Today we want to provide some guidance around autism incontinence treatment for children. 

According to the Continence Foundation of Australia, parents of children with disabilities make up a large portion of the 2.7 million unpaid carers across Australia.  

The majority (63%) of children’s disabilities are mental or behavioural, this includes autism spectrum disorder (ASD) which in some children can cause varying degrees of bladder and bowel control issues.

While incontinence (urinary and/or faecal) is common among kids with ASD, it’s important to note that not all will experience it. 

For those who do, the severity will vary from case to case.  

One study of children with ASD found that those with the disorder had higher rates of both bedwetting (nocturnal enuresis) and daytime incontinence (daytime enuresis), compared to the participants who did not have ASD.

As for why children with autism can be susceptible to incontinence, there are a number of symptoms that contribute.  

Sensory issues

Children and adults with autism can experience over or under-sensitivities to lights, sounds, touch and other events. Using the toilet can trigger these sensory issues - the cold feeling of a toilet seat, the loud flush. This can then disrupt the toilet training process.

Communication challenges

Social interaction for children with ASD can be challenging. This could mean they’re reluctant to share when they need to use the toilet, or they may not absorb toilet training learning because they may avoid engaging in the communication of instructions.

Body awareness

Children with ASD may not recognise the urge to go to the toilet until it’s too late.

Knowing that the bowel and/or bladder is full is called interoceptive awareness. Essentially, it’s the process of your organs’ receptors sending messages to the brain for regular vital functions, such as emptying the bladder and bowel. Research into sensory integration in people with ASD found that there was a notable difference in under-responsivity to sensory markers. Sensory differences were also highest for children aged 6-9 years old. 

Therefore, those with ASD can have difficulties identifying the sensation of needing to use the toilet. For example, they may not realise they need to urinate until it ends up being a pant-wetting or bed-wetting incident. As for bowel movements, sometimes those with ASD won’t realise they need to empty the bowel and can end up constipated.

Learning delays

Developing new skills can take longer, and be more challenging, for some kids with ASD. So for example, switching from wearing a nappy to learning to use a toilet can be a huge leap. This process can typically take longer for kids with autism, so just remember to be patient with them and with yourself throughout.

Gastrointestinal issues

Compared to their peers, kids with ASD are more prone to experience gastrointestinal symptoms, including constipation and diarrhea [1]. These can be caused by factors including selective eating, lack of hydration and fluid intake, and anxiety. Overflow soiling can be caused by constipation. This is where stool from higher up in the large bowel leaks from around the constipated area of stool, and can often be mistaken for diarrhea.

While incontinence (urinary and/or faecal) is common among kids with ASD, it’s important to note that not all will experience it. 

For those who do, the severity will vary from case to case.  

One study of children with ASD found that those with the disorder had higher rates of both bedwetting (nocturnal enuresis) and daytime incontinence (daytime enuresis), compared to the participants who did not have ASD [2].

As for why children with autism can be susceptible to incontinence, there are a number of symptoms that contribute.  

Sensory issues

Children and adults with autism can experience over or under-sensitivities to lights, sounds, touch and other events. Using the toilet can trigger these sensory issues - the cold feeling of a toilet seat, the loud flush. This can then disrupt the toilet training process.

Communication challenges

Social interaction for children with ASD can be challenging. This could mean they’re reluctant to share when they need to use the toilet, or they may not absorb toilet training learning because they may avoid engaging in the communication of instructions.

While of course there are two forms of incontinence - urinary and faecal - there are types of incontinence that each of these can fall into. 

Urge incontinence

This is when there is a sudden and intense urge to empty the bladder. In children with ASD, a lack of body awareness can mean they experience urge incontinence. For example, they might be watching television or playing and not realise they need to urinate until it’s actually happened. 

Functional incontinence

This occurs when there’s a physical or mental impairment that prevents a person from making it to the toilet in time. As mentioned earlier, some children with ASD can have sensitivities or resistance to using the toilet, so they experience incontinence in that way. 

Bowel incontinence

Bowel and faecal incontinence describes the inability to control bowel movements. In kids with autism, it often results in the bowel leaks we mentioned earlier, due to the higher likelihood of having gastrointestinal challenges. 

Toileting difficulties

Toilet training can take a bit more time for children with ASD. Difficulty communicating when they need to go, using different toilets and cleaning themselves can be some of the barriers you may face as a parent when trying to help your child learn to use the toilet. But don’t worry, there are plenty of resources to help with this and the above types of incontinence.

There are plenty of resources and products out there to help you with autism incontinence treatment. 

Remember, you are not alone.  

Here are some ways you can manage your child's incontinence and give them the right support.

Speak to their doctor

If you’ve noticed your child is experiencing incontinence and/or reluctance to toilet train, it’s important to see their pediatrician. They can help decipher whether your child’s symptoms are linked to autism or another underlying medical condition. Then you can work with them to tailor an incontinence treatment plan that will best suit your child’s needs.  

Use high quality continence management products

Whether your child is experiencing urge, functional or bowel incontinence, or still learning to use the toilet, continence management products can be a huge help. They provide your child with comfort and confidence to go about their daily activities.

Our Magics Youth Pants range is not only soft and comfortable enough that they feel like regular underwear, but they’re also effective in keeping kids dry for up to 12 hours. They’ve been developed with Magical Tubes® technology for top-tier protection against leaks. Their adaptable design moulds to the shape of your child’s body for the best possible fit throughout the day and/or night.

We offer two incontinence youth pant sizes, which cater for ages up to 15, unlike many other brands which only stock products for toddlers. Plus, if they’re not quite the right size or fit for your child, we have a 100% money-back guarantee because we want buying continence management products to be as easy and as risk-free as possible. 

Follow a consistent toilet training routine

We understand how tough toilet training a child can be. But the best thing to do is not give up. Consistency is key when teaching a child with ASD how to use the bathroom. Giving them verbal (“great job”, “yay you did it!”) and nonverbal (clapping, thumbs up) praise after each successful toilet break, rewards like a sticker chart, showing visual support examples, and habit training (teaching them to use the toilet at set times) are just some techniques you can try whilst toilet training. For extra support, you can always speak to your paediatrician or GP.

Be prepared when leaving home

Ensuring you have a change of clothes and spare continence management products whenever you’re leaving the home will help combat any incontinence episodes. That way you and your child won’t feel added stress when you’re out and about. To ensure that there are available toilets in the area you plan to visit, you can use the National Public Toilet Map as a resource.

Identify any incontinence triggers

Understanding your child’s incontinence triggers can be a helpful way to avoid accidents. Keep a journal of their incontinence episodes as this can help you identify patterns in their behaviours. You may find that a certain distraction, sound or sensation is consistent with their accidents. You can then use this information to further support your child in preventing incontinence episodes. 

Maintain food and fluid intake

Having a regular food and drink schedule can help your child use the toilet at necessary times. For example, giving your child a drink around 15 minutes before a scheduled toilet break can increase the chance of them urinating in the toilet. Keeping your child hydrated with enough water can avoid constipation, as can incorporating high-fibre fruits and vegetables in their diet. If your child stomach is bloated or swollen and painful, or they haven’t had a bowel movement in a week, see their GP for treatment.

Incontinence can be a sensitive issue for children with autism and their families, but it doesn't have to be a barrier to a happy, fulfilling life. By understanding your child's unique needs, establishing a consistent routine, and seeking support from healthcare professionals and support groups, you can help your child manage incontinence effectively.

With patience, empathy, and practical strategies, you can provide the necessary care and support your child needs to thrive. Remember, you are not alone in this journey, and there are resources available to help you and your child navigate this challenge.

If your child is experiencing incontinence, check out our youth range of continence management products.

You can also call our customer care team on 1800 86 11 99 or email us at hello@confidenceclub.com.au to find a product that will best suit your child so you can manage their continence more comfortably and confidently.

If you need any further Autism-related resources or support you can visit Autism Awareness Australia or The Raising Children Network.

CITATIONS

1- https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/expert-answers/autism-and-digestive-symptoms/faq-20322778   

2- https://pubmed.ncbi.nlm.nih.gov/26052001/