Caregiver-implemented standardized-to-individualized behavior-analytic toilet-training package for preschoolers with autism.

Children with autism often face challenges with incontinence and may benefit from more structured toilet training relative to neurotypical children. In the current study, we evaluated a standardized-to-individualized behavior-analytic toilet-training package with caregivers as the interventionists. We used telehealth to train caregivers remotely to support their implementation of the procedures and obtain additional data on implementation and outcomes. Four preschool-aged children with autism and their caregivers participated. Three of four participants met mastery criteria with a standardized toilet-training package and one participant required a contingent progressive sit schedule. Intervention components were successfully faded, and all participants maintained performance after 4 weeks. The findings demonstrate that clinic-based toilet-training procedures can be implemented at home by caregivers with telehealth support. This approach to toilet training provides families with an alternative to clinic-based treatment and could increase access to treatment among those residing in rural or underserved areas.