Two mothers wrote us about toilet training…..

“My child is about ready for toilet training and I’ve heard that it is very important to be consistant. My problem is that I work and am only home with my child for a few hours at a straight stretch. Any suggestions?”

“I have a wonderful child with Down’s Syndrome. He is getting up to toilet training and I would like information on how to do this with a child with special needs.”

We turned to Yona Assaf-Barashi. She worked with me for many wonderful years in a program for special children until she had the nerve to get married and move away for a while. She was the “Toileting Queen” in our program. Before you wonder at the dubious nature of such a title, talk to all the moms of special and “regular” kids she’s helped!

SUCCESSFUL TOILETING STRATEGIES FOR ALL AGES AND LEVELS OF FUNCTION

Learning to be toilet trained is part of the natural course of growing up.  We all learn how to be responsible for body functions much like we learn to walk, talk, read and write. It is not beyond most individuals; even those with special needs. Clearly any type of spinal paralysis or severe mental retardation would impede process greatl. However, for the bulk of the population, here is a method that does work.

This method is very natural, taking a step by step approach to what some children complete on their own without any assistance. So before starting this program, assess where your child is at and then you can begin from the appropriate stage. Good Luck!

(Shoshana’s note – Summer is a great time for this as children will naturally feel better undressed)

Stage #1 What would you do if you had a camel? You’d bring him to water and he’d drink a ton. In order to introduce toileting with success, we need to have the children drinking quite a bit so that they’ll have to use the bathroom. Experience is our greatest teacher. So we need to set it up for success. Give your child plenty of fluids he likes. Don’t try carrot juice if he won’t drink it because it defeats your purpose. Remove the diaper for up to three hours at a time. Two is also adequate. Your child can wear a long shirt. Underwear is not advised. It can replace the feel of the diaper so why take the chance. The airy feel is the best way.

So here you are with plenty of fluids and diaper free. You should be experiencing some accidents or urgent runs to the bathroom. Either way, your doing great! We learn from mistakes most of our lives and this type of accident is the best kind to learn from. Of course, it may have to happen a bunch of times but we are human and that’s the way we learn.

Don’t make a big deal over accidents. Be excited that there is no diaper and tell your child how you are excited about how much they are learning about their body. Try to direct them to the potty or toilet but either way, they get a “Yay”! Remember, there is nothing in the diaper.

Spend as much time as you need on Stage #1. Don’t move ahead till the child has had many experiences and failures. Once that has happened, you are ready to move on. I recommend up to 2 months for a child with moderate level retardation.

Stage #2- It’s time for a reward system. Tell your child that every time they remember to run to the potty on time or even if they run in the middle of losing it, they will get rewarded with something they like and view as worthwhile. It can be food or toys or time on the computer, etc.. Also, begin to take the child  to the bathroom every 15 to 20 minutes.If this interval is too often for you, it can be done every half hour. They must sit, however, for a full 5 minutes and running water in the background helps. Remember , there is no diaper for this two to three hour period and the child is drinking plenty of fluids.

After a few successes in running to the facilities on time, your child is ready to move on to the next level of  toilet training.

Stage #3- At this point, we want to turn over some of the responsibilities to the child himself/herself. He will now be responsible for the clean up. You will tell your child that a change is coming and  he’ll have to clean up after his accidents. You continue to give him plenty of fluids, without  a diaper or underwear. You still continue to give 15 minute reminders. But instead of telling him to go to the bathroom, you ask him if he feels he needs to go. He is responsible for the decision, not you. After all, he’ll have to clean up after himself. This is where the next crucial learning stage begins.

When an accident occurs, no yelling! This is how we learn. Have plastic bags, wipes or towels handy and you direct the child verbally. No actual helping. When the child cleans up, he gets rewarded. He is learning! Eventually, he won’t like the constant bother of the clean  up and he’ll do his best to get to the toilet on time.  There is still no underwear or diaper for this learning period of two to three hours.

After much experience at this level, you should get the feeling that your child is ready to move on.

Stage #4- The child is ready for underwear. He must still have plenty to drink during the learning sessions. An accident remains his responsibility to clean up. The difference is that he gets an extra special reward if the accident happens in the bathroom. You reward success and you reward an accident in the bathroom as it shows that he attempted to achieve success. After all, we are not perfect.

After much success at this level, you can move on to the next level.

Stage #5- You can extend the timeframe that your child wears underwear. Instead of 2-3 hours, make it 5 hours. But you can stop the drinking craze. At this point, your child should have had enough experience with knowing what it feels like to control his body movements. Limit the no diaper zone to the house for now.

After much success, you are ready to move onto the next level.

Stage #6- It’s time to pack an extra pair of underwear and wipes in your child’s backpack but your child can leave home in underwear. Be sure to go to the bathroom before leaving the house and give plenty of opportunities to use facilities. Reminders when necessary are important to help their independence and success. Again, be sure to reward any and all successes in a way your child will like. Having no accident means success!

Stage #7- After about half a year of completely being trained in the day, you are ready to move on to abandoning the diaper at night. The child must get plenty of warnings that soon he’ll not wear a diaper in bed. Every morning of success gets rewarded once again.

Children with mild to moderate retardation should spend 2 months on every stage of toileting Other children can glide through even in one month. Although, giving it three months is much more relaxing. Each child is different to choose as you go.

I did not cover bowel movements. Bowel movements should emerge in stage #3. Although it happens less often, enough food and drink should cause those experiences to arise naturally and be a part of the stage by stage process.

Good Luck!
Yona Assaf Barashi