Monday, March 9, 2015

Potty Training Wisdom: Readiness

 credit: Envato Images
Dear Melissa,
My 3-year-old daughter, who has Autism, has recently been removing her diaper. Does this mean she is ready for potty training?

I will admit that toilet training was my least favorite part of being a mommy!  Some children are independent and literally tell you, the parent, when it is time to lose the diapers. Other children are more subtle. There are a wide variety of factors involved with determining when a child is ready for toilet training. In sharing my insight I reiterate my stance - you can’t force children to eat, sleep or potty. But, there is a lot you can do to support your child during their journey to becoming ready to toilet train. 

As parents, if we are unable to answer "yes" to a majority of the questions below, then toilet training will likely end up being a frustrating failure for both the parent and the child. Below I have listed five common readiness indicators that I recommend parents consider.

5 Common Readiness Indicators
1) Verbal skills: 
  • Does the child have some way (either verbally or non-verbally) to tell you that she needs to use the bathroom?
2) Motor coordination skills: 
  • Does the child have the ability to manage simple clothing, wipe after voiding, flush the toilet, and wash her hands independently? 
  • Can the child control her sphincter muscles for voiding?  
  • Can she climb onto the toilet/potty chair independently?
3)  Cognitive skills: 
  • Does the child understand the cause and effect of voiding and soiled clothing?  
  • Does the child have the capacity to sequence the steps of toileting?
4) Sensory processing skills: 
  • Can the child tolerate the sounds of the flushing toilet, running water, and echoing bathroom?  
  • Can the child feel the difference between wet/dry?  
  • Is the child able to tolerate the sometimes scary sensation of sitting on a toilet (vs. a solid chair seat)?
5) Emotional skills: 
  • Does the child have any desire to wear “big kid underpants”?  
  • Is she in a phase where she is fighting you tooth and nail and saying “no” to everything you say? 
Again, regardless of your child’s chronological age, these are the precursor steps for toilet training. This is where many parents understandably despair. We often feel like toilet training is an all-or-nothing deal. BUT IT’S NOT! There are many, many actions you can take to encourage toilet training readiness and help set your child up for success.

 Ways to Encourage Readiness
Change diapers in the bathroom. This encourages her to associate voiding with THIS room in the house, rather than elsewhere.

Wash hands in the bathroom. All toddlers need more practice washing their hands. I love them to pieces, but our toddlers can be like little Petri dishes!  Also, washing hands in the bathroom helps the child to integrate the sensory input piece of the process – stepping on a stool, splashing water, echoing bathroom, you get the idea. 

Practice dressing. Even if you are placing your hands over your child’s hands to help her pull her pants up and down, this begins the motor planning process. 

Establish routine. This will assist with the emotional/behavioral piece. If we are going into the bathroom at regular intervals in the day for diaper changes, then it will eventually become just as easy to use the toilet during these times. 

Sit on the potty. Listen to music, sing songs, read books, keep your clothes on, whatever.  Just help the child get used to sitting on the toilet or potty chair in a “no pressure” situation. 

Establish “potty time”. If your child is comfortable and ready, begin a routine of sitting (bare bottom) on the toilet several times a day. The times for best success are generally when first waking in the morning or after nap, after meals, and before bath time. 

Praise like crazy! If the child “accidentally” uses the potty correctly, then YES, singing and dancing are required. Party hats and confetti are strongly encouraged. 

Next week I'll dive into different techniques for toilet training once your child is developmentally ready. 

Learn More
Consider attending the March 26, 2015 talk:
at the University of Arkansas, Fayetteville. 

 Resources:
Establishing Toileting Routines for Children. (2014). American Occupational Therapy Association, developed by Jay Doll, Bonnie Riley. Retrieved February, 2015 from AOTA.org.
Toilet Training Children with Special Needs (2014). American Academy of Pediatrics, retrieved February, 2015 from HealthyChildren.org.
Toilet Training. (2010). University of Michigan Resources on Child Development and Behavior Resources, compiled by Kyla Boyse and Kate Fitzgerald. Retrieved February 2014 from Med.umich.edu.
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