Toileting Program

Toileting Program began March 27th, 2012, using the Foxx and Azrin Method. Shannon has made a lot of progress, but it is still an ongoing process.

 

Procedures/Rules

• Initiation:
• Definition: Shannon walks into the bathroom, pulls down her pants/underwear, sits on the toilet, and voids
• Do not provide ANY verbal/physical/gestural prompts until she has entered the bathroom and pulled down her pants
• If there was any prompting, it does not count as an initiation
• Any kind of prompting could make Shannon become prompt dependent, leading her to have more accidents
• Once Shannon sits on the toilet, you can encourage her to void in the toilet in any way (turn on the DVD; tell her to void; remind her of the reinforcer)
• If Shannon voids in the toilet, provide HUGE verbal praise and a small reinforcer, then have her wipe, pull up her pants, and wash her hands, then provide additional praise and the largest reinfocer you can think of
• Accidents:
• If you see Shannon having an accident, let her finish to prevent infection
• Once Shannon finishes, remove any reinforcers present (turn off TV; take away food/drink)
• Procedure:
1. Tell Shannon, "No. You do not pee on yourself! You pee in the toilet!"
2. Give Shannon clean clothes and have her redress as independently as possible.
3. Have Shannon put her soiled clothes in a laundry basket, then prompt her to take the basket to the laundry room and load the soiled clothes into the washer (Shannon does not like this, so you can take advantage of this time by stressing to Shannon that she "would not have to do this if you peed on the toilet. You need to pee in the toilet!"
• Prompting:
• It is very important not to prompt Shannon to the bathroom; however, there are two times when prompting is allowed:
• Immediately before getting in a car
• On outings: since Shannon does not know how to find a bathroom outside of home and school, it is permissable to take her to the bathroom on outings
• Bowel Movements (BMs):
• BMs are not currently being targeted
• If you observe Shannon acting as though she is about to have a BM, take her to the bathroom and prompt her to go
• If Shannon does have a BM in her pants, take her to the bathroom, clean her, then continue with having her change as independently as possibole and put her clothes in the wash

Current Procedure

• Continue with the procedure outlined above
• Make sure you are providing a large enough reinforcer when she initiates
• Get more practice on weekends by pushing fluids
• Data: graph daily totals of accidents (do not include BM accidents), prompted voids, and initiations (successes)