Potty training questionsthen, i would take him to the potty and sit there with him for 5 to 10 minutes talking about the potty, and going pee pee and poo pee in the potty. after each "talking" session, we would walk through the steps of going potty, since my son likes numbers, so we would say... step one.. "take the pants off" step two... "sit on the potty" step three... "go pee pee and poo pee on the potty" step four... "wipe the {body part}" step five... flush the potty step six... wash hands, use the soap, turn on the water being a numbers guy, he liked that routine, and wanted to be good at it, so he eventually started getting interested in potty training. then, he had a thing that when he had to go #2, he's say, "i need a diaper mom" and for months he was doing #2 in a diaper, and making it hard for me to change him, he didn't like the wiping part and he preferred to just hide and keep that diaper on four hours if i didn't chase him down then we started withholding the diaper, so if he aks for it at 6 he wouldn't see it until 8. then we finally took the diaper away and started to sit him on the potty for 10 minutes going through the "poopee" motions, such as "push" "push" etc. after that session, he would get a diaper, but he had to sit through the session first. finally, i started threatening him during the session that, there would be no diaper after this, so you better go poopee in the potty. eventually, after months of training, he started to go #2 on the actual potty. things are not perfected yet. he still sneaks into a diaper that he finds around the house for a #2 whenever he gets a chance, still wears diaper at night. Potty training is so hard! There are so many ways to go about it, so many different methodologies.....I'll describe a few ways that I've done, maybe one will help? 1. Habit Training This is an entire program that you can probably find somewhere online. You start it by writing a social story about going to the bathroom at certain times. (Example: Before I get in the car, I go to the bathroom. Before I watch a video, I go to the bathroom. etc.) You set it up so that your child will be visiting the bathroom before any major event, so that they are visiting frequently enough to prevent accidents. You review the story frequently, and fade prompting to get them into the bathroom as fast as you can, and provide them with a TON of reinforcement when ever they initiate. This method works well only if your child will go to the bathroom whenever brought in, as it teaches them when to go, not how to go. It also works particularly well for children who are not necessarily able to feel the urge to go to the bathroom due to sensory issue. It can also take a rather significant amount of time to work, as it takes a while for children to learn the story, and to learn how to follow it. 2. Initiation training Part 1: The most important thing you need to do is find the thing the child most loves. Whether it is TV, a certain type of food or a certain activity. You can either use a timer, or do it on your own schedule to start... You begin by taking the child to the bathroom on your terms, and reinforcing with what you deemed to be their biggest reinforcer for a short amount of time after that (5-15 minutes), if they go to the bathroom. During this part of toilet training, you can give minor assitance to the child with the actual toileting process, but you will want to give as little help as possible! Part 2: Once the child begins to understand the connection between going to the bathroom and receiving the reinforcer by going consistently/frequently to get it, you begin to teach initiating. You can do this with words, PECS, or signing. You ask the child if they have to go to the bathroom, and if they indicate they do (by giving you a PEC, signing, or saying yes), then you bring them. They again receive the reinforcer for a short amount of time if they go. During this part of the process you no longer go into the bathroom with them, you will stand outside of the door, or in a different room, but you should not be assisting them in the bathroom at all. Part 3: Once the child consistently correctly indicates yes or no in regards to having to go to the bathroom, you will begin to fade your verbal prompting. At this point, the child may need a prompt to go into the bathroom, so you may use ONLY the word bathroom (spoken, signed, PECS.) If they go to the bathroom, they get to KEEP their reinforcer until they have an accident. If the child does not go, they do not get it. Accidents are negatively reinforced during this part of the process by taking away the child's reinforcer until they initiate bathrooming again. Tips: Throughout the process accidents should be reinforced with a "grochy face", a reminder of "no wet pants", and the expecation that the child will clean up the mess. 3. Timer Training Starts at the moment the child wakes up in the morning, when they are brought to the bathroom immediately. The child is placed on the toilet as soon as s/he wakes up.The child remains on the toilet until s/he urinates. When s/he urinates, the timer is set for 10 minutes and the child is allowed a break from the toilet. As soon as the timer sounds, the child is told, “time to potty” (or another appropriate direction) and guided to the toilet. S/he remains on the toilet until s/he again urinates and is then allowed another break. If the child has been on the toilet for a while, you may run water in the sink or pour lukewarm water over the child’s legs and private parts. When the child is successful at a break length (e.g. 10 minutes) twice, the time can be moved up, usually in 5 minute increments. If the child is not successful, stay at that break length or perhaps even shorten it. This continues until at 1 ˝ - 2 hour breaks. For this type of toilet training, it's ABSOLUTELY necessary to have an adult who is in charge at ALL times. This person can change throughout the day, but whoever it is that's in charge should be focusing SOLELY on taking the child to the bathroom. If you catch the child in the act, run him or her to the toilet and put them on for a few minutes. If you think the child is done, say “NO wet pants” in a stern tone of voice while placing the child’s hands on the wet underwear. Also try to make a grumpy face. Then, take the child to the bathroom seat on the toilet for about 3 minutes. Afterward, clean the child up having him or her help as much as possible. As always, REINFORCE REINFORCE REINFORCE every time the child goes, even if it is just a little! This method works well for children who have not yet begun to urinate on the toilet, and can be used as a precursor to habit training, or any other method for teaching initiation. 4. Night time toilet training Limit fluids after dinner time! There are two primary things you can do, either set an alarm to go off every 1-2 hours, and take your child then. Or, take the child before you go to bed. Make sure lights are dimmed, and wake the child as little as possible when you do this. If you are consistently waking them at the same times every night, they should eventually begin to wake on their own after a few weeks. Tips and Common Mistakes (that can lead to regression): 1. Pull-ups should only be used for nap itme, if they're going to be used at all. It's best to just avoid them! 2. Don't stop reinforcing too soon! This can cause you to lose all progress you've made with toilet training. You should continue reinforce for at minimum two weeks after the child begins to use the bathroom consistently and independently. 3. Pushing bowel training too early. You should ideally wait until the child is fully urine trained before begining a bowel training regiment. However, it will not hurt to have the child sit when you feel he/she is going to have a BM, or after they have one, as long as you are not forcing them. 4. Allowing the child the opportunity to refuse going into the bathroom before they are able to accurately indicate if they have to go. If the child is not correctly indicating (at least 80% of the time) whether or not they have to go, then they are not ready to start initiating using the bathroom. 5. Make sure that what you're using is TRULY what the child finds reinforcing, not what you think is reinforcing for the child (example: one little guy I work with loves watching TV, so we used this as an initial motivator, because it seemed like he enjoyed it more than anything....however, he also loved dangling beads, and we quickly found out he was fine sitting and dangling beads even though he didn't have TV, but when we turned it around and used the beads as a reinforcer, he was not willing to watch TV without them, and was in turn SIGNIFICANTLY more motivated to use the toilet!) Jess, it is sooo messy! He had probably 6 small BMs today, and one he had peed his underpants and shorts, then left them on the kitchen floor. As I went to collect them, Cole went into the master bedroom (away from the hubbub) and laid down on the carpeted floor to produce his BM. Fortunately, we caught him early in the process, so while I whisked him without drama into the master bathroom, DH cleaned up. He would NOT go on the toilet, so I asked if he needed a pullup. He said, Yes - I'd like a diaper. He is making a little fuss when we take him into the bathroom, so we are leery of making a big deal out of this, emotionally. He also had a BM in his pullup up in the treehouse (wooden jungle gym). He slid down the slide and took off his poopy pullup and shorts, then climbed back up the slide totally nude and with a muddy butt. Did I mention our backyard is on the golfcourse and the cart path is about 100 feet from the backyard? Oh yeah! And that the weather today was sunny and in the mid70s? God knows how many golfcarts full of guys saw him! Before I could get him in the house, he slid down the slide with a BM skid mark! I'm laughing right now, but was NOT earlier. My thoughts are to get him to ask for a pullup when he needs to have a BM, and with no heavy sighs nor no happy grins, just let him have it. Cole is on the spectrum, but he is also a former 26 week preemie. His fine motor skills are really, really poor and his attention span is pretty bad, too. So while I can mostly hand-over-hand make him cleanup, Cole is physically not capable of the motor planning and fine motor work that Kristy's little sweetie was when he was training. Am going to look for a book on toilet training kids with cerebral palsy or something. Bladder and spincter control are fine motor skills, so perhaps they may have clues. I like your ideas! Thanks for the replies, everybody. I wish I could respond to several interesting points in-turn but we have a busy morning.I like the idea of giving up pull-ups altogether, but I doubt his preschool would go for it. I'd be sure to enact it at home though; he doesn't go if we're in the community though he will in our yard (or wherever he feels at ease.) The only thing is I doubt my wife would go for it. She and I both have had a hard time learning to relax from the shock of discovering a mess that we feel could have been avoided. I guess we have a lot to learn yet, eh? In the meantime I'll continue to keep the Smarties coming. I just don't want him to start depending upon them. BTW - I believe that timer training would be the most effective but like I alluded to before, we've got a busy schedule with multiple therapies during the week and a little brother to care for who I'm already trying to recruit to help - at 20mos he's already getting rewards for showing an interest in sitting on the potty. We've been attempting to potty train my 4.5 yo since he was about 2.5 but it hasn't been taking. During that time we've seen successes, regressions and a general apathy toward using the potty. I believe that we just haven't been doing enough and relying on the pullups to do our job for us. It's just easier for everybody to change a wet pull up. Still, we've had some success with getting him to go by showing him his reward before he actually pees. If he has to go (i.e. his pull up isn't already wet and warm from recently going) he will usually release with no problem. There are a couple of problems though. First, we have to physically prompt him to go into the bathroom, disrobe (with help), get him to climb up on the potty (too big for a booster) and flash the good (Smarties) before he'll perform. BTW, the Smarties are a necessity and if he even lets go of one tiny drop of urine he will tantrum until he gets his reward. OTOH if he can't perform he'll pull and scratch at himself which also has me really concerned. Poop is much different. For starters, nobody likes a poopy diaper but for no reason will he sit on the potty. Usually he just abides having the poop roll around in his pants and we (who don't like the smell) jump at changing him. Is this actually counterproductive though? Should we let him be uncomfortable for at least a little while? This can backfire on us because he's been known to strip off poopy pullups if not supervised - especially if it's a particularly mushy or runny one. Needless to say, I'm tired of scrubbing floors, wall, furniture. Regardless of whatever happens on the potty it has to be initiated by an adult. I'st frustrating because he can do it and has even shown that he can hold it overnight or while out of the house. He certainly will not go poop while in unfamiliar territory which shows me that he knows where it's appropriate to go, he just needs to be cajoled. Also, any criticism (however small) just causes him to either dig in his heels or cause a meltdown that can easily get out of control. So what can I do? I want him to be able to just run into the bathroom and go with a verbal prompt. He's shown that he can do that for other (albeit less complicated) tasks. He's shown a remarkable ability to control his bodily functions but his sensory issues and emotional outburst almost seem to get in the way. Am I still expecting too much? What can I do to make it a more preferred task? Would making a schedule of this (and all the other tasks of the day) be something that would be attainable and productive? Any ideas would be appreciated. BTW, part of what makes it so difficult is that I also have a very energetic 20 month old to look after and a very messy house with a spouse who has certain poorly-defined expectations for my homemaking efforts yet can only offer a few hours a day in real support. Add to that a full schedule of therapies, preschool, etc. with no family support (from aunts, uncles, grandparents, etc.) and it feels like I'm battling for my very sanity, let alone getting things accomplished. Did I mention that I'm also the father here, so there's also an added stigma - especially in public. What's a guy to do? LeeannC, Boy oh boy do I love holders! */end sarcasm* I have one who is capable for holding for upwards of 18 hours, it's ridiculous. Is your DS bothered at all by the feeling of the poop in his undies? If so, then definitely leave him in undies all of the time. There will be messes, but it's unavoidable... Another thing you can do with BM training is teach him to ask for a pull up, and allow him to have it on for only a short amount of time (15 minutes?) and then have him do exactly what KristyS said her DS did-put the poop in the toilet, wash himself up, and throw away the pull up, and back into undies immediately after. If he makes a mess make him clean it up, if this dosen't bother him, use overcorrection (make him clean it up five times every time he goes, even though there won't be a mess the last 4 times...it will make going in his pants an incredibly undesirable thing.) Question - when the kid weighs 65 pounds (age 8) and he has multiple small BMs when at home, MUST we keep him entirely in underwear? I too will cut the sides off and throw out the poopy ones, as the by-product of a 65 pounder is not something you want accidentally sling-shotted across the room. He wears underwear at school and stays dry all day long, usually. However, he often is HOLDING HIS URINE FOR 8 HOURS. Everything comes flowing when he gets home, but he will not use the toilet. The pee either ends up on my kitchen floor, once he relaxes, or if I"m not up for wet and muddy pants, in his pullup. We had success by bailing on pullups completely. I bought a TON of underwear with fun interesting characters and simply announced one day "you're a big boy now and will wear big boy underwear and use the potty." We went cold turkey, daytime and nighttime at the same time. Lot's of praise when he used the potty. Lots of laundry LOL (thought I have to admit that some particularly vile underpants went right in the trash sometimes.) When he had an accident we wouldn't scold him, but we'd look at the undies and say things like "oh no, spiderman is all dirtly, I don't think spiderman likes to be dirty." It took a little while, but it worked. There is nothing comfortable or fun about wet / poopy underwear. He got the pee in the potty thing consistent right away, the poop part took another 6 months. However, he learned to poop in his underwear, carefully dump the poop into the toilet without spilling, put the soiled undies in the washer, then get a clean pair and redress himself. We simply ignored this entire operation completely and one day he just started sitting and going by himself. It was right around age 4 when we could say he was fully trained. He still wet the bed 4+ times per week until age 5 1/2 but we stayed the course and dealt with the wet sheets. Once the pullups were gone, they never came back. It was a leap of faith, but it worked for us. My son will do this. After I struggle with him, get his pants down and get him to sit he will sit for a sec and then get up and expect his reward. I keep pushing him back down and he will then stick his hands in the toilet water cause he is mad.I was told he may need a visual to stay sitting. Like a timer or a hour glass with sand so that he know he has to stay sitting for this amount of time. If he don't go no reward. His school has a sand filled timer they will be sending home and I will give this a try. No real advice as I am struggling in this area too, but I wish you good luck! FWIW, he's a big stimmer. Mostly it's visual (he likes to make faces in the mirror, he'll look down into the water at his reflection) so if he feels he has to go #2 he'll request that I turn off the light. Now, there seems to be some other issue going on as well because he won't stay on the potty unless I'm in the room with him (to corral him) Maybe it's "stage fright?" Anyway, we'll sit in there for an hour and often I'll pass out from the lack of sensory input and being dog-tired. He'll be completely engrossed in the smallest amount of light in the room. BTW - he also preferred to be on his little potty, but after two years it was getting pretty ratty (the foam was soaked with urine) and when he had a meltdown and flipped it over after he'd peed in it I threw it out. Now it's a booster on the big boy toilet (or none at all.) I feel as if I've painted myself into a corner. |
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