Friday, March 16, 2012

Potty TRAINING

As I finish up potty training one child and begin to enter the 2-year-old phase of training two more, I thought this post was a good review...long, but thorough.

I tend to keep potty training very low-key and the child's responsibility. It usually takes us about two weeks, with rare accidents for a few weeks longer. If a child makes the decision they want to potty train, and they have been prepped along, then it really is like a light switch flicking and the war is won, we just need a few battles to finalize it. I have had children be potty trained from diapers to done in 24 hours if THEY decided it was time. 


My soon-to-be 2-year-olds have been sitting on the potty chair here and at home since they were 18 months whenever and however they wanted. Now, at two, when we diaper, we discuss that pee and poop go in the toilet and not our pants and that if they need to go, they need to let me know so they can go in the potty chair. This is simply prep, creating the expectation and knowledge base, for the next six months, unless they show that they are really ready for potty training prior to 2 1/2.



22 months first time trying to poop on the potty.
Parents always get excited when their around-18-month-old child starts showing interest in the bathroom processes. Even though I explain to them that the interest is in ANYTHING that the parent does, as they are at that developmental stage of mimicking adults, the parents almost universally think the child is interested and ready for potty training. They soon realize that THEY, the parents, are much more interested in it than the child. 

All research shows that the optimum age for potty training is 29 months. Any earlier, and it's just frustrating for the child and the care givers, as children are usually completely potty trained with no accidents right around the age of three, no matter what age the training begins. Boys frequently take longer than girls, being closer to that 36 month mark. So any earlier, and you are setting up the child for frequent failure [a wonderful introduction to their first independence], a power struggle when the failure leads to them not wanting to participate at all, and the child feeling inadequate and a constant disappointment to the parents. Not a good situation. It is best to wait until they are really ready, willing and able.


Frequently people will say a child was potty trained prior to two. It is actually the caregiver that is trained to watch for the child's cues and takes the initiative to toilet the child. It is not the child totally responsible for doing the toileting, i.e. POTTY TRAINED.



Signs of readiness in the child:
  • Stays dry for a few hours at a time 
  • Wakes up dry 
  • Understands words like potty, wet and dry 
  • Participates in dressing and undressing 
  • Follows simple directions 
  • Appears to know s/he is about to go
  • Able to communicate in some manner that they need to go
Signs of readiness in the PARENTS:

  • Are committed to the process 
  • Are willing to make the accommodations necessary for their child to be successful 
  • Are willing to let their child have some control of the process 
  • Are ready for the mess and willing to handle it calmly and respectfully 
  • Understand that potty training is a two steps forward one step back LEARNING PROCESS 
  • Are doing this because their child WANTS TO or is READY FOR IT, not because grandma or some other person has determined that the child "should be potty trained by now." [Eye roll because I can't begin to count the number of times my clients have talked to me about being pressured by relatives to begin potty training!] 
  • Understand that home success and school success are often on separate timelines 
32 months and working on that last accomplishment -
5 day straight with no accidents 
Preparing a child:
  • Teach your child the words for bathroom functions and body parts 
  • Allow your child to observe others using the toilet and explain the steps involved 
  • Have your child assist in dressing and undressing 
  • Read to your child books and watch videos about toilet learning 
  • Get a potty chair/toilet topper and explain that it is his/her chair 
  • Around 18 months they can begin sitting on the potty chair when the parent is going to the bathroom. Describe every single step in the process of toileting as you perform it. This is important to establish routine. This can be accomplished with the child clothed or down to their diaper, or unclothed. This is one time when it's nice to have a potty chair, because the parent can sit on the big one (even if you don't have to go!) and the child can sit on the little one, and often this camaraderie will assist the child with wanting to do it, rather than them having to do it just themselves. 
  • Let the child "teach" a doll or stuffed animal how to go on the potty, watch them play and guide them as needed in the correct procedure, including praise. It's even better if it is a doll that actually wets. 
  • Around 2, transition all toileting activities to the bathroom. Stop using a changing table. Keep all toileting items within child’s reach and have him/her responsible for getting them and using them to their ability. For instance, have the child bring the new diaper and wipes, and afterward re-dress and place the used diaper into the trash. Let your child know that if they need assistance, they need to ask for it. Don't just help. Ask if they would LIKE help. If the answer is no, then back off and let them know you are available if they would LIKE help, and to just ask. Start giving over responsibility for toileting to the child and start stressing that it is their job now, but you are available to help if THEY feel they need it.

Children view potty training as a grand adventure...for a while. Then the new wears off and they back slide. They don't want to take the time out to go to the bathroom once the fanfare has died down, which it must always do. So, I try to keep the fanfare to a minimum from the beginning. 
One of the hardest parts of potty training is getting down the routine, so I suggest you work on the routine first. 
  • We (everyone in the family above the age of 2) go to the potty as soon as we wake up. 
  • We go to the potty before we leave the house to go ANYWHERE...shopping/church/etc. 
  • We go to the potty before going to nap/bed.
Make it a routine that the child is sat on the potty immediately after waking up. S/he usually will need to go at that time and will learn to hold it until you get him/her there. This is the one time when sitting there and staying there is non-negotiable, if the child is found dry in the morning. Leave the child there with a toy or book until s/he goes. If the child gets up, return him/her to the potty. This is the one time of the day that you can GUARANTEE they have to go, and provides the perfect, consistent scenario to establish that this is what we do now, absolutely every morning, no matter what.

Consistency is key!

The routine if frankly the hardest part of potty training for the busy lives families tend to lead today, and it is as much about training the parents and caregivers as it is the child. Children do NOT want to stop to go to the bathroom, and this leads to the greatest number of accidents. Parents also find it difficult to change their routine to build in time to toilet the child in a calm manner, without rushing or demanding, which is vital to success.

Remember that toilet usage (actually going, and going between routine times) is a child's choice and responsibility and that must be stressed at all times. The routine is NOT the child's choice...This is WHAT WE DO. When the parent goes, the child should be present and sitting on their seat, and the parent should explain EVERY SINGLE LITTLE STEP that they are performing...I'm taking down my pants, I'm sitting down on the toilet, I'm putting my peepee in the toilet, I'm getting some toilet paper... Then ask the child, what comes next? What is a normal process for us is a multi-step activity for a child learning how. TEACH them how to do it and when. As for the actual going in the pot, that's just gravy.

Commend your child for dry diapers. When they DO go on the potty, a simple, "Good job" and a high five should be enough. Have the expectation and the child will live up to it. This isn't a circus, it's a normal part of everyday life, and that's how it should be treated. Remember as well, that this is the first time, the first THING, your child has complete control over. They CAN hold it until they get their pants up, they CAN wait until they get a diaper on. That's why you work on the process first. That's the hard part. Getting them to stop and sit. In this they have no choice, because once they are in underwear, they won't have any choice.

However, in the early stages, the simple expectation is that they will sit on the potty. Not that they will stay there, not that they will do anything productive, just that they will take a moment and sit down on the pot at the designated time to work on the routine. The routine is that we toilet first thing in the morning, before leaving anywhere, and before bed. Period. We all do. That they can get down between 2-2 1/2.



Before making the decision to potty trainensure that all care providers are equally committed to the process. If you decided that, “Oh, it’s vacation time and we don’t really want to mess with it this week,” then your child will regress. This is a huge issue for your child and you must be committed to making it work for your child or it can lead to feelings of shame, inadequacy, frustration, fear, and confusion, rather than empowerment and pride. Begin ONLY when the family environment is calm, without new or upsetting events or transitions, such as a new baby, parent's new job, visitors, family member illness, a move, transitioning to a toddler bed or another room, or holidays.

Things to remember:

  • This is a skill. It takes time for the concepts and steps to come together, and it takes practice to build the muscle memory necessary for success.
  • Girls are born with the physical ability to be potty trained. Boys are not. Boys develop the muscles necessary to control their bladder usually by the age of three. However, it is not uncommon for these muscles to not develop within this time frame, or to not develop fully at all. That is why there are thirteen-year-old boys who still wet the bed. Please keep this in mind if you have a boy to toilet train. If there are continuous problems, it may be that they are physically unable to be potty trained at this time. Especially at night when the muscles relax.
  • Nighttime dryness and pooping in the toilet may follow much later than daytime dryness.
  • Children know that Pull-Ups are the same as diapers. I have seen potty trained children suddenly go in their pants when placed back into a Pull-Up. Why make the effort to go to the potty when they can comfortably go where ever they are and keep doing what they want to do? The reasons for moving from diapers to Pull-Ups are to utilize the feel-and-learn aspect many of them have now so that they can feel some wetness when they go, and to learn the behaviors of pulling the pants up and down to go. The wetness aspect can also be achieved by placing a strip of paper towel into the diaper at every change. Once you transition to Pull-Ups and again to underwear, do not go backwards! You will simply confuse the child and let them think that going in their pants is still a viable option. Using Pull-Ups at night after transitioning up is fine. When they go at night, it is not a conscious decision.
  • When the child is transitioned to Pull-Ups, act as if they are underwear when changing the child. Have them stand up and bend over to be wiped down and wipe with toilet paper for poop, placing it in the toilet. Do not have them lay down to be changed after the age of 2 1/2.
  • Once the child shows a good understanding of potty training, the most effective thing you can do is to transition to 5-ply training pants with plastic pants over them.You will need many sets at first. Or, use underwear with a Pull-up over the top.This is a messy process but highly effective. It is a huge wake up call to a child when they feel that soaking wetness all over themselves after having a couple years of the moisture being wicked instantly away with disposable diapers
  • A good activity for quick results is to have a potty boot camp. By taking two consecutive days and devoting them to potty training your child. This is the time to load them up with all the kool-aid or other coveted beverage s/he can drink and salty snacks to keep them drinking. Camp out in the bathroom (hopefully tile) with a FEW books and toys, or somewhere else in the house or outside in a tent with a plastic drop cloth. The child needs to be segregated with a single parent who is paying strict attention to the child [no phone, etc.], a potty chair, and no distractions. Sing together, read together, and regularly have the child try to go on the potty. Offer rewards during boot camp. Have the child call daddy/grandma/grandpa, etc. if successful. Boot camp is the one time to make a big deal of potty training. Keep it calm and fun and exciting. 
  • At 3 years old, if not potty trained, and often boys are NOT, the child is old enough to be responsible for cleaning up any messes they make. Be prepared to clean up AFTER they clean up and assist as needed, but a 3 year old should be responsible for cleaning up even poop messes they make and placing the soiled clothing in an appropriate receptacle. 
  • At school we can't keep them naked, but at home you can. Warm weather is a wonderful time to potty train outside where messes can be hosed off and no big deal. Even at school we have a peeing tree where the boys can go in the back corner of the yard and do their business. It seems to be a good incentive for them. 
  • That being said, do yourself a favor and do not let little boys stand up when using the potty chair or toilet. I have grown boys and a tween, and they still can't seem to always control the thing, which is why they clean their own bathrooms. Have little boys sit down and tell them to use their finger to point it down. A cup guard on your potty seat can be helpful, but they are messy and make it more difficult to sanitize the seat. The pee soaks down between where it fastens on and getting it off usually is rather yucky. Pee is STERILE, though, unless left sitting around to collect bacteria. So don't fret too much about pee getting germs anywhere. Poop is another issue. It is full of bacteria and can cause horrible stomach ailments, so sanitizing is extremely important.
  • Potty training while in child care can be very emotional. Children do not want to leave an activity, potentially lose possession of a toy, or be segregated in another room away from all the action. At home there are usually fewer distractions, more order, and more security that a toy will still be waiting for their return and not have disappeared into the hands of another. Care providers can assist with this through routine of toileting at certain times when most activity stops for diaper changes or group toileting, toileting during transitions, having a safe place for toys in the child's possession to be stored while toileting, and reassurance that they can return to their activity once through. Parents need to be educated that fully potty trained at care will most likely come much later than fully trained at home. There are just too many distractions and social issues at play to make it an easy choice for the child to comply.
Once in full potty-training mode:
  • Have child wear loose-fitting training pants and clothing. This is not the time for a lot of buttons, zippers and overalls. S/he needs pull-and-go clothing.
  • Provide reminders to go to the potty, and don’t ask if s/he needs to go potty, as the answer will usually be no, even if s/he does. Use a timer and take child in regularly every 2 hours. Encourage dry pants.
  • Be sensitive to child’s fear, if any, of flushing.
  • Have the child help place poop into the toilet every time out of the Pull-Up (or diaper) and have child flush it to build an understanding of that is where it belongs. 
  • Practice the entire process with a doll or stuffed animal if the child shows interest. 
  • Keep wipes, Pull-Ups/underwear, and clothing changes where the child can reach them independently. The child should be able to change a wet Pull-Up by him/herself and encouraged and allowed to do so.
  • Expect accidents and be relaxed about them, helping the child to clean up and change clothing to the best of their ability with your follow-up. Make the child responsible for their own toileting. 
  • Toilet training is the first thing that s/he has complete control over and will or will not use that control. Don’t shame or punish.
  • Have a basket/bin of special toys and books next to the potty that the child only can use when on the toilet as an added incentive.
  • It is hard for a child to stop an activity to go potty. Follow a not so desirable activity (potty) by a desirable activity (story, outside).
  • TAKE THE POTTY WITH YOU! Outside, Grandma's house, in the car, in the mall... If you are taking your child into an environment that is potentially setting them up for failure, then it is your responsibility to assist with their success. If your child says they need to go, you make sure they CAN GO, even if it means pulling off the freeway and toileting in the mini van's cargo space. 
Purchase a convertible potty chair. One that can be a potty chair or toilet topper, so that they will remain comfy with it as they transition, and if you need to take just the topper on outings due to size. It will fit in a plastic tote to take to shopping or restaurants. I also LOVE, LOVE, LOVE the one I got because it has a comfy cushiony seat so little bottoms can park out on it for as long as they would like comfortably. 

In the beginning, offer incentives and give good reinforcement for their accomplishments. As success is gained, transition to celebrating new skills, such as staying dry, asking to go, or pooping in the toilet. Try to not make it a completely huge deal, though. If you do, once the child isn't receiving the hoopla then they WILL backslide. They need to be successful because they choose to be and because it is something that is expected of them, not for rewards and outlandish praise.


I AM A POTTY MASTER!

My criteria for a child getting a Potty Master certificate, in the order I expect them to be accomplished:

  • They tell me they need to go PRIOR to going
  • They pee in the toilet/potty chair 
  • They poop in the toilet/potty chair
  • They tell me the need to go while OUTSIDE and hold it until we come inside to go (early potty training we have the potty chair outside, but only the first week or two)
  • No accidents for 5 consecutive days 
Click image for link to print
After meeting all the criteria, we have a ceremony and the child gets their certificate and a king-size candy bar, to be doled out as seen fit by the parents. I have to do it on day 5, because accidents WILL happen in the first few months and I want to celebrate the initial accomplishment. The children in my care get few sweets, and this is a major accomplishment, so they get a major prize. 


Always remember: unless there is a major physical or emotional issue, 
every child is potty trained by 5. 
So, RELAX!

Good Websites:
www.drgreene.com
http://drphil.com/articles/article/264

Tags: preschool, daycare, childcare, potty training, potty training certificate, potty training steps, toddlers, toddler, potty chair, toilet topper, easy potty training, stress free potty training

No comments:

Post a Comment