Potty Training Children with Disabilities
Handling the physical aspect of training a child with a disability is wildly different with individual kids, depending on the disability. You may need to provide high-tech props that facilitate movement from walker or wheelchair to the toilet (see the "Working with Special Gear" section in this article.) On the other hand, your child may need nothing more than some bars to grab onto when she's sitting down — and your friendly assistance.
One of the hurdles that parents and caregivers face is that kids with physical disabilities sometimes are so hamstrung by their limitations that even the idea of pleasing adults doesn't motivate them, the way it does other children. Also, some aren't moved by the idea of being a big kid or wearing big-kid underwear because they're happy being "little" and "dependent" — it feels safer, considering the physical mountains they must move every day, when they're trying to move around successfully.
Obviously, different disabilities have special problems built in. To discover the best way to potty train your child, try some of the following ways of obtaining advice on potty training a child with a disability:
- Study up on your child's disability. A good resource for info is the Family Village.
- Seek insight from other parents of children with disabilities. Your community will probably have support groups, or you can join one of the many on the Internet.
- Ask an occupational therapist or psychologist for advice on potty training a child with a disability.
Understanding muscle control issues
While most children can control their bowels and bladders by about age 3, kids who have disabilities may take much longer. Their medical problems can delay the development of the muscle control a child needs to regulate herself. In some cases, a physical problem can even prevent a child from developing this ability. Check with your doctor to find out whether you can expect eventual potty use — or not. Remember, however, that a doctor is not a prophet.
You have the advantage of knowing this particular child better than anyone. Therefore, if you're sure that she can be trained, you have nothing to lose by trying — as long as you're not pushy or critical.
Coming to grips with your child's muscle control issues is key to helping her become potty-proficient. You'll discover, as you investigate, many strategies that work in training special-needs kids.
Sometimes, a child's motor difficulties will make her use the potty only if you take her. Escorted, she will do it. Otherwise, she's a no-show. The good news is that eventually she'll decide to go on her own, but that may take time.
Get your physician to be your ally. She should provide you with information on understanding your child's limitations and boundaries insofar as muscle control. You don't want to try to get your child to perform actions that are beyond her capacity, but you do want to be there with encouragement.
Enhancing physical progress
One of the best ways to enhance your child's physical progress is to potty train her as you would any child: "You can do this — I know you can. We'll find ways to work around your brace."
To promote physical adjustment to potty training, you can forge mind/body links in the following ways:
- Help her connect bathroom with body functions: Move into the bathroom for diaper changes and emptying diapers — you want her to associate poop and pee with the place where the toilet is.
- Brag on tiny successes: Make sure your child gets huge bravos for the baby steps she makes, whether that's making a tiny dribble in the potty bowl or saying "I potty" after she has done it in her diaper.
- Help her handle nighttime frustration: For a child with disabilities, staying dry at night is hard. You can expect a child who lacks mobility to have trouble making it through the night dry, and she'll need special handling and empathy. You may need to transfer her from wheelchair to toilet many times before she's able to handle it by holding on to grab bars (see the "Working with Special Gear" section later).
Before you kick off her program, make sure she's eating and drinking a nutritionally sound diet. You don't want constipation to get in the way of progress. Next, talk to her about the body signals that tell your child she needs to go potty. Unfortunately, certain physical disabilities tone down that urge feeling. Remember, too, that a child with a disability may have a muted sense of body in general, so being messy may not bother her.
Your child may miss the potty sometimes, so you should tell her not to worry about accidents. She may also be pretty bad at cleaning herself. All toddlers are fairly messy at this stuff, but the disability may take your child's messiness quotient up a tad. If handling toilet paper is out of her league, just do the task for her. She may eventually learn how by mimicking your moves — but for now, you remove the possible frustration involved in her desire to be clean but lacking the coordination to accomplish that.
After addressing diet, body signals, and messiness, try these ways of enhancing your child's potty progress physically:
- Set up a success-oriented environment. Get removable obstacles and stressors out of the way. Install handrails or other physical supports so that she can feel safe and sturdy when she sits on the potty.
- Pad the potty seat with foam (from a crafts store) or buy a softer, padded toilet seat if your child thinks the seat is too hard or cold.
- Use waterproof sheeting on surfaces where your child sits so that she can hang out clothed in just underpants or diapers. That way, she can be wet long enough for the feeling to bother her. The waterproof stuff is there just to make cleanup easier.
Working with special gear
You can train a child with a disability on a specialized potty chair (custom-made for the child); or build steps up to the potty; or mount a set of grab bars on the walls on each side of the adults' toilet. You can also purchase some terrific wheelchair-conversions that make potty use easier for a wheelchair-using child.
A tot with motor developmental problems is often potty trained on an adaptive toilet seat or extra-high toilet, which you can shop for at a medical supply store, or online at Web sites such as the following:
Another possibility is checking with your occupational therapist for availability. Some state agencies provide equipment for families whose incomes make these pricey toilet options out of the question.
Some of the aids and options that are good for potty training a child with a disability are the following:
- A custom potty chair, or one that's modified from an existing chair. Check Able Generation — they work with kids and their parents to get the product just right.
- A wheelchair with a hinged center-section padded seat that lowers to become a commode chair.
- A cushion that self-inflates to assist a child in going from wheelchair (the getting-up part) and moving onto the toilet.
- Grab bars on each side of the toilet for leverage in moving from a wheelchair or walker to the toilet.
- Toilet supports that come with chest strap, safety belt, padded cushion, armrests, and footrest.