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Toilet training: the long term effects of the Azrin and Foxx program for people with intellectual disabilities

The eighth publication for free download was added to the web site,, in January, 2014.

It outlines the first study in the large toilet training research program which led to the development of the range of toilet training procedures which are covered in my latest book, available for sale on this web site (Bettison, 2010).

It describes a pilot study trialing the toilet training procedures designed by Azrin and Foxx for people with intellectual disabilities (1971).

One of the eight people being trained became almost entirely self-toileting with rare voiding accidents. Most of the remaining people showed only partial improvement. Several showed little or no improvement.

The detailed results indicated that many of the discrete tasks involved in self-toileting were not aquired fully if at all, and should have been taught individually. In addition, resistance and distress during training was common, especially in the early stages. This would have interfered with learning in general.

As a result of these findings, the ongoing research program began the development of new toilet training procedures, beginning with an in-depth analysis of the entire set of toileting tasks.

You can read about the analysis and the new procedures amongst the articles listed on this website.