Occupational therapists are all about promoting independence and quality of life around the ‘occupations’ (activities) which people need and want to do each day. Learning to use the toilet independently is an important self care activity and an exciting milestone for children and parents/carers alike. Having a clear idea of how to guide, instruct and support children is key to efficient, stress-free potty training, so kids can get back to the business of the day’s work (AKA: PLAY)!
It can be tricky to establish exactly when a child is ‘ready’ to begin using the potty / toilet. Many factors contribute to successful toileting, from sensory processing and medical aspects, to cognitive, social emotional and physical development. In terms of support, the best directions and instructions will vary according to each child and the circumstances surrounding each stage. So, rather than there being a specific flow chart of how and when to support children, the journey each child takes is unique; a kind of ‘Choose Your Own Adventure’! Below are some general tips and tricks to reassure and inspire you to carry on in your potty training ‘adventures’!
TIPS FOR SUPPORTING CHILDREN TO USE THE TOILET INDEPENDENTLY
It’s never to early for children to start learning about their self care. Even babies can follow the process as their carer comments on what is happening as it is happening, such as “legs up, …clean bottom,… pants up…”.
Follow your child’s lead. When children begin to show an interest in toileting and using the potty, you will have their attention which is vital for learning, and creating a memory of the process. (Typically sometime between 18months and 3 years, children will notice they have done wee/poo in their nappy/diaper).
If something is not working, don’t be afraid to try something different; but give each strategy a ‘decent’ try (at least 2 weeks), prior to switching approaches.
Humour is fine (kids LOVE toilet humour), but be careful of how you might use reactions/comments like “pooo!”, “stinky!”, “disgusting!”, “yucky!”, or laughing at their attempts or accidents, as the aim is not to make kids feel embarrassed, ashamed or ‘dirty’.
Keep your emotions at bay – as hard as it might be at times, your own anxiety and impatience are not helpful. Kids don’t need that extra burden to bear as they learn a whole new skill. Instead: breathe, hang in there, and repeat! Regardless of how much you may ‘wish upon a star’ for it to happen in the next 24 hours, the less anxious you are, the more relaxed your child will be. Obvious, but worth reinforcing!
Try to keep instructions calm, supportive, and practical when dealing with repeated accidents. “Never mind, maybe next time you’ll make it here quicker. You’re learning. … Now you need to change your pants and clean up. Here are the wipes/ paper, here’s a bag, …. ” Sure, if your child is sitting and waiting while they try, maybe they could read a book, or you could read a story to them. However, in general, cleaning up after an accident is not the time for special playtime, attention, and bonding at the toilet / potty. It is
Don’t be discouraged by comparing your child’s progress to other children. In fact, try not to compare at all – there will always be someone worse off and better off (slower and faster developing) than your child. Training can be completed anywhere between 3 days and a number of years. Stay with your child, focusing on the very next step only. It will happen when it happens. It will take as long as it takes. Furthermore, kids may regress for a time, at any moment along the way, if they are going through other big changes or learning other big skills, or if they are especially tired or unwell.
BUILDING YOUR POTTY TRAINER INSTRUCTION ‘TOOL KIT’
Backward training – this involves stepping back and allowing kids to do the last step in the task by themselves first (eg. drying hands), then once this is well established, the last two steps (eg. washing and drying hands), and so on.
Modelling – providing the visual examples from which children can learn potty (or toilet) skill sequences. This includes letting your child watch as you manage clothing, do your ‘business’, prepare paper, clean, flush, fix clothes again, wash and dry hands. It also involves emphasising any step you are wanting to work on specifically with your child, such as “Excuse me, back soon, I just have to go to the toilet” for kids who are reluctant to leave their friends and their play zone to go to the potty / toilet; and “Uh oh! Think my alarm system just went, I’m going to go to the toilet”, to cue kids into ‘passing wind’ as a potential signal that more might be on the way.
Narrating – talking through the steps as your child goes through them (with or without assistance). These verbal cues linked with their actions create more powerful memories than actions alone.
Visual checklists – whether they are ready made, purchased, or home made, visual checklists are a great way to reinforce task sequences, and to give clear feedback about where they are along the process. In the example below, the visual checklist intends to prompt a child to take their nappy/diaper off, try at the toilet/potty, wipe/clean, wash hands, then get dressed…before playing (and getting too comfortable with the nappy)!
Chants/Songs – whether improvised or ‘proper’ songs – music can really boost confidence, the ‘fun factor’ and help the potty training messages stick! For example, I love this Potty Song by The Kiboomers; and the catchy Potty Time song shows kids signing that they need to go to the potty. The Poop Song by Growing Sound goes through all the steps of ‘number twos’ in an awesome little rhyme, and The Potty Song by Little Baby Bum reinforces that is ‘okay’ to have an accident (that we just keep trying). For us though, the ultimate celebration tune for the whole family is the Poo Party song by a very cool band The Mudcakes.
Social stories – you can make your own, or obtain a ready made story, they are another great way for the instructions to be reinforced in a different format. The Potty Time with Elmo social story and songs (from the Toys Games TV Channel) are a terrific example.
Dolly play – Practising toileting and potty use skills with your child’s favourite teddies, dolls, figurines etc as it comes up in the context of play is a fun idea too.
Linking trips to the potty / toilet to daily activities – For example, “as soon as we get out of bed, we go try”, “before we take a car trip, we go try.”, “when we get home, we go try” …
Prompting with a timer – Sometimes setting a regular alarm every 60-90minutes helps tune kids into the need to go. “When the alarm/music sounds, it’s time to go try”. Also, usually, every time they are sitting/trying, when they do successfully pee/poo on the potty, they have the opportunity to notice and feel the sensation prior to the ‘release’.
Whenever you go – they go – this is a good general guide around frequency, and gives little ones the chance to learn by at least observing what the regular process involves.
Be creative! Creative solutions might be just the answer to specific difficulties. For example, a different way to direct a child who is potty trained by day but still wears diapers (nappies) overnight, to go straight to the potty in the morning before soiling the diaper (nappy) amidst the distraction of play (or the relaxed feeling of being in the ‘comfort zone’ if you catch my drift), might be to leave them a surprise pathway to follow, leading them directly from their bed to the bathroom… perhaps a road, train track, foot prints, arrows, leaves… It would make for a fun visual prompt, and possibly a nice change from an adult to verbally prompting (calling?!) “Hey! Don’t forget to go to the potty/toilet! … Now!… Come on!…”
WHEN THERE’S A PROBLEM
When there’s a problem, an accident or step that gets missed every single time… it’s time to be a ‘Potty Training Detective’ and try to figure out WHY. I will always encourage families to keep a journal to help shed light on the core issues limiting progress in potty training. This means recording: when your child goes to the toilet, has an accident, what was happening at the time, where they were/ who they were with, and what happened as a consequence. Solutions may include:
Relaxing and waiting for more signs of potty training readiness.
Reviewing appropriate equipment/ environmental set up, and being sure they are drinking enough fluids.
A medical review with your family general practitioner (GP) in order to rule out any medical issue which may be present.
Focusing on reducing anxiety. In serious cases, consultation with a child psychologist may be helpful.
Discussing your concerns and the situation with others involved in your child’s care (teachers/carers, other family members, maternal and child health nurse).
A final word on potty / toilet training instructions…
Rest assured, potty training help is out there. However, it’s important to remember that whilst there are plenty of potty training tips around the internet, the advise is usually general, and solutions may need to be quite individualised. You know your child best, trust your instincts, and don’t be a stranger to your local, friendly, paediatric occupational therapist!
This post is part of the Functional Skills for Kids 12 Months Series by Occupational and Physical Therapists. You can read all of the functional skills HERE. Read all of my monthly posts in this series HERE.
Looking for more information about potty and toilet training? Stop by to see what the other OTs and PTs in the Functional Skills for Kids series have written…