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Wilson Pediatric Therapy & Learning supports Occupational Therapists, Physical Therapists, Speech Therapists, and Educational Interventionists in their pediatric practice.  

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Wilson Pediatric Therapy wishes to share valuable, transformative, information; this blog will be the vehicle for us to share.  

Potty Training advice from an OT

The Wilson's

 Photo credit  thejbird

Photo credit thejbird

Of all the early childhood milestones not many are met with as much dread and apprehension as potty training. Graduating from diapers to undies can be an exciting and welcome change for parents, but it can also be stressful. As an early intervention therapist that works with 0-3 year olds I am all too familiar with this milestone and the vast variety of approaches that parents use. If you do a simple web search of potty training, you will find a multitude of different opinions of the matter.

One may claim that their approach is best, while swearing that another doesn’t work.

Another approach may promise to “change your life!”

While the next assures you that it is fool proof.

However, just like all children are different and have different needs - different approaches will work for different children. So how do you know which one to use?  Find one that makes YOU feel the most confident and that you feel comfortable using. Whether it is a book written by a world renowned child psychologist or a blog written by a mom, finding one that fits your family’s needs is most important. After all, you aren’t going to stick to a technique that you aren’t excited or confident about or isn’t a good fit for your child’s personality. You know your child best and have a better understanding than anyone on what type of approach is going to work the best. If your child has sensory processing disorder, autism, or a physical impairment, you may need some additional guidance from a developmental interventionist or occupational therapist. However, this post is to give general tips about the process, as well as to share the tips that my OT colleagues and I have found to be the most successful.

The first thing to consider before jumping into the process is readiness. Ask yourself the following questions. If the answer is “yes” for most or even several of these, then it may be time to begin the potty training process.

  • Does your child stay dry for at least two hours at a time during the day?
  • Does your child consistently wake up from naps AND mornings dry?
  • Can child identify touched body parts without looking?
  • Can child verbalize need to go?
  • Is he/she imitating mom or dad in the bathroom?
  • Can your child follow simple instructions?
  • Does your child seem uncomfortable with soiled diapers and want to be changed?
  • Is it obvious to you when your child is about to urinate or have a bowel movement?
  • Can your child walk to and from the bathroom, and undress himself?
  • Does your child express interest in wearing "grown-up" underwear?

Where do I start?

  • Start at home, use a small training potty or seat to go on the regular toilet.  Children feel more confident if their feet are touching the ground to give them support.
  • Consider all the sensory components of the bathroom:
    • Bright lights
    • Loud noises (water running, toilets flushing)
    • Cold floor, cold toilet seat
    • Mirror to see reflections in
    • Sound echo’s sometimes
  • If they are sensory sensitive and are overwhelmed by one of the things listed above, consider starting by putting the potty chair somewhere else in the house to start there.
  • Consider reading a potty book with your child such as “The Potty Book for boys” or “The Potty Book for girls”.
  • Have them watch their same gender parent go potty.
  • Practice by sitting on potty every time child wakes up dry.
  • Take your child shopping for regular underwear with character of choice – this will increase the intrinsic motivation and make it exciting for them. State “try not to pee pee on Minnie Mouse!”
  •  Have them drink plenty of fluids – take them to the potty 15-20 minutes after food or drink.
  • Develop a set schedule and have the child sit on the potty several times throughout the day.
  • Consider using stickers or small item (I’ve had some parents SWEAR by mini m&ms) for rewards each time they go. Praise them verbally after they use the potty. (Reward them for trying initially).
  • Use a couple sheets of paper towel folded and placed between the diaper and the child (or one of those thin wash clothes you can get at the dollar store) so that when they are in their diaper and they pee they will feel wet and uncomfortable but not ruin the carpet/furniture, etc. Diapers that are made today make it too comfortable for kids who are potty training which decreases the incentive for them to use the potty. If they pee in their diapers, they don't feel it. 
  •  Also try using a pair of preferred underwear under the pull-up or diaper to increase sensory awareness of wetness.
  • Social stories are great for increasing understanding of sequencing of task, predictability of process, and guidance of expected response behaviors. Matter of fact comments from the parent also help: "Oh your underpants are wet! You can put them in the hamper and then put on dry ones." Using simplified language in a sequential way also helps child with predictability.

Here are some examples of approaches that some parents have used:

The “All Day” approach (Works for many but not for all!)

Pick a couple of days when they will be home all day (if possible) and set a timer for every 30 minutes. Then they have to sit each time the timer goes off whether they think they have to go or not. Keep toys and books in the bathroom and let them play/"read" while they are sitting. Or keep a potty chair in living room/playroom. If possible, buy an extra potty chair and kept it in the back of the car.

The “Naked” approach

If it is warm out, there is always the old stand-by of allowing the child to go naked while playing outside, and they will soon dislike the feeling of the pee going down their legs. Many parents opt for this over a weekend and find it works really well. The child (if cognitively aware enough) sees what is happening and feels what is happening and is more aware of what "going to the potty" means.

Written by Rebecca Smith,  Occupational Therapist