Potty training is tough and overwhelming for both parent and child. Join occupational therapist Marissa as she breaks toileting readiness down into manageable steps. This video is filled with tips to help your child master toileting in a stress-free way!
[00:00:00] Hello everybody. My name is Marissa and I’m an occupational therapist. I would like to share some information about the skill of toileting. Specifically, what are some signs of readiness to try toilet training, and also what strategies we can use to support your child’s success in this area. As adults, the process of toileting might already be so ingrained in us at this point that we don’t think of it as having multiple components anymore. But toileting does consist of various steps and different aspects that we can work on individually to facilitate overall success in the skill. Broadly, the components include your child having a long enough attention span and being regulated enough to participate in the process actively.
Them being able to communicate that they are soiled, uncomfortable, need changed, or need to use the bathroom, which also ties into having the body signal awareness that they need to have a bowel movement or that they need to pee. [00:01:00] The phrase for this kind of awareness of body signals of how our body feels on the inside is interoceptive awareness.
Lastly, they also need to have motor skills that match the kind of toileting that they’re doing. If it’s on a small potty or if it’s on the big potty, we want to assess and see if they’re physically able to coordinate the movements needed to position themselves for each step of toileting.
Toilet training has the highest rate of success. If your child is demonstrating signs of readiness and has adequate supports, these are signs of toileting readiness to look for so we have a rough idea of when would be a good time to start the process. And one of the first signs is them showing an awareness that they’ve soiled their pull-up and that they are aware that they have voided.
And if they seem uncomfortable with the feeling of being dirty or soiled, it’s more likely for them to be involved in participating in toilet training. And if they show an interest in exploring the [00:02:00] toilet, like flushing it, opening the lid, shutting the lid, it shows that they understand what it’s used for. When they’re able to stay dry for longer periods of time with a more consistent schedule such as staying dry overnight or during naps, it shows that they have some kind of control over if they void or not, and that ties into the interoceptive awareness that we talked about before, the brain’s awareness of the body signals that they need to go, whether it’s bowel movement, or whether it’s peeing. When your child chooses to or is agreeable to wearing underwear instead of a pull-up, it could signal an increase in their level of confidence.
And the last sign we are going to talk about is their motor skills. We want to look at how they do with positioning themselves on the potty seat. Do they have good balance? And we also want to look at: are they able to manage their [00:03:00] clothing zippers? If they pull their pants down, when they pull them back up, can they redo the buttons?
As well as looking at how they manage toilet paper for wiping or bidets as part of toileting hygiene.
While we were waiting for the interoception piece to develop, there are other ways we can support the child’s confidence and independence in the whole toileting process. We could work on the skill of recognizing body signals in general that are not specific to toileting. We can continue to model the entire toileting routine to make the process more familiar.
We can read stories about toileting. We can evolve them in other aspects such as clothing management, taking their pants off or putting it back on after toileting. And in general, modifying the difficulty of the entire process to match their level of readiness and modifying the bathroom environment so that it is sensory [00:04:00] safe and low stress.
There are a few suggestions for modifying the activity so that it matches their sense of readiness. As caregivers, we can provide more assistance for the tricky parts of getting dressed after, such as pulling pants up and down past the bulk of their diaper, or helping them find the legs of their pants, and then threading your feet through until the their ankles are in. It can also help to opt for clothing that they can easily manipulate, such as an elastic waistband instead of buttons or zippered pants such as jeans, which tend to be a little more stiff. and then it also helps to make sure their clothes are sized just right, so that it’s not too tight or too loose for them to put on and have them stay on.
For toileting hygiene if they aren’t ready to participate in wiping or washing their bottom yet, a modification could be involving them in identifying if their bottom is clean or not clean by looking [00:05:00] at the wipe or TP to check if there’s still poop on it. Or if it’s almost clean and just needs one more wipe, et cetera. The challenge can be graded to start off initially showing them an almost clean wipe so they’re not as disgusted or stressed by the appearance of their poop, and then gradually increasing how much they’re ready to identify. Another modification could be seeing if they want to try sitting, facing the wall, holding onto the water tank for balance instead of facing forward.
It can sometimes help with feeling more balance or less wobbly on the big potty.
Some other considerations for, environmental modification: A re we, are they worried about, some sensory differences such as the feeling of wet wipes or warm wet wipes versus cold wet wipes versus a rough toilet paper? Are they worried about the water from the toilet splashing them after they have a bowel movement, or is the [00:06:00] smell of the poop too strong or is the seat of the toilet really cold?
To facilitate the child friendly environment, we could utilize items such as step stools and like potty seats, even small potties if they prefer to be closer to the ground or utilize like a crouching position. Involving them in putting up, cute bathroom decor, with characters or cartoons that they like, as well as grab bars to help them feel more secure when they’re sitting on the toilet.
To summarize, here are some strategies we can incorporate into potty training. Appeal to their strengths and interests. Modify the process, the task, and the physical environment, facilitate their independence and success in other aspects besides the act of voiding, providing them with just the right amount of challenge.
[00:07:00] Work on their overall interoception and body signal awareness, and finally maintain a no pressure approach and create a supportive environment for them to build this skill in.
Thank you.