Disclaimer: As far as I’m aware, I had no issues with toilet training.
So, a few weeks ago, I saw a comment somewhere (I no longer remember where, but it may have been Twitter) that essentially claimed that the only reason autistics might have trouble with toileting issues is low intelligence (note I didn’t say “IQ”). This is my response.
As we know now, most – if not all – autistics have trouble with sensory issues; sensory issues that when unaccompanied by other elements are diagnosable (in North America) as Sensory Perception Disorder, or SPD. Those difficulties can be summed up in three parts: hypersensitivity (overly sensitive to stimuli); hyposensitivity (very not sensitive to stimuli); and sensory seeking (seeking out certain sensory stimuli). Note that sometimes hyposensitivity and sensory seeking end up focused on the same form of stimulus, and one seeks out that form of sensory stimulus because one is hyposensitive to it.
As we also know, there are more senses than just the commonly known five (sight, hearing, taste, touch, and smell); there’s:
- proprioception: feedback from soft tissue re where the parts of your body are in relation to one another and in space;
- vestibular: sense of balance and of forces acting on your body (gravity, “G-force” of acceleration, etc.);
- interoception: feedback from organs and also pain sense.
The one we care about for this particular topic is interoception, which is the sense that tells us things like feeling pain, feeling hungry, feeling thirsty, feeling cold or hot, feeling unwell, etc – including feeling the need to use the toilet.
So, what happens when someone is hyposensitive to interoception, particularly the interoceptive signals that tell them they need to go use the toilet?
They’re going to have toileting issues that have absolutely nothing whatsoever to do with their intelligence, because their bodies are effectively not telling them that they need to do this.
Now yes, intelligence issues can come into play in terms of finding workarounds – like, say, going to the washroom every two hours or so, just in case – but the fact remains that if your body isn’t telling you that you need to go do something, you’re not going to have any reason to go do it.
So, there we go.