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How to Potty Train a Developmentally Delayed Child
byJulie ChristensenJan 10, 2013
Achieving major milestones such as potty training can take a bit more effort for a child with development delays. Hang in there, though. With an extra dose of patience and time, your little one will eventually master toileting.
Children need some control over the process, according to Fran Walfish, a Beverly Hills-based child and family psychotherapist and author of The Self-Aware Parent.
"One of the many goals of childhood is for each child to become master of her own body," she says. "Encourage this and praise every increment in her behavior and attitude toward autonomy and independence."
In most cases, children with developmental delays need more time to become potty trained than other children. Portland, Oregon mom, Freda Emmons, whose daughter has cerebral palsy and autism, says, "I learned that potty training my daughter would be very different than potty training other children. She was my first child, so I was quite unfamiliar as to what to expect."
Family members questioned her about why her 2-and-a-half-year-old daughter was not yet using the toilet, which added to the stress.
"I really had no answer," Emmons admits. "I think at that time, I blamed myself. It took me about seven years to potty train her completely."
Some special needs children require a great deal of time for potty training and that's fine, according to the American Academy of Pediatrics. Keeping your child motivated is far more important than quick potty training success. Look to your pediatrician—rather than misguided, but well-meaning family members and friends—for support during this journey.
Signs of Readiness
Before becoming potty trained, most children show some signs of readiness. According to the American Academy of Pediatrics, these signs may include recognizing the difference between being wet and dry, staying dry for more than two hours or expressing an interest in potty training. Waiting for signs of readiness can cut down on the time it takes to potty train, as well as frustration for both of you. If a child is resistant, your best bet is often to wait. Even a few weeks or months can make a big difference in a child's willingness to try.
Maine counselor and autism parenting coach, Connie Hammer, says that parents must make sure they are ready as well. This begins with a thorough self-assessment. Some questions to ask yourself, according to Hammer, include: "Am I prepared and do I have a realistic plan? Am I motivated to invest the necessary time and effort? Are other adults in the household going to be informed and on board?"
"Approaching this task with intention and being prepared intellectually, physically and emotionally will enhance the potential for success," she notes.
Potty training can seem intimidating or downright scary to a young child. Hammer says that creating an environment that is sensory- and child-friendly and free of stress will make the process less intimidating and more pleasurable.
"Ask, 'What kind of bathroom environment is going to really set my child up for success? Is it easy to use? Is it calming to the senses in terms of temperature and lighting?'" recommends Hammer. "Your goal should be to eliminate the possibility of any triggers that might create a roadblock to success."
Creating a more inviting potty-training environment is simple. Keep a basket of favorite books near the bathroom for your child to look at while sitting on the toilet. Use a potty chair or add a stool so she feels more secure. Offer a stool to reach the light switch and faucet, as well. If your child is bothered by textures, opt for extra soft toilet paper and install adequate lighting. A soft or plush toilet seat won't feel as cold on little bottoms as a harder one, so consider this option as well.
Visuals and Cues
Children with developmental delays usually benefit from visual cues. A small poster displayed in the bathroom that lists the steps for using the toilet can help children remember what to do. Using sign language for common toileting words and phrases also seems to reinforce learning.
Hammer explains, "Most children with developmental delays are visual learners so it makes sense to use photos, drawings, pictures, images and social stories when preparing them to use the potty. Using these images to create visual schedules will make it easy for your child to follow the new routine and make it more predictable—something she will thrive on."
An interactive schedule will further boost your little one's autonomy. Hammer suggests designing a chart that encourages your child to check off her accomplishments and track her own progress.
Positive reinforcement is key when potty training any child, but particularly those with developmental delays. Focus on achievements and don't make a big deal out of setbacks.
"Be really patient with your child," says Emmons. "The physical and mental delays are not something she has chosen and the accidents are not by choice either."
A kind word of praise or even a small reward can motivate your little one to keep trying. Simple age-appropriate toys and stickers will delight most children. Snacks such as a cookie or raisins are fine, too. You can also boost your child's feeling of independence by permitting her to do "big girl" tasks such as picking out her own clothes and underwear.
When you see your little one smile upon each accomplishment, you'll know all the hard work has been worthwhile. Give your child—and yourself—a pat on the back for every success.