Every professional out there from Dr. Phil to Nanny Jo has opinions on toilet training. And each of these professionals seems to think that it’s a fairly easy process, especially Dr. Phil who swears his technique can train a child in just two days. For most children this may be the case, but for children with sensory or other developmental issues that interfere with the whole learning aspect of toilet training, it isn’t as simple of a process.
For children with sensory issues, particularly Sensory Processing Disorder (SPD), understanding the process of toileting isn’t the specific challenge. SPD adds to the struggles for a child with an extremely sensitive tactile system, as well as weaker vestibular and proprioception systems, as it not only intensifies the fear of the feeling of going, but also the prospect of being wiped or wiping themselves, the smells and sounds in the bathroom, as well as the unsteadiness of sitting on a hard, plastic training seat.
The fact is that a child with SPD isn’t just being difficult or stubborn in trying to learn to use the toilet. Aside from the inability to deal with the sensory aspect, they often get confused with the steps involved. So, what are parents of these children to do?
The basic steps are the same with every child whether there are sensory issues in play or not.
- Pay attention to your child’s body functions, then teach them to.
- Teach that the toilet is the place to go, not the diaper or training pants.
- Help them get to the toilet on time.
There are a few additional steps involved in dealing with a more sensory sensitive child than the basic a-b-c list above.
Here are a few suggestions:
Make it a routine. Tapping into the SPD child’s need for routine can assist them in learning the toileting process better. Setting specific times worked into their existing routine is helpful for them, such as first thing in the morning, before/after snack, before/after meals, before/after naps, and before bed.
Talk about it. For many children with SPD, there is an absolute need to have all of the information about an activity before they’ll feel comfortable enough about starting it. Parents should be open about the whole elimination process, including why it’s so important for healthy bodies. If communication skills aren’t as solid, using visual cues or even a book like Everyone Poops, by Taro Gomi and Amanda Mayer Stinchecum can help the child put words and actions together. Talking about things and addressing any questions or concerns reduces some anxiety about the whole thing.
Be relaxed. A child will feed off of a parent’s anxiety or frustration so trying to remain calm is important. Make jokes. Laugh through each attempt. It’s a skill that will take some these children many tries before understanding it so having a more relaxed attitude about it will relax them too.
Deep pressure. Understanding that a child with SPD has the additional challenge of vestibular and proprioceptive issues effecting balance, body awareness and coordination will also help with the process. These children may have anxiety with their legs and feet ‘hurting’ when sitting for longer than a few minutes. Deep pressure massage a few minutes before sitting on the toilet, as well as while on it, can offer some comfort and calmness.
Have a step stool. This is another option for the proprioception and vestibular side of things. Dangling feet can be very uncomfortable for children with SPD who have weaker muscles or posture problems, and can be even scarier for those with balance and body-awareness issues. These children have more of a chance of falling right off the toilet if they lean too far forward or too far to one side, or may even feel nervous if the toilet feels too high or too big. A foot stool helps keep the feet stay on ‘solid ground’, which maintains balance and prevents slipping as it offers a steadiness for the body. Another option in the beginning is a seat that is right on the ground so that the body feels stable, then move up to the toilet when they are ready.
Get a soft potty seat. Plastic seats are hard on sensitive bottoms. Many potty seats these days, such as the ones put right inside the opening of regular seats, are much softer. These seats not only give a child a sense of security, but they are also much easier on the bum.
Have bathroom sensory tools. We have a little bucket under the bathroom sink with a lap cozy, fidgets, chewies (such as KidCompanion chewelry), headphones and textured objects to pull and stretch. The more of the child’s senses that are tapped into at one time, the calmer they will become. And that’s essential for sensory sensitive children.
Use incentives…initially. There is nothing wrong with having little rewards for trying in the beginning. When all else fails, having their favorite treat on hand may be a good way to get things started. Parents should be cautious not to allow reward-giving to go on for too long or the child won’t go unless given a treat. If that occurs, the process will have to be started all over again. The idea is that the child will keep trying with the hope of getting a treat, then it should be weaned off completely. Eventually the claps, hugs, kisses and High Fives, plus the good feeling of, “I did it!”, will become enough of a reward.
One last point for parents is not to make a big deal about ‘staying dry’. Accidents happen and it’s all part of the process. But if there is a lot of emphasis placed on dryness, the child may focus too much on it. A child with SPD can switch from being obsessed with not going to being obsessed with going. In this situation, these children may actually start pushing on their stomach to ‘feel’ when they have to go.
This action is actually common for many children with sensory issues. Eventually, parents will learn that by giving their child enough sensory input throughout the day, the child will become more in tuned with what their body needs so they won’t need actual pressure to understand when they have to go.
Many children with SPD struggle with toilet training at first. But with love, patience and a few extra steps included in the process, it will become a skill that will become second nature.