My Autistic Child

Parenting Children on the Autism Spectrum

“Shy Bladder,” is a type of social phobia. Autistic people can find it very distressing when out and about in public places. Let’s learn more about it, what causes it and how it can be treated.

Symptoms of Shy Bladder

A person with Shy Bladder has nothing physically wrong with their urinary tract or bladder. The problem is psychological. It may start at school, where a child could develop a fear of public toilets for any number of reasons. Sometimes children are bullied in school toilets, and that can be a trigger. For boys, it can be distressing and embarrassing to urinate in a public urinal, flanked by other people.

Because of this fear, people with shy bladder may be unable to urinate in public toilets, or even at home if there are others around. In a public toilet, this may because they do not have complete privacy, or they know that other people are in the area or may be waiting outside. They can have a fear of people hearing them urinate, or leaving a smell that others might notice.

An autistic child may have a meltdown due to the distress that this causes, They may really want to relieve themselves, for example on a long car journey break, but may feel physically unable. If their bladder is uncomfortably full, they may feel physical pain sensations which further exacerbate their anxiety.

The body needs to relax to a certain extent in order for urination to be possible. An anxious person sends signals to their body which prevents the flow of urine.

Treatment For Shy Bladder

Exposure techniques can be useful for treating shy bladder issues. If someone is nervous about using a public toilet, they can take smaller steps to slowly reach this goal.

The most basic therapy would be simple relaxation techniques. These are an important first step to overcoming the anxious feelings that come with urinating in public. It is also important to get checked by a doctor to make sure that the problem is definitely psychological rather than having a physical cause.

Graduated exposure should be taken gently. At first, the person could go to a location where they feel comfortable going to the toilet. This would likely be at home. They could ask a friend or family member to stand outside the door as close at they feel comfortable. The aim would be over time to get the person to come closer and closer to the door.

if the person is nervous about someone hearing them in the toilet, they should gradually try and increase the amount of noise they make, whilst knowing their family member is outside the door listening.

Once they feel comfortable with this, they could try moving on to a public toilet in a quiet place that doesn’t get much footfall. Again, the goal is to use the toilet without anxiety. Once this is accomplished they can gradually visit busier public areas like shopping mall toilets or motorway service stations.

In conclusion, shy bladder can be a very uncomfortable and embarrassing situation for your autistic child, but it can be helped by gradual exposure therapy and if needed, intervention by a professional.

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