Toilet Training in Children with CdLs
Published by CdLS Foundation USA, Reaching out, third quarter 2017
By Mary Pipan, M.D., Behavioral Pediatrics, Children’s Hospital of Philadelphia
Toilet training a child with developmental disabilities requires commitment, patience and time. The method of learning to achieve continence depends on their development, awareness of bodily functions and motivation to be independent. Children as young as six to nine months developmentally can be trained, but will continue to need adult assistance in maintaining continence.
First, you will need a potty chair on which they feel secure, where their feet are solidly on the floor and that places them in a squatting position. Get your child comfortable with sitting; they can read, watch TV or play on a device. You’ll then start placing them on the potty without their diaper at times when they’re likely to void or stool, e.g. first thing in the morning or after dinner. Make a routine of putting them on the potty whether they go or not, taking them to the bathroom whenever someone uses the toilet and reading about toilet training during story time.
For children who are unable to dress, have very little bodily awareness and do not have a means to communicate, toilet training requires frequent placing on the toilet,
Toilet Training in Children with CdLS
rewards for success and immediately being taken to the toilet with accidents. They then learn to go when placed on the toilet and eventually will go on their own. Some behavior agencies have toilet training teams that will work with the child intensively for a few days at a time to accomplish this.
There are helpful resources when developing tactics for toilet training, such as: “Toilet Training in Individuals with Severe Handicaps” by Dunlap, Koegel and Koegel and “Toilet Training in Less than a Day” by Azrin and Fox. The Azrin and Fox publication is a program for children who have the readiness skills to train but are oblivious to bladder or bowel fullness. You and your child will teach a doll to toilet train and then spend the next day or two doing the same with your child.
Remember that children may have difficulty paying attention to bodily signals when they are absorbed in another activity, so reminders are often needed to prevent accidents. However, persistent nighttime accidents are common, even after being trained for a while. Developing the ability to hold urine at night comes much later for many children, with or without CdLS.
When you are ready to make the commitment to potty train, prep with some reading materials. Share your plan with everyone who will be helping your child train both at home and school to maintain consistency. Don’t be discouraged if it takes several efforts, and consult the experts in your community if you hit a roadblock. With patience and persistence, you’ll get there!
