Dr Catherine
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4-7 years

My 6 year old son is ASD, ADHD & SPD. We have tried to night time toilet train with absolutely no success at all and as such finds himself getting incredibly upset, so we have gone back to wearing dry nights full time. Everything I see from other ASD parents is suggesting that pushing them can cause them to regress. Is this the case? Is there anything we can do that is a more gentle approach? Or are we better letting him do it in his own time?

A number of studies have shown an increased risk of bedwetting among children with both Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder. Many of these children will outgrow bedwetting on their own however some will benefit from a more structured behavioural training program as is achieved through the use of bedwetting conditioning alarms. You could certainly look into introducing an alarm, however it would be important that you speak with a continence advisor or his pediatrician first. Conditioning alarms work by helping your son learn to recognise the need to pass urine and either wake-up and go to the toilet or learn to hold on until morning. I will note that the success of these programs are higher amongst children who are slightly older than your son (6 is still quite young, with bedwetting still considered to be developmentally normal at this age) - this is mostly likely linked to the fact that older children tend to be more motivated to become dry, and amongst children who experience less frequent wetting (i.e., only wet 3-4 nights a week). It is completely fine to hold off for a bit and to continue to use DryNites to help manage his bedwetting and reduce the stress associated with wet sheets. All the best, Dr Cathrine