Toilet Training and Communication

Many parents of children with special educational needs run into some difficulty when it comes to toilet training. In fact it can be part of the diagnostic discussion with the public health nurse and a source of some shame and embarrassment when you are comparing your child to others.
The first thing to say is that the professionals ask about it as an indicator of developmental delay, not to judge and pressure you.

Remember, a lot of parents LIE about toilet training so do not beat up on yourself when comparing your child to “normal” kids..

Sure your kid might still be in pull-ups during the day, but their kids might still be wetting the bed or wearing a nappy at night (hell, they might still be wetting the bed themselves) Ignore them and choose your starting age for training according to your needs. You can spend 18 months trying to potty train for NO 1s and 2s or you could wait a year and get it done in 3 months when you are both ready.

You will know that your child is ready, when they are dry at night, so get up and check them first thing; as many kids have their first wee in a nappy, after they wake up.
My son slept in the nude from about age 2 (hated clothes) and didn’t wet the bed once. But he was 4 before he finished training. Because I started before I was ready.

You will know that YOU are ready when there are no other distractions like house moves or starting a new school, starting a new babysitter or a planned absence of either parent or carer. Anything that is going to rock the boat is also going to set back the training. So just keep the nappies or pull-ups on and wait until everything settles down.

In the meantime you can do some toilet preparation, which is where the communication comes in.

The basis of most communication systems in the initial stages is meeting a request. The request has to be naturally rewarding so that the act of communication is repeated. I sign hand to mouth and you give me a cookie. I pick up the picture of a chocolate and you give me a chocolate button. I say DWINK! and you top up my cup with cola.

The connection between communication and reward is established with highly reinforcing items like sweets and treats.
Going to the toilet, at least in the first stages is not rewarding enough to encourage communication. So, when you and your child are ready to start training, how are they going to tell you they need to go?

The first step is to introduce them to the toilet/bathroom as a room; as soon as your child is big enough to stand, stop using the change table or mat to change nappies.
Put all of the wipes, nappy sacks and pull-ups or nappies in the bathroom and begin teaching them what that room is for.

Now you should make a picture of a toilet to give your child every time you go in there. Use a drawing or download one from the web but please do not start with a photograph of Your Toilet. You may have problems in the future if they refuse to use any toilet that does not look exactly like the toilet in the photograph.

Copy, print and cover this picture with plastic and then attach it using soft velcro on the picture and the prickly velcro on the light switch of every bathroom in the house.
As you go in to the room to change the nappy, grab the picture and hand it to your child while you do the change.
Let them hold it and look at it as you work away and point to it every now and again saying "Toilet". Prompt them to put it back as you leave the room.

Then start prompting them to take it off the switch themselves as you go in. Do this with your hand over theirs saying TOILET! in an enthusiastic tone and again let them hold it while you clean up.

Slowly fade your prompt so they are independently reaching for the card as you go in to the room, giving them the communication initiative.
When they hold the card prompt them to show it to you and say TOILET, pointing at the card as you finish the task. Once you have that in place, you are ready to start some sitting practice. (see Potty Training for more)

For signers, you can of course prompt the child to sign on the way in, but please make absolutely sure that everyone including your postman knows the sign for toilet.
When they do start asking for the toilet spontaneously, you will not have a lot of time for translation.
Immediate understanding and reinforcement is the key once you and your child get going.
More on Toileting next week!