I understand that there is a movement to avoid the word “training” when referring to learning to use the potty. I respect the reasons why, but just so we are all on the same page and because that’s what the book I will be referring to calls it, I am going to call it Potty Training. Maybe you like to call it “potty learning” or “toilet training” or “Crap Mastery”… whatever you like, please feel free to insert your personal choice when reading this 🙂
Also, if you have not read the previous post, Lets Talk About Poop Logs: Our Potty Training Struggle, please stop here and read that first. Otherwise you’ll be more lost than I was when I started watching LOST in season 2. Seriously, I was like “What the heck is going on?!” Point is, I had to go back and watch season 1.
This will be long! So feel free to break it up over your lunch break for the next couple of days LOL ;). I had wanted to post a more detailed account of our experience before, but decided a lighter approach would be better. After receiving comments about my post, I decided to do a follow up. My first post, Lets Talk About Poop Logs, was to just say “Hey, you’re not crazy and you’re not alone.” Now I want to give you a real account of our journey so you can see how “not by the book” (even though we were using a book) our experience was. This is mainly inspired by a woman on a thread I had been commenting on about Lets Talk About Poop Logs. She had brought up the very important fact that putting kids with physical limitations on a schedule can cause more damage than good. I wholeheartedly agree. We experienced the same problem with JEM. Her testimony brought up the negative side of what I call “THE POTTY TRAINING PUSH” or TPTP. So I decided to write this to clarify some things I referenced in the book, The Potty Journey and to give you a detailed look at our approach.
There is a huge cultural pressure to potty train our children at a young age. I have known parents who started their kids on the potty at 18 months and have agonized over how long it took. Its not their intention, but their complaints have been discouraging because I felt they were diminishing the true struggle of potty training a child with a physical disability. I’m going to speak boldly now *takes deep breath*, so prepare yourself for some admonition parents. If you have decided to potty train your kid at 18 months and they are struggling and not finding success…it’s going to take a long time. You have a “choice”, though. You can choose to stop and start again when they are ready. So for a parent who is struggling against a real disability combined with a lack of support and information to understand what that disability means, how it affects the child and how to resolve the situation, listening to that “whining” (for lack of a more sensitive word) is really painful. Its not that we don’t care about your discomfort, its just comes across as not being grateful. You have a choice. We don’t. So don’t get sucked into the The Potty Training Push and just let go! Be free to do what’s best for you and your kids and stop the madness in your life. You deserve peace. Lets face it, very few babies are ready to use the potty in a completely autonomous nature at 18 months. Yes, “BABIES”. Babies are considered to be “BABIES” until they are two years of age. We call them “infants”. Then, they are considered to be toddlers and most of that age group is still not ready to use the potty until they are 3. I’m just talking about children with NO disabilities. When you take a physical disability into account, those statistics change dramatically. (I don’t have actual statistics…I’ll just call that a figure of speech and move on 🙂 ). But really, all of the moms I speak to that started TPTP at 18 months regret it.
Note: I am not judging or discouraging the Elimination Communication style of toileting. Please see below for more information and breaking the myths behind it.
Even when I would begin to dispair I thought of all of those parents out there whose kids will never be able to use the toilet. Imagine how that must feel to them. Their child is being denied the basics of a normal life, toilet use, writing, walking and talking. Some have disabilities so severe they will be in the mind of an infant their whole life. Or some, the mind of a 6 year old and those children understand that they are different. The reality of not being able to use the toilet affects them greatly. As their bodies grow and their mind stays the same, they know they might never get married or have kids. So when I start to feel really bad. I remember that there is always someone struggling more than I and I need to respect their pain by getting over mine. Rather than belittle someone’s experience, when asked, I would simply reply that we were having great difficulty and prayers were welcome. But it hurt to hear parents complain about decisions they had the power to change. It hurt a lot. My purpose for sharing this particular piece of information, is not to accuse, stir up strife or judge. Its to be a voice for the hurting and lonely out there who have less suppoort and help than I. So, please understand that I write this admonition with the greatest of reverence and least of condensention. I only want to give a voice to those who are hurting and be their advocate.
On To The Next
So! I want to talk more about the book The Potty Journey that I recommended, to give you all a clearer understanding of what the book is trying to convey and to talk about how we utilized it and how we didn’t. 🙂
Judith, in regards to her book, The Potty Journey, says “It is NOT a book of ‘toileting tricks. Step-by-step, it leads you, the tour director, all the way through the toilet training journey to its ultimate destination: successfully toilet training your child with special needs.” This book is less about a rigorous schedule and more about routine. It is not for children with a severe medical physical disability because those children have very special limitations. It’s for those children with special needs, Autism spectrum disorders, including Sensory Processing Disorder. It is designed for a child with the physical age of 4 years, the mental age of 18-24 months, stays dry for 1-2 hours, has formed BM’s (meaning they don’t have a medical problem that causes loose stools), they are emotionally ready and additional stress is absent (there’s no major familial change like the birth of a new sibling), and there is an absense of Physical Contraindication. Physical Contraindication “basically means the medical professionals agree that tthere is no medical reason not to begin toilet training”. I am very interested in information on Potty Training children with medical physical disabilities and extremely sensitive to those difficulities. I encourage any of you to send me comments with that information to broaden my understanding. The main voice of the book is for children with Autism, which most agree that a schedule and routine is essential for. Kids with SPD need routine too and like those with Autism, are often scared by TPTP. She addresses this and creates a very slow systematic approach.
One thing I struggle with is caving into the meltdowns and tantrums of my Sensory kid (weird label). All of the professionals, specialists and SPD Potty successful moms that I know agree that gentle pressure can provide amazing results. The key is not to overwhelm, but to get them used to change and discomfort. So they can learn to regulate themselves in order to function among their peers. Therefore, pushing them to a breaking point with some huge shove, is not as effective as our mainstream society would tell us. Tough Love, they call it. Cowboy Up! No one just throws their baby into a pool and says, “Deal with it! Sink or swim, kid.” That approach is not effective in a child with Sensory Issues. However, a gentle but firm approach, in a safe and secure environment, displays amazingly effective results. I have seen this produce INCREDIBLE results in our son. However, he had to be ready physically and emotionally. Determining when that is, is the most difficult part of the journey (at least, it was for us).
NOTE: These blogs are not written by a professional. They are written by me. A real mom just like you! Well, you’re probably normal. 😉 I want to be clear when I say, we did not follow this book step by step because it wasn’t appropriate for our son to do so. We took the parts that were applicable to him and went with that. So, without further ado, here it is!
How we overcame The Potty Training Push and finding victory! Yay!
As I mentioned in my previous post, Lets Talk About Poop Logs (I admit, I love writing that), JEM really struggled with using the potty. We first started him on the potty 5-6 months after his little brother was born (he was 3.5yo). We bought a little potty and had him sit on it for a couple minutes at a time , 3 times a day. We did this for a couple of weeks and realized that he was just not physically ready. Other than his own motivation and excitedness about the potty, he showed no sign of physical readiness that was mentioned to me by our friends and pediatrician. He wasn’t staying dry through the night. We noticed other things that no one mentioned though. We noticed he didn’t truly understand what we were saying and he could not communicate to us at all about the potty. He wasn’t staying dry, but biologically it appeared he just couldn’t do it. So we stopped. We didn’t talk about it until he was nearly 4.
After our vacation in late October of 2011, we decided to try again at the recommendation of our friends and pediatrician. So we began The Potty Training Push. Sigh. Not only did it take a confident sweet little boy and turn him into a fearful little maniac, but it had physical set backs as well. He began withholding. No matter how hard we tried to find a motivator and encourage him with prizes and candies, movies, books, trips, EVEN A PUPPY, it only made things worse. By that Christmas (only 3 weeks after the start of TPTP) he’s was so bound up and in physical pain that we were in absolute dispair. Our poor little guy. I would just be in tears at the end of the day and I entered such a deep depression I thought the world, especially my kids, would just be better off without me. For those of you who haven’t read my previous post, Lets Talk About Poop Logs, please stop here, read the post and come back so you can see the full scope of pain this little guy was in.
Now we were just trying to get him to poop at all!!! We didn’t even care if it was in his diaper. We tried to tell him it was okay to poop in his diaper if he wasnt ready for the potty, but the damage was done. He felt like a failure if he didn’t go in the potty and he didn’t want to poop in his diaper because he desperately wanted to be a big boy. So he held it. We went through 3 major incidents of the sore butt, but really, the wounds never fully healed. We talked to our Pediatrician over the phone (who is a GREAT doctor btw), our friends who are doctors and pediatricians, had those three even look at our son and they all said that even though it was the worst they had seen that it would heal and everything would be fine. Those were the longest 3 months of my life. I just knew something wasnt right.
By his 4th birthday I had started noticing other delays in his gross and fine motor skills. So at his appointment, I talked again to the doctor about the struggles, wounds and the other issues. He advised stopping potty training and potty talk altogether. He also gave him Miralax to help. He referred us to an OT (Occupational Therapist) to evaluate JEM for the other delays and we finally got to the root of the problem. I totally expected them to say I was overreacting and there was nothing wrong with him. To my surprise the told me he had Sensory Processing Disorder with subtypes Postural Ocular Disorder and Self Regulation Disorder. And problems in potty training are one of the most prevelant symptoms for that particular subtype. WHAT?! SO I’M NOT CRAZY?! Now, let me just say, I don’t pretend to know more about child rearing than anyone that has paved the way ahead of me, but no one knows their kid like their parent/ main caregiver. I was relieved that I trusted that. They told us to stop potty training altogether and wait for the therapy to help him. We were told that it could take up until he was nine, but we believed that our little persistant guy would be ready again.
So…we waited. We spent the next 5-6 months just working on the withholding issue. If he wanted to sit on the potty, we let him but we didn’t push it. As we approached this summer (2012) we felt like he was ready to talk about it and that’s when I found the book, The Potty Journey. I found that it was more important for me to be ready this time around. Over the last 6 months I’ve struggled with anger and frustration. I was up to my elbows in poop all day long for a year now and I was absolutely exhausted. I was ashamed of myself. I sought forgiveness. I got some courage on me, put on my sh** boots and prepared to get dirty. Things began to go well, with gentle pressure, strong reinforcers and lots of encouragement and cuddles. We noticed JEM asking dad for help. So, he decided to take a week off of work so that could work with JEM on it and I could have a break. There, at last, VICTORY!
1. We started with bowel training first, since that was the problem area. I made note of when he was having his BM’s so that I could be watching him for his urges and help him to the potty.
2. I increased his Miralax (recommended by doctor) which enhanced his feelings so he could push during the urges.
3. I created VISUAL potty reminders and put them up in every room. (See picture!) The book I used has a great recommendation for creating a communication chart for children with low language comprehension. This helped him tremendously because I could just refer to the picture. Boy on potty = iPad Time. Later, it was Boy on Potty + Poop In Potty = iPad Time.
4. I spoke in words he used instead of my words. That took a couple of weeks listening to him talk about it. He used words like “feelin’s”. So I used the term “feelin’s”. That way I could say, “When you have feelin’s, stop, go to the bathroom, push your poop into the potty.” That helped a great deal.
5. I put him on the potty for very short periods of time and rewarded him for potty time spent. Poop or no poop.
6. We talked calmly about the potty and tried to find a really powerful reward for the end of the journey. At first he wanted a puppy, but after seeing a karate class, he decided that Karate was the thing he really wanted to do. Note: This took us a year to find his motivator. So if you haven’t found one yet, have hope. There is one, but your child might not be able to communicate to you, in words, what that is. When they are capable, they will let you know. But keep trying!
7. I started having him sit on the potty for longer periods of time so that he didn’t do the whole… Drop a half nugget in and your done. For large BMs we through a huge celebration in the bathroom. Jumping and singing and clapping (not good for all kids… some prefer no attention drawn to them).
8. NOW, it was time for Daddy to come and SAVE THE DAY! We had set the groundwork for him and now it was in his hands. I took a back seat and took on a demo and build project in our bathroom. There’s nothing more cathartic than putting on your TARDIS shirt and swinging a sledge hammer at some ugly tile ;). If you have the means, I highly recommend you do it. It is so choice (random Ferris Bueller reference). So last month, he spent a week with Daddy and surprised us. My husband took the baby with him to run some errands one day that week, and while watching TV I heard a voice cry from the bathroom “I DID IT!” I couldn’t believe it. He had gone to the bathroom and put his poop in the potty on his own!!!! Amazing! What a victory at 4.5yo!
UPDATE: he is still in diapers and still has lots of accidents. This is not a “How To” post, but a “Heres How We Did It” post. And we’re STILL doing it.
That being said, the victory lies in him being able to go to the bathroom by himself and actually push out a POOP LOG! That’s a huge deal for him. I am not concerned with consistency right now. I’m just celebrating with him in his new found autonomy. He’s still on the Miralax periodically and he has had one sore bottom episode since then, but it was nowhere as bad as before.
To Sum Up:
1. Potty Training a Sensory Kid is HARD! …LOL…duh 😉
2. You are NOT alone.
3. There’s no one book or person who can tell you what to do. They can only tell you what has worked for them. It is then our job as parents to look into our kid, see their need and use the information we read or hear just like any other tool. Not all jobs call for a flathead screwdriver. Some require a paintbrush. But the flathead screwdriver might come in handy when opening the paint can!
4. We need to fall out of agreement with The Potty Training Push. We need to wait for the child to tell us when they are ready. Now, some kids are ready but because they fear change they will resist it. The key is to know the difference between the two. If you are a person who believes that TPTP works, then use it. 🙂 But as a society, a one size fits all approach to potty training is just ineffective. It’s rare that it works for a Sensory Kid, so we parents need to renounce our guilt and be sure in ourselves.
5. Reach out to people who will be supportive and offer encouragement, even if it means getting online and talking to a bunch of strangers like me who only now took a shower after 2.5 days had gone by. My poor family and they sensitive olfactory organs!
6. Do whatever is best for your kid. They deserve it!
7. Contact me if you ever need anything by leaving a comment. I’m happy to encourage you the best I can. I honestly love people and pray for you parents out there that are hurting. I will do whatever I can to help you.
Thank you so much for reading these posts and spreading the word to other parents out there who need help. Like I said, I’m not a professional. I don’t have all the answers. I don’t even consider this post to be any kind of answer! Mainly I just want you all to know that there is hope. Even when it seems like there isnt. There is also love and empathy. Sometimes when we cant find an answer or don’t have one to give, it really helps to just hear someone say, “I’m sorry you’re going through this right now. I’m here for you.” So if none of what I wrote above helps you, just know that I’m saying those very words to you now and you are cared for deeply.
This was incredibly taxing and difficult to write. So please be kind in your comments. I really would like this to be place for postitive talk.
The Potty Journey: Guide to Toilet Training Children with Special Needs, Including Autism and Related Disorders, written by Judith A. Coucouvanis, published by APC (Autism Asperger Publishing Company), copyright 2008
*Elimination Communication is not early potty “training”, but a method of noticing signs of eliminating and placing the child on the potty to do so. I don’t want to bring judgement against that movement. I’m only saying that there is a more inappropriate movement (that they would agree with me) that is damaging to some children (not all children). Like me, they are just providing an alternative to The Potty Training Push. I found A Hippie With A Minivan’s blog about this very interesting. Though I don’t feel like this method is right for my family, I don’t want my post to bring criticism against alternative toileting methods. We’re all looking toward the same goal…a child that has a confident and positive perspective of using the potty!