All parents look forward to not having to deal with nappies but toilet training can be a challenge for some children. Here are some general tips to get you started. Training children with special needs to use the toilet can be especially challenging and if you feel you need extra help support from an occupational therapist can be invaluable as they can help you understand you child's developmental and sensory issues and develop a plan specifically for your child's needs.
When to begin?
Children become ready for toilet training at different ages. Most are around two years of age though some can be as young as 18 months while others may be older. Most children are dry at night by five years of age but some can still wet at night up to eight years of age. It is best to look for signs that your child is ready rather than trying too soon, which can lead to frustration for both you and your child. Also avoid times of major changes or stress in the family such as a new baby or moving house. The time of the year should also be considered. The warmer months mean less clothes for your child to remove and less for you to wash when there are accidents.
Some signs that your child may be ready are:
- showing an interest in the toilet and in watching others
- being able to sit still for a period of time
- being able to complete simple tasks and follow simple instructions
- being able to pull their own pants up and down
- being aware when they are wet or dirty and being able to tell you this
- having periods of dry nappies for two or more hours, showing they can hold urine in the bladder
- has regular formed bowel movements
- dislikes wearing a nappy
Your child most likely won't have all these signs but of you notice a few of them it may be time to think about beginning training.
Potty or not?
Once you feel your child is ready to try toilet training you will need to decide whether to use a potty, toilet or both.
Potties have the advantage of being portable and may be a good idea if your toilet is a long way from your living area. They also look more child friendly and some children can be apprehensive about using an adult sized toilet initially.
An advantage of going straight onto the toilet means you don't have to relearn things later, which is good for children with special needs, especially kids with autism who don't deal with change well. You may decide to use both. If you will be using the toilet your child may need a step and a smaller seat to help them feel secure.
Familiarise your child with the idea of using the toilet.
There are kids books and DVD's about toilet training. Some children are keen to watch others use the toilet, such as a parent or older sibling which can be useful if you feel comfortable with that. Teach your child the words they will need, such as "wee, poo, go toilet". You may wish to introduce some visuals such as signs or picture cards for the words your child may need. You might also want to use a visual schedule which shows your child the steps they need to do from pulling down their pants, through using the toilet to washing their hands afterwards.
Let's get started!
Choose a day to start, preferably when you have no plans for a few days.
Stop using nappies except for bedtime and day sleeps. Use underpants or cloth training pants. Perhaps let your child help you choose some pants that they like. Cloth training pants feel less like nappies than disposable ones but will catch "poo accidents". Disposable training pants or pull ups are handy for outings when you can't get to the toilet quickly but feel more like a nappy, so if they are used all the time they may slow the training process.
Dress your child in clothes that are easy to get on and off, such as track plants or even just a t-shirt with underpants in warmer weather.
Make sure your child drinks plenty of water and eats food with fibre so they are not constipated.
Sit your child on the toilet at times when they are likely to produce something such as after a bath or sleep and half an hour after a meal. Watch for signs that they may need to go to the toilet such as posture, going quiet or passing wind. Remind them through the day by asking now and then if they need to go.
Five minutes is long enough to sit. Longer may make your child not want to co-operate.
Praise your child for sitting on the potty or toilet and give lots of praise for producing something. Gradually reduce praise over time as your child becomes more successful.
If your child does not want to try don't push them to, just try again later.
Boys may want to stand to wee and floating a table tennis ball in the toilet may help them learn to "aim". They may choose to sit and wee initially. Teach them to shake off drops when finished.
You will need to help your child with wiping initially. For girls it is important to wipe from front to back to avoid infections.
Teach your child to wash their hands as part of the process right from the beginning.
Clean up any misses or messes without commenting.
Let your child progress at their own pace. Make it a relaxed and positive process.
What about night times?
Children take longer to learn to stay dry at night. Most are between three and four years. Let your child know you will help them if they need the toilet in the night.
- Accidents are a part of the process so make sure your child knows that it is ok, and you won't be mad at them.
- Watch for signs that they need to go.
- Remind them if they have not been for a while or if they have been absorbed in an activity for a long time.
- Make sure that the toilet is within easy reach and your child can get to it, can open the door, can get their clothes off quickly.
- Encourage your child to go to the toilet before bed and nap times.
- Stay calm when your child has an accident.
What if my child has special needs?
This can be an extra challenge. Some children may need extra support. Organisations which support children with disabilities may have resources to help such as DVD's and more specific advice for parents so contact them and ask for help if you need it.
Occupational therapists can help with toileting so make an appointment to discuss this if you feel you and your child need extra support. Speech pathologists can also help with visual supports and schedules to help your child understand the process and with signs, words or picture cues to help your child show that they want to go.
Talking Matters has occupational therapists which can help with toileting and has some books available for purchase in the waiting room.
Sue Larkey has a tip sheet for toilet training children with ASD which can be downloaded here
Talking Matters provides speech and occupational therapy services to children of all ages. To find out more about our speech pathology services click here. To find out more about occupational therapy click here.
Good luck with this important stage in your child's development!
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