without resistance?
< My Thoughts > “…imitate actions…” “…where the bathroom is located…” “…transitional potty…”
Some children will need a high level of support for these. Many children with autism have difficulty ‘imitating’, ‘locating’ areas in the house (except their room), and any type of ‘transiting’.
What are the signs that a child with autism is ready to be potty trained?
Nunez, A. (2025) continues, that when children with autism are ready for toilet training, they will begin to demonstrate the “Three Signs of Readiness” listed below –
1. They do not like the feeling of a wet or soiled diaper or pull-up and will show it by taking off the wet or soiled diaper/pull-up, and they vocalize displeasure in being wet of soiled and want to be changed.
2. They show interest in the toilet by sitting on it, flushing it, or watching an adult use it.
3. They will take an adult to the bathroom to get a clean diaper or pull-up.
< My Thoughts > “…clean diaper or pull-up.”
The problem with some diapers and/or pull-ups is that they can mask the feeling of wetness. Then, the child won’t recognize and request a trip to the bathroom. Sometimes kiddos will stay dry if they can wear underwear with their favorite character’s picture on it. It also took a few more years before he would use a bathroom anywhere but home.
Prepare for Successful Potty-Training Experience
Nunez, A. (2025) continues, Successfully toilet training children with spectrum disorders takes a lot of thought and preplanning. Being unprepared can lead to frustration for both parent and child. Training happens in phases, with the first two stages being the Planning Phase and the Setting Up Phase.
< My Thoughts > “…Training happens in phases…”
It took over two years to get our Sonny to understand the toileting process. Many, many starts and stops. He liked to flush the toilet, so the smallest independent toileting steps were always rewarded by multiple flushes.
Gulsrud, A., Lin, C. et al. (2018) give us suggestions from this study that there may be deficits in gross and fine motor skills which are preventing successful toileting. Motor skills can be most concerning when delayed, or even limited. In this study, ‘parent-rated’ autistic behaviors, noted the distinction as to how the child’s toileting difficulties varied and to what extent the child’s difficulties were ‘problematic’ for the child.
< My Thoughts > “…deficits in gross and fine motor skills…”
Yes, a child with autism may take years to learn and remember to use all the skills related to toileting. They need pincher finger skills to pull pants up and down. Gross motor skills to put feet and legs into pantlegs. But most of all, he or she must get their body’s message that toileting is needed. Then, they need to be able to communicate the need to use the bathroom. And, that is just the beginning.
REFERENCE: UNIT 3, CHAPTER 1, PART 2, APPENDIX A.
Gulsrud, A., Lin, C., et al. (2018). Self-injurious Behaviors in Children and Adults with Autism Spectrum Disorder (ASD); Journal of Intellectual Disability Research; V2:12, p1030-1042.
Nunez, A. (2025). Potty Training for Autism – The Ultimate Guide. Retrieved online from –https://www.autismparentingmagazine.com/autism-potty-training-guide/
End of UNIT 3, CHAPTER 1, PART 2, APPENDIX A – Toileting.
CHAPTER 1 – Gross & Fine Motor Skills PART 2 – Toilet Training
APPENDIX A – Toileting
Nunez, A. (2025) answers the question – Can a child with autism be potty trained?
Children with autism can be toilet trained as long as they don’t have any medical issues that prevent them from urinating or having a bowel movement. Some signs that would indicate a child is having discomfort or other problems would be –
- Foul-smelling urine
- Too much or too little urination
- Inability to hold urine
- Stools that are small, hard, dry, and painful to pass
- Having fewer than two bowel movements a week
Before beginning the toilet training process with children with autism, it is recommended a pediatrician confirm with a physical exam there are no medical issues.
< My Thoughts > “…no medical issues.”
Neurological conditions, like autism, can make toileting very difficult. Along with that, certain medications cause urination, constipation, and diarrhea problems. Persons with autism have more gastrointestinal issues than most people in the general population.
Nunez, A. (2025) continues, "There is no specific age to begin toilet training children on the autism spectrum because every child has different needs and different skills."
Instead of focusing on age, focus on the child’s skills. Below is a list of five questions that determine whether children with autism ready to start toilet training.
1. Does the child have the fine & gross motor skills to carry out a toileting routine?
2. Can the child pull down his/her pants & underwear & pull up pants & underwear with little to no assistance?
3. Can the child imitate actions? (i.e., sitting on the toilet, wiping, etc.)
4. Can the child identify where the bathroom is located in his/her house?
5. Can the child sit on a toilet with a potty-training seat or sit on a transitional potty without resistance?
< My Thoughts > “…imitate actions…” “…where the bathroom is located…” “…transitional potty…”
Some children will need a high level of support for these. Many children with autism have difficulty ‘imitating’, ‘locating’ areas in the house (except their room), and any type of ‘transiting’.
What are the signs that a child with autism is ready to be potty trained?
Nunez, A. (2025) continues, that when children with autism are ready for toilet training, they will begin to demonstrate the “Three Signs of Readiness” listed below –
1. They do not like the feeling of a wet or soiled diaper or pull-up and will show it by taking off the wet or soiled diaper/pull-up, and they vocalize displeasure in being wet of soiled and want to be changed.
2. They show interest in the toilet by sitting on it, flushing it, or watching an adult use it.
3. They will take an adult to the bathroom to get a clean diaper or pull-up.
< My Thoughts > “…clean diaper or pull-up.”
The problem with some diapers and/or pull-ups is that they can mask the feeling of wetness. Then, the child won’t recognize and request a trip to the bathroom. Sometimes kiddos will stay dry if they can wear underwear with their favorite character’s picture on it. It also took a few more years before he would use a bathroom anywhere but home.
Prepare for Successful Potty-Training Experience
Nunez, A. (2025) continues, Successfully toilet training children with spectrum disorders takes a lot of thought and preplanning. Being unprepared can lead to frustration for both parent and child. Training happens in phases, with the first two stages being the Planning Phase and the Setting Up Phase.
< My Thoughts > “…Training happens in phases…”
It took over two years to get our Sonny to understand the toileting process. Many, many starts and stops. He liked to flush the toilet, so the smallest independent toileting steps were always rewarded by multiple flushes.
Gulsrud, A., Lin, C. et al. (2018) give us suggestions from this study that there may be deficits in gross and fine motor skills which are preventing successful toileting. Motor skills can be most concerning when delayed, or even limited. In this study, ‘parent-rated’ autistic behaviors, noted the distinction as to how the child’s toileting difficulties varied and to what extent the child’s difficulties were ‘problematic’ for the child.
< My Thoughts > “…deficits in gross and fine motor skills…”
Yes, a child with autism may take years to learn and remember to use all the skills related to toileting. They need pincher finger skills to pull pants up and down. Gross motor skills to put feet and legs into pantlegs. But most of all, he or she must get their body’s message that toileting is needed. Then, they need to be able to communicate the need to use the bathroom. And, that is just the beginning.
REFERENCE: UNIT 3, CHAPTER 1, PART 2, APPENDIX A.
Gulsrud, A., Lin, C., et al. (2018). Self-injurious Behaviors in Children and Adults with Autism Spectrum Disorder (ASD); Journal of Intellectual Disability Research; V2:12, p1030-1042.
Nunez, A. (2025). Potty Training for Autism – The Ultimate Guide. Retrieved online from –https://www.autismparentingmagazine.com/autism-potty-training-guide/
End of UNIT 3, CHAPTER 1, PART 2, APPENDIX A – Toileting.
Missing poster for autistic nonverbal N.Y. teenage student Avonte Oquendo, 14.
UNIT 3, What Is Most Concerning?
CHAPTER 1 Gross & Fine Motor Skills
APPENDIX B – Wandering
Hotez, E. & Onalwu, M.G (2023) say that ‘wandering’ is a significant public health concerns, especially involving children with autism. There are reportedly 20 cases each month, with 2-3 of those cases resulting in death.
< My Thoughts > "... ‘wandering’..."
This APPENDIX for ‘wandering’ is under 'Gross Motor Skills', because once your child masters walking and running then he or she will most likely begin ‘wandering’.
Stevens, C., & Stevens, N. (2011) say, I stuck my head into the sitting room.
David wasn’t there. Calling to him was pointless (he never answered to his name). I tried to guess where David would go.
(As I rounded a corner in the neighborhood) I caught sight of David: he was marching with a purpose to the grocery shop. I grinned. It was a relief to know he was safe.
< My Thoughts > “…he was safe.”
Check doors, fences, and gates often. Children who are on the spectrum can wander or bolt suddenly. That’s why having a secure perimeter is essential. To keep your kids extra safe, install a keyed or combination lock on any exits. This ensures that a strong wind, or curious hand, or determined pet won’t be able to open them. But, one still must be vigilant about ‘checking’ all perimeters, especially pool or other water areas. Good idea too, to put a sign in the window of your home with information about the child / children / adults with Autism who live inside.
Stevens, C., & Stevens, N. (2011) (a week later) "I called David’s name, once or twice, half-heartedly. I was too scared to care whether strangers thought I was a bad father for losing my child, but I knew there was no point in shouting. He had never come at our call. Never, not once."
He probably hadn’t even noticed my absence. (I finally found him) David was tucked into a corner, where he wouldn’t be trampled, lying on his back and gazing at a mirror ball.
“How was the zoo?” Nicky asked later. ‘David had fun,’ I told his mom.
Sicile-Kira, C. (2014) cautions, “children on the autism spectrum are at a higher risk of being hurt, victimized or wandering off. Children with autism do not appear to have a safety 'antenna' built in, and their sensory processing does not effectively work to help them in the area of safety and crisis prevention.”
Stagliano, K. & McCarthy, J. (2010) say, Gianna (one of three siblings with autism) spent much of her day screaming and running away from me.
Her autism moments are usually like bolts of lightning. They strike and then disappear, like she does when she wanders away from us.
To keep Mia from wandering out into traffic I wrapped my leg around her, twisting my body into a bizarre ballet pose. Mia had no sense of danger; common in autism.
I’ve had one daughter wander into a stranger’s home.
Brodie, P. (2013) remembers how someone was always on ‘Scott duty’ when we went out. It usually meant actually holding on to my brother…so he wouldn’t just run off.
< My Thoughts > “… holding on to my brother… so he wouldn’t just run off.”
Children with autism often feel compelled to flee from their environment. The situation or setting doesn’t seem to matter; they just take off to parts unknown.
Siri, K. (2015) said that he had photos of son Alex with contact information printed on an engraved bracelet. Besides his name and my name and phone number, I included –
One autistic child may run away at the sound of a loud siren, whereas another may be attracted to the lights and loud noise. There have been numerous cases of autistic children running back into a burning building and hiding because the scene outside was perceived as too chaotic.
Hilton, L. (2017) shares that Naoki Higashida, a 13 year-old-boy with nonverbal autism, through facilitated communication, answered questions concerning his elopement activity.
Question: Why did you wander off?
Answer: My body was lured there by ‘something’ outside. As I was walking farther from home, I didn’t feel any fear or anxiety. I had to keep walking on and on. Turning back was not permitted, because roads never come to an end. Roads speak to us people with autism, and invite us onward. Until someone brings us back home, we don’t know what we’ve done and then we’re as shocked as anyone.
Hilton, L. (2017) writes that “Shortly after noon on October 4, 2013, a 14-year-old African American 8th grade student named Avonte Oquendo” ran out of the side door of his school and into the community. Identified as severely autistic and nonverbal, Avonte had a “strong sensory affinity for trains, cars, and water systems.”
The city has been transfixed by the story that autistic and non-verbal Avonte Oquendo, 14, is still missing after almost five weeks. Avonte ran out of Center Boulevard, Long Island City school, after being left unsupervised.
On Tuesday, U.S. Senator Charles E. Schumer called for the Department of Justice (DOJ) to create and fund a program to provide voluntary tracking devices for children who have autism or other developmental disorders, for whom “bolting” from parents or caregivers is common. It also allows for door alarms on public school buildings.
Senator Schumer announced the agreement Wednesday. Avonte’s Law was put into place. It comes after the remains of autistic teenager Avonte Oquendo, 14, were found in the East River.
REFERENCES: UNIT 3, CHAPTER 1,APPENDIX B – Wandering
Brodie, P. (2013). Secondhand Autism; eBook.
Hilton, L. (2017). Avonte's Law: Autism, Wandering & the Racial Surveillance of Neurological Difference; African American Review, V50:2, p221-235.
Hotez, E. & Onalwu, M.G (2023). A Neurodirersity-0riented Approach to Address Autism Wandering as “Problem Behavior” in Pediatrics. Autism & Health Across the Lifesp.an; June V15(6).
Sicile-Kira, C. (2014). Autism Spectrum Disorder (revised): The Complete Guide to Understanding Autism; New York, New York: Penguin Random House Company.
Siri, K. (2015). 1,001 Tips for the Parents of Autistic Boys; eBook Edition.
Stagliano, K. & McCarthy, J. (2010). All I Can Handle: I Am No Mother Teresa: A Life Raising Three Daughters with Autism; eBook Edition.
End of UNIT 3, CHAPTER 1, APPENDIX B – Wandering
UNIT 3, What Is Most Concerning?
CHAPTER 1 Gross & Fine Motor Skills
APPENDIX B – Wandering
Hotez, E. & Onalwu, M.G (2023) say that ‘wandering’ is a significant public health concerns, especially involving children with autism. There are reportedly 20 cases each month, with 2-3 of those cases resulting in death.
< My Thoughts > "... ‘wandering’..."
This APPENDIX for ‘wandering’ is under 'Gross Motor Skills', because once your child masters walking and running then he or she will most likely begin ‘wandering’.
Stevens, C., & Stevens, N. (2011) say, I stuck my head into the sitting room.
David wasn’t there. Calling to him was pointless (he never answered to his name). I tried to guess where David would go.
(As I rounded a corner in the neighborhood) I caught sight of David: he was marching with a purpose to the grocery shop. I grinned. It was a relief to know he was safe.
< My Thoughts > “…he was safe.”
Check doors, fences, and gates often. Children who are on the spectrum can wander or bolt suddenly. That’s why having a secure perimeter is essential. To keep your kids extra safe, install a keyed or combination lock on any exits. This ensures that a strong wind, or curious hand, or determined pet won’t be able to open them. But, one still must be vigilant about ‘checking’ all perimeters, especially pool or other water areas. Good idea too, to put a sign in the window of your home with information about the child / children / adults with Autism who live inside.
Stevens, C., & Stevens, N. (2011) (a week later) "I called David’s name, once or twice, half-heartedly. I was too scared to care whether strangers thought I was a bad father for losing my child, but I knew there was no point in shouting. He had never come at our call. Never, not once."
He probably hadn’t even noticed my absence. (I finally found him) David was tucked into a corner, where he wouldn’t be trampled, lying on his back and gazing at a mirror ball.
“How was the zoo?” Nicky asked later. ‘David had fun,’ I told his mom.
Sicile-Kira, C. (2014) cautions, “children on the autism spectrum are at a higher risk of being hurt, victimized or wandering off. Children with autism do not appear to have a safety 'antenna' built in, and their sensory processing does not effectively work to help them in the area of safety and crisis prevention.”
Stagliano, K. & McCarthy, J. (2010) say, Gianna (one of three siblings with autism) spent much of her day screaming and running away from me.
Her autism moments are usually like bolts of lightning. They strike and then disappear, like she does when she wanders away from us.
To keep Mia from wandering out into traffic I wrapped my leg around her, twisting my body into a bizarre ballet pose. Mia had no sense of danger; common in autism.
I’ve had one daughter wander into a stranger’s home.
Brodie, P. (2013) remembers how someone was always on ‘Scott duty’ when we went out. It usually meant actually holding on to my brother…so he wouldn’t just run off.
< My Thoughts > “… holding on to my brother… so he wouldn’t just run off.”
Children with autism often feel compelled to flee from their environment. The situation or setting doesn’t seem to matter; they just take off to parts unknown.
Siri, K. (2015) said that he had photos of son Alex with contact information printed on an engraved bracelet. Besides his name and my name and phone number, I included –
- Nonverbal
- Autism & Epilepsy
- Multiple medications
One autistic child may run away at the sound of a loud siren, whereas another may be attracted to the lights and loud noise. There have been numerous cases of autistic children running back into a burning building and hiding because the scene outside was perceived as too chaotic.
Hilton, L. (2017) shares that Naoki Higashida, a 13 year-old-boy with nonverbal autism, through facilitated communication, answered questions concerning his elopement activity.
Question: Why did you wander off?
Answer: My body was lured there by ‘something’ outside. As I was walking farther from home, I didn’t feel any fear or anxiety. I had to keep walking on and on. Turning back was not permitted, because roads never come to an end. Roads speak to us people with autism, and invite us onward. Until someone brings us back home, we don’t know what we’ve done and then we’re as shocked as anyone.
Hilton, L. (2017) writes that “Shortly after noon on October 4, 2013, a 14-year-old African American 8th grade student named Avonte Oquendo” ran out of the side door of his school and into the community. Identified as severely autistic and nonverbal, Avonte had a “strong sensory affinity for trains, cars, and water systems.”
The city has been transfixed by the story that autistic and non-verbal Avonte Oquendo, 14, is still missing after almost five weeks. Avonte ran out of Center Boulevard, Long Island City school, after being left unsupervised.
On Tuesday, U.S. Senator Charles E. Schumer called for the Department of Justice (DOJ) to create and fund a program to provide voluntary tracking devices for children who have autism or other developmental disorders, for whom “bolting” from parents or caregivers is common. It also allows for door alarms on public school buildings.
Senator Schumer announced the agreement Wednesday. Avonte’s Law was put into place. It comes after the remains of autistic teenager Avonte Oquendo, 14, were found in the East River.
REFERENCES: UNIT 3, CHAPTER 1,APPENDIX B – Wandering
Brodie, P. (2013). Secondhand Autism; eBook.
Hilton, L. (2017). Avonte's Law: Autism, Wandering & the Racial Surveillance of Neurological Difference; African American Review, V50:2, p221-235.
Hotez, E. & Onalwu, M.G (2023). A Neurodirersity-0riented Approach to Address Autism Wandering as “Problem Behavior” in Pediatrics. Autism & Health Across the Lifesp.an; June V15(6).
Sicile-Kira, C. (2014). Autism Spectrum Disorder (revised): The Complete Guide to Understanding Autism; New York, New York: Penguin Random House Company.
Siri, K. (2015). 1,001 Tips for the Parents of Autistic Boys; eBook Edition.
Stagliano, K. & McCarthy, J. (2010). All I Can Handle: I Am No Mother Teresa: A Life Raising Three Daughters with Autism; eBook Edition.
End of UNIT 3, CHAPTER 1, APPENDIX B – Wandering
Thank you so much for sharing, commenting, and 'liking' on Facebook!
Regards,
Sara Luker
DISCLAIMER Know Autism – Know Your Child: with < My Thoughts > by Sara Luker
Just to let you know that I, Sara Hayden Luker, have put forth my best efforts in presenting what I have learned about autism, by sharing the stories and studies of those who have gone before us. Any author’s mention of products, services, treatments, and interventions or actions are not to be considered an endorsement, thereof. Know that to some, autism is an ‘unregulated business’. The content of this website material, digital or in any other form does not represent medical advice; nor does it constitute medical suggestions in any way. The material, including any downloadable parts, is for informational and/or educational purposes only. Your download and/or use of any of this material indicates your acceptance of this disclaimer.
This is a Personal Use Electronic Download. By downloading, you hereby agree and acknowledge that you are not acquiring any right, title or interest in, or to, the material; nor any associated copyrights, other than the right to possess, hold and use for personal, non-commercial purposes. Furthermore, you agree that you will: (i) not scan, copy, duplicate, distribute or otherwise reproduce the material(s) to resell, (ii) not use the material(s) for any commercial purposes. By purchasing/downloading you agree to these terms unconditionally. No ‘rights’ are given or transferred.
Regards,
Sara Luker
DISCLAIMER Know Autism – Know Your Child: with < My Thoughts > by Sara Luker
Just to let you know that I, Sara Hayden Luker, have put forth my best efforts in presenting what I have learned about autism, by sharing the stories and studies of those who have gone before us. Any author’s mention of products, services, treatments, and interventions or actions are not to be considered an endorsement, thereof. Know that to some, autism is an ‘unregulated business’. The content of this website material, digital or in any other form does not represent medical advice; nor does it constitute medical suggestions in any way. The material, including any downloadable parts, is for informational and/or educational purposes only. Your download and/or use of any of this material indicates your acceptance of this disclaimer.
This is a Personal Use Electronic Download. By downloading, you hereby agree and acknowledge that you are not acquiring any right, title or interest in, or to, the material; nor any associated copyrights, other than the right to possess, hold and use for personal, non-commercial purposes. Furthermore, you agree that you will: (i) not scan, copy, duplicate, distribute or otherwise reproduce the material(s) to resell, (ii) not use the material(s) for any commercial purposes. By purchasing/downloading you agree to these terms unconditionally. No ‘rights’ are given or transferred.
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