You did it — they’re potty-trained! But now, your autistic child is wetting the bed. Whether it’s soon after you trained them or years later, here is what to do. Take steps to support your child and find out causes for the behavior.
- Strategies for bed-wetting autistic children
- Frequently asked questions
- Free Diapers and Pull-Ups for Children & Free Incontinence Supplies for Adults
Strategies for bed-wetting autistic children
Below are five things to do when your autistic child has an accident (written by an autistic adult who has been there and still occasionally wets the bed).
1. Approach with empathy
Bedwetting behavior is traumatic, but doesn’t have to be. How you approach the matter and deal with it is everything. It’s not too late to correct your own behavior if you’ve already yelled at your child.
Society attributes shame to anyone who wets the bed, even in the event of medical reasons. However, shame cannot coexist with empathy.
Autistic children, and even adults, struggle to control natural bodily functions. Why are natural bodily functions, like burping when you yawn, passing gas and urinary incontinence, considered “rude” per society?
Lack of interoception contributes to the inability to know when you have to go, especially during sleep.
Forgo losing your temper with your child and be aware of what your face looks like, because they’re going to remember . The trauma might be why they wet the bed in adulthood. Every time I have a dream about water, my estranged mother, and impending doom, I awake to a wet bed and clothes.
Have your child help you “reset” the bed based on their developmental capabilities:
- If they can’t properly strip the bed of soiled sheets, ask them to choose new sheets and blankets from the closet.
- Bring the sheets and blankets or pillow cases to the laundry room, or put them into a plastic bag to take to the laundromat.
- Assist in putting the sheets on the bed and pillow cases on pillows. Even if they struggle with the pillow cases, they’re still helping (and it’s great for problem-solving!)
This teaches them that:
- You are a safe, trusted adult they can go to with their problems. You don’t hate them because they wet the bed, and your actions prove your love.
- Kindness and empathy are the priority during stressful situations, no matter how upset a person is.
- Help is available when they make messes they can’t clean up.
Gentle approaches build resilience and help them thrive. Punishment breeds shame and incompetence, and lowers their self-esteem — which could make matters worse.
2. Check for stress, anxiety and trauma
The most common reason any child wets the bed is due to stress. Developmentally, children aren’t capable of handling stressful situations by themselves, and they shouldn’t need to, either.
Even if you don’t think your child has anything to stress about because they’re a kid, remember: They’re autistic. Even if your household is neurodivergent and “everyone has autism/ADHD/etc.”, that’s not a reason to dismiss your autistic child’s needs.
Environmental stress includes yelling and spanking your child, especially an autistic child. Children are the only living beings that adults can legally hit in the US — several countries have banned this form of punishment altogether.
Punishing children — not to be confused with disciplining them — causes a myriad of psychological and developmental problems that may initially surface as wetting the bed.
Other forms of stress include school bullies, vicarious trauma (seeing tragedy on the news), and autistic masking. If your autistic child had a severe meltdown, they are more likely to wet the bed that night, or a few nights, after.
3. Rule out any medical concerns
There is medication for incontinence, but you should first determine why your autistic child is wetting the bed before medicating them — even if you don’t want to face it.
Wetting the bed is a common sign of grooming and sexual assault that often goes unnoticed and gets dismissed.
I was prescribed medication for my bedwetting caused by lack of interoception, but was quickly taken off the meds because they caused too many side effects. I was diagnosed with irritable bowel syndrome (IBS) and lactose intolerance.
Kids with IBS are more likely to have an overreactive bladder than kids without IBS. Despite the science, too much fiber increases my incontinence. Work with your pediatrician to develop a nutritional plan that works for your autistic child.
4. Consider their nutritional intake
Hydration comes in many forms. Too many fluids or too few fluids cause an overreactive bladder. The issue isn’t necessarily about how much your kid is drinking before they go to bed.
Foods high in water content, like fruits and soups, add to hydration and may pass sooner than a glass of water. If your autistic child struggles with gastrointestinal issues where some food “runs straight through”, these foods are going to stress their bladder.
Nutrition plays a larger part in our overall health than we generally think. Dosing your child up on Vitamin C might cause incontinence instead of boosting their immune system. Supplemental nutrition should be a backup and carefully considered against the current nutritional intake.
5. Include your autistic child in problem-solving
Children could tell us so much about themselves, if only we’d listen.
I helped a child overcome her fear of strawberries (she was afraid of having an allergic reaction) by:
- listening to her worries.
- explaining what an allergic reaction was.
She was able to calm down enough after eating them to tell me why she was afraid of them. Turns out, her grandparents lied to her because strawberries were her favorite fruit, and they didn’t want her eating them all.
Non-autistic children have little control over their lives and typically don’t care. Autistic children, on the other hand, need autonomy in order to feel safe, secure and loved. They’re not trying to control you. Rather, the social hierarchy is a social construct that makes zero sense to them.
Including your autistic child in the process to finding a solution to their bedwetting, even if that only looks like adding a pad under their fitted sheet. This teaches teamwork and encourages creativity when solving a problem.
Partnering with your child also increases the likelihood of success, as you can’t “make” your child stop wetting the bed just because you decided on a solution.
Frequently asked questions
Free Diapers and Pull-Ups for Children & Free Incontinence Supplies for Adults
Did you know that you can get pediatric diapers through Medicaid? If your child has been diagnosed with a medical condition resulting in incontinence and is on Medicaid, you may be able to order supplies at no cost through programs such as ActiveStyle or Aeroflow.
Your doctor will need to provide a prescription in order for insurance to cover diapers, pull-ups, bed liners and more.
For adults, supplies such as briefs, bed liners, cleaning products, overnight pads, and gloves may be covered through insurance or Medicaid.