ConnectABILITY

Steps Towards Toileting Independence

Children develop a sense of independence and self-esteem when they are able to care for their own toileting needs. Although toilet training can be challenging at times, remember that each step your child achieves will bring him closer to the goal of toileting independence.

Before you begin the formal process of toilet training your child, think about the following signs of toileting:

  • Is your child’s diaper dry for at least two hours at a time?
  • Does your child have an interest in the toilet? (e.g., flushing)
  • Does your child indicate verbally, or through the use of signals that his diaper is soiled and he wants it changed?
  • Does your child sit on the toilet with his clothes on?
  • Does your child show the same signals with other care providers?

If you feel that your child is showing a few signs that he is ready to begin toilet training, here are a few tips to help you prepare for this important step and make it successful for you and your child:

STEP 1: PREPARATION

  • Decide on a start date and be sure to discuss your plan to toilet train your child with other caregivers. You can also let your child know about the “big day” by marking it on a calendar.
  • Build a positive association with the bathroom as you count down to your start date. You can do this by playing music or playing with fun toys in the bathroom. You can even decorate the bathroom with your child’s artwork, stickers, or toys of your child’s favourite TV character.
  • Move all diapering and toilet related dressing to the bathroom. This helps your child associate elimination with the bathroom, which is now a fun environment.
  • Get a toilet ring that can be placed on top of the toilet seat. It is important to make sure that your child is comfortable and supported when sitting on the toilet.
  • Although you may want to consider using a potty, we strongly recommend that training starts on the toilet. This eliminates extra teaching time down the road when moving from the potty to the toilet.
  • Get a step-stool that can be used to support your child’s feet while sitting on the toilet. His hips, knees and feet should be at a 90 degree angle for maximum support. This ensures that your child’s leg muscles are relaxed, which makes it easier to urinate or have a bowel movement in the toilet. The step-stool can also be used to access the sink for hand washing.
  • You will also need a supply of cloth underwear for your child to wear when the start date arrives. If possible, involve your child in purchasing the new underwear.
  • Think of some highly preferred items that you can use to reward your child for urinating or having a bowel movement on the toilet. Favourite food items such as candies, chips and cookies are recommended because they can be delivered in small quantities and are consumed quickly. If you are using a food treat, try not to let your child see the whole bag, or else he may keep asking for more.
  • Review the data collection sheet and the toileting steps. Keeping track of your child’s progress will help you to determine when to fade your assistance, and to identify areas that may need extra teaching. (See STEP 5 for more details)

STEP 2: THE FIRST DAY

  • Dress your child in pants that are easy to push down and pull up, or in underwear only.
  • Encourage your child to drink lots of liquids. Increasing the amount of fluids your child consumes will mean more trips to the washroom. This approach will allow your child to practice sitting on the toilet and have an opportunity to experience success. Remember to bring the data sheets and a pen into the bathroom so that you can easily fill in the information after each toilet trip. The data is very important as it allows you to track your child’s progress. (See Part 5 for further information)

STEP 3: THE TOILET TRAINING STEPS

  • Initiate a toilet trip every 45 minutes OR when your child shows clear signs of needing to go. This will help your child to associate the “gotta-go” feeling with going to the toilet.
  • It is important to follow the same sequence for every trip to the toilet you initiate. This helps your get child become familiar with the routine and expectations.
    1. Approach your child and say, “It’s time to go pee.” (or whatever phrase you have decided to use).
    2. Then, walk to the bathroom with him.
    3. Once you are there, have him pull down his pants and underwear, and sit on the toilet.
    4. Your child should sit on the toilet for at least 2 minutes (or longer, if he seems comfortable).
    5. Give him some toys, books, or other interesting materials to keep him relaxed while he sits.
    6. If your child is successful on the toilet, immediately show him that you’re proud by giving him a reward and praising him. Then continue with steps 6 through 10.

    7. Wipe, if necessary.
    8. Have your child stand up and flush the toilet.
    9. Have him pull his underwear and pants up.
    10. Have your child wash and dry his hands.
    11. Return to the previous activity or a new one.
    12. If your child is not successful after 2 minutes or so, let him know that he can try again later. End the toilet trip and continuing with steps 8 through 10.

  • Let’s take a look at the sequence that we recommend you follow:

  • Try to avoid giving verbal instructions during toilet training as your child may become overly dependent on you to tell him what to do. In general, physical help coming from behind, without verbal instructions closely mimics how it will feel for him to do it by himself.

STEP 4: ADVANCED TOILETING SKILLS

Once your child is consistently successful during the day, and only having a few accidents, you can then attempt night time toileting. There are a few tips to keep in mind when you decide to tackle night time toileting:

  • Limit your child’s liquid intake in the evenings and try to avoid giving fluids for 2-3 hours before bedtime.
  • Have a regular time for going to bed.
  • Have a consistent bed time routine, which includes toileting just before going to bed.
  • Take your child to the toilet as soon as he wakes up in the morning.

Also, keep in mind that bowel control generally emerges later than bladder control. Expect that your child will begin to experience controlled bowel success after an urination routine has been established.

STEP 5: DATA COLLECTION

The Toileting Independence Data Sheet includes all of the steps involved in toilet training. The sheets will help you keep track of your child’s progress during this process and also help you figure out if your child may need more (or less) help. Take a look at the “Toileting Independence Data Sheet” for step-by-step instructions on completing the form.