Potty Training Children with Special Needs
It is not uncommon for children with special needs to have difficulty with potty training. This may be because they cannot recognize bodily sensations and link them to using the toilet, or because they require more systematic teaching methods to be successful.
Parents are often unsure when and how to start toilet training, which can lead to starting and stopping and ongoing frustration. This article provides tips for determining readiness and successful toilet training.
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Is your child ready?
Children show both physical and behavioral signs of readiness for toilet training. Your physician should always be consulted to assist in this determination, but your child may be ready if he or she can:
- Walk or run and sit upright without your assistance
- Stay dry and clean for extended periods (e.g., 45 minutes)
- Release a full bladder and have routine bowel movements
- Demonstrate awareness of bodily functions (e.g., grunting, squatting, grimacing)
- Stop or change activities when wetting or soiling in the diaper
- Imitate other people and demonstrate independence by refusing help.
- Come to you or hide when he or she has a wet or soiled diaper
- Respond positively to praise and rewards
Are you ready?
Before you begin toilet training, it is important to make sure you can devote the necessary time and energy and make it a priority in your routine. If possible, set aside a long weekend or several days when you know you can focus on toilet training.
Stock up on food and supplies and clear your calendar so you can remain home as much as possible. Be prepared for accidents commonly occurring when children are learning, which will require more laundry and clean-up time. Engage other family members to help, and arrange for them to entertain siblings and run errands.
Being prepared and having support can give you the encouragement you need to keep at it and stay positive with your child.
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If so, let’s go.
Once you have determined that you and your child are good to go, there are steps that make toilet training more successful.
1. Get Prepared: Take it to the bathroom! Start changing your child’s diaper in the bathroom. Flush bowel movements down the toilet and encourage your child to watch.
Talk about using the toilet. Read books, watch videos, and, if you are comfortable, let your child watch family members use the toilet. While preparing your child, you can also get equipment and supplies together.
These include a potty seat, training underwear and rubber pants, activities and items (e.g., toys, treats) to reward success, a sticker chart if it will be used, and a timer to keep on schedule.
2. Keep a Potty Record: Collecting ‘data’ is very helpful both when deciding when to start toilet training and tracking success. Start by doing “pants checks.”. Set your timer for every 15-20 minutes and record whether your child is dry, clean, wet, or soiled.
This information will help you know how often you will need to take them to the toilet when you start training. Once you begin toilet training, be sure to continue recording.
3. Set the Stage for Success: Put the diapers away and introduce underwear during the day so your child will be able to use the potty quickly and feel wetness if accidents occur.
If appropriate, increase fluids to give more chances for success. Plan your schedule for taking your child to the bathroom based on your potty record, planning trips frequently enough to avoid accidents.
4. Take your child to the bathroom: On schedule or if your child shows signs (e.g., facial expressions, stopping activities) that he or she needs to use the toilet, bring your child to the bathroom and have him or her sit on the toilet for 2-3 minutes. You may have to interrupt activities.
Say, “First go to potty, then play with _____ again.” Avoid power struggles by telling (not asking) your child to go, but also trying to make it fun. For example, you might pretend to be different animals or form a conga line in the bathroom.
[3]5. Reward Successful Toileting: Continue your pants checks every 15–20 minutes. Praise dry and clean pants. When you take your child to the bathroom, praise him or her for walking to the toilet and sitting. If your child urinates or has a bowel movement in the potty, have a party!
Cheer, call family members, do a little “potty dance,” and/or provide stickers or other rewards. Don’t be afraid or embarrassed to be silly, even in front of other people. Accidents are to be expected when toilet training.
If your child is wet or soiled, just tell him or her so without scolding or anger, and clean it up. If more accidents start occurring, increase your praise for successes and how often you bring them to the toilet.
6. Expand Your Horizons: Once your child begins to experience success at home, focus on toilet training in other places. Toileting in public can often be difficult. Being prepared will help avoid frustration and embarrassment. Keep extra clothes, plastic bags for wet/dirty clothes, and rewards in your car or in a bag you can carry with you.
Work extra time in your schedule to use the potty before leaving the house, as soon as you get somewhere, and before you leave. To increase your child’s comfort, you might bring a portable toilet seat or preferred activities such as books or music to relax your child.
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7. Encourage Independence: The ultimate goal is for your child to use the potty without reminders. If your child says he or she needs to use the toilet or walks in that direction without you telling him or her, provide enthusiastic encouragement, even if your child has an accident while on the way to the toilet.
As time passes, decrease your assistance and rewards, letting the natural consequences take over. This is when sticker charts or long-term rewards (e.g., if you stay dry for 5 days, we will ____) come in handy.
You can also extend the time between pants checks and trips to the bathroom as successes build.
Remember that consistency is essential to toilet training success. You want to stay the course once your child begins wearing underwear and using the toilet. Inconsistency can cause setbacks.
For that reason, you will want to get everyone who cares for your child on board. Also, keep your eye on the ball. Initially, the goal will be to get your child to use the potty.
You should probably focus on other skills, such as dressing and washing hands at different times or after toilet training.
Each child is different and progresses at different rates. Some children respond almost immediately. Others can take months or even years to use the toilet independently or may require a schedule and long-term support to be successful.
Don’t get discouraged if successful toileting doesn’t happen immediately or your child needs continued support. Toilet training may take some time and energy, but by making it fun and focusing on success, it can be a rewarding experience for both you and your child.
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This post originally appeared on our March/April 2013 Magazine [17].