How to Potty Train Children with Special Needs

Successfully potty training a child can be a challenge for parents, but it can be especially true if the child has special needs. Having special needs can make potty training difficult because it is often a challenge for the child to sense, understand, or do certain things. Depending on the type and severity of the special needs, it is possible to potty train most children with some planning, a little extra effort, and some help.

Method 1
Method 1 of 5:

Assessing Readiness for Potty Training

  1. You will want to make sure your child is physically ready and it is safe for them to begin toilet training before beginning. [1] Forcing your child to begin too early, or not providing enough assistance to them, may be detrimental to the potty training process. If they are not ready, choose to either wait or create assistive measures to help them succeed. Some ways to determine if your child is physically ready include the following. [2]
    • Can they sit with or without support?
    • Can they attempt to squat with or without losing their balance?
    • Can they walk without help?
    • Can they stay dry for at least an hour at a time?
  2. This involves making sure your child is cognitively and emotionally ready to begin toilet training. [3] It will help to determine where you child's ability to sense their own need to use the bathroom and how they process through the steps of toileting. If they are not ready, choose to either wait for them to become ready or help them by providing extra assistance. Some ways to determine if your child is cognitively or emotionally ready include the following. [4]
    • Can they tell the difference between being wet and dry?
    • Can they sense when they need to go to the bathroom?
    • Can they undress themselves with or without help?
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  3. Having a child with special needs, you are probably speaking to their doctors regularly. Inform your child's doctor of your intention to begin potty training. The doctor will be able to talk with you about the readiness of your child to begin potty training, which can vary greatly by child, especially with children with special needs. [5] Additionally, having a discussion with your child's doctor may be very helpful to you during the process.
  4. [6] As you are assessing readiness for beginning toilet training, make sure you have all the supplies and equipment you may need. Consider common toilet training needs, such as child toilets or seat extenders. Also, determine the need for equipment that may be specific to your child, their disability, and their needs. Consider the following equipment or logistical considerations you may need to make.
    • Physical assistive devices, such as portable toilets, hand rails, and appropriate access to the sink, and materials your child may need.
    • Consider the logistics of your child's access to the bathroom. Is it easily reached, or will you need to make adjustments to your home?
    • Cleaning supplies for possible accidents during the training process.
  5. Children with physical special needs should be potty trained in a different manner from children with behavioral, cognitive, or emotional special needs. Knowing your child and how potty training will be affected by their specific complications will allow you to tailor each stage of the training so that they have the best chance of being successful.
    • If your child has special needs that make walking or standing difficult, potty training should focus on different mobility options as well as how to give themselves more time to get to the bathroom.
    • A child that is blind may need more detailed instructions due to not being able to model behavior they view, or they may need instructions on how to locate the toilet bowl or the toilet tissue paper. [7]
    • Children with paralysis or nerve damage may have difficulty recognizing the feeling of their internal organs nearing capacity so they may need help developing a schedule.
  6. Children with mental or emotional special needs have a different set of challenges in potty training than children with physical special needs. Some potential difficulties can result from an impaired level of comprehension or understanding of what the parent is trying to get them to do or the process altogether. Be aware of the potential obstacles and meet your child where they are functionally and work from there.
    • Recognize that with emotional, mental, developmental, or intellectual disabilities, the potty training process can take significantly longer. [8] Exercise patience with your child and celebrate small steps with them.
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Method 2
Method 2 of 5:

Developing Methods to Toilet Training

  1. One method that may be helpful for potty training children with special needs is for the parent to set up a fairly precise daily potty schedule. Creating something visual or even rewarding for the child to view helps them organize and keep track of what they are working on. Create a schedule based around what times of day the child tends to go to the bathroom in their diaper. [9]
    • Observe your child's schedule. Most people’s bodies have their own internal schedule and by observing when the child does these things, the parent can try to get the child to the toilet before they use their diaper.
    • If the child uses the toilet successfully, the parent should praise them and reward them so that they can begin to form connections. Connections such as being able to complete a task successfully, as well as the connection between how their body feels when it needs to go and the toilet, will help them continue to be successful.
  2. If there are no paralysis or nerve damage disabilities present, and the child is capable of understanding the parent, it is possible to teach them to recognize when their bladder is full. [10] If there are paralysis or nerve damage disabilities present, help the child develop a schedule for toileting. Help the child by paying attention with them to when they drink a lot and then when they go to the bathroom. This will aid them in making connections to any sensations they may be having.
    • Place a nonabsorbent cloth in your child's diaper so they may begin to be aware of feeling wet.
    • Talk to your child about how their stomach feels when they are full and how it feels after they use the bathroom. Help them make the connection between those sensations.
    • Develop a regular schedule with your child if paralysis or nerve damage makes sensation difficult or impossible. Prompt and help the child get used to the schedule.
  3. This may sound like a strange suggestion, but it can help to allow your child to watch you model the behavior of using the toilet. [11] Children copy other children and adults all the time; it's part of a natural process for mimicking behavior. Let that work for you. Some children with mental disabilities pick up on toilet training simply by watching a parent of the same sex do it repeatedly.
    • You might not feel comfortable having your child watch while you use the toilet, but it is worth the slight feeling of embarrassment if it works to get the child to use the toilet on their own.
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Method 3
Method 3 of 5:

Tailoring Potty Training to Your Child's Needs

  1. [12] One method that might be used to help potty train children with physical disabilities, is to utilize assistive devices. Depending on the type and severity of the physical disability, it may be helpful to incorporate something like a portable potty during the training process. This allows the child to have quick and easy access to a toilet while they are learning a schedule. As you move through the training process, use any of the devices to further help your child potty train.
    • For example, if you use a portable potty, move the portable potty closer and closer to the stationary bathroom. This will help your child adjust to and practice continence in having longer distances to reach the potty.
    • It may be necessary to get an adult sized portable toilet depending on the age and disability of your child.
    • Consider the addition of hand rail, step, or back rest adaptive devices to help with positioning while getting on the potty or staying on the potty while training.
    • You may also consider dressing the child in easy to remove clothing, such as loose fitting clothing or clothing with hook-and-loop fasteners. This may help to make undressing and dressing easier when the child needs to use the bathroom.
  2. Visual difficulties or disabilities make many stages of the toilet training process more challenging for you and your child. Without sight ability your child will not be able to witness modeling behavior as well as the smaller tasks involved in toileting. [13] Rely more on language, hearing, and touch sensations to help your child understand how the process works. This may mean waiting a little longer to begin toilet training with your child.
    • When you are ready to begin, let your child explore the bathroom, making sure to help them locate and identify the toilet and handle, as well as the toilet paper.
    • Talk to your child more about the process of toileting, explaining all the steps and letting them talk to you about it.
    • Utilize training products such as musical potties to help reward your child for successful use of the toilet. [14]
  3. Similar to difficulties in potty training a special needs child with visual disabilities, hearing and communication will also greatly impact training. If your child is fluent in sign language or is able to communicate, you may find it somewhat easier. [15] To help your child with potty training rely on visual observation and explanations that you can provide to them. Work on one part of the process at a time to not overwhelm your child and to make sure they understand before moving on.
    • Let your child observe you, and if possible, other children like their siblings, using the bathroom.
    • Consistently use the same signs, gestures, and facial expressions when training your child.
    • Place a few drops of food coloring in the toilet bowl and have your child guess what the color will change to after they urinate. [16]
  4. Your child's special needs may not be difficulties with interpreting or understanding the toileting process. Instead, your child may experience trouble with continence and frustration with the training process. Try to help your child by making a regular potty schedule to get them used to regularly going to the toilet. This may help with frustration of accidents or interruption of activities. You may also need to help your child with dietary changes to facilitate easier toileting. Consider the following specific special needs:
    • Children with Cerebral Palsy may struggle with bladder awareness, bladder control, and constipation. [17] Concentrate on developing awareness of needing to go to the bathroom, and altering diet or medications to avoid constipation.
    • If your special needs child struggles with Spina Bifida, spinal cord injury, or spinal tumors they may have some similar difficulties to children with Cerebral Palsy. You may need to focus toilet training more on teaching your child to use a catheter for urination and visit the bathroom on a schedule for toileting. [18]
    • It might not be possible to completely potty train some children, especially those with neurologic disabilities.
  5. If your child's special needs include conditions such as Oppositional Defiant Disorder or Attention Deficit Hyperactivity Disorder, toilet training difficulties may include low motivation, concentration, or a lack of response to typical reinforcements. [19] Your child may struggle because it is difficult for children with these needs to adjust to change in their daily lives. Take training slowly and focus on one small change at a time as not to overwhelm your child with changes all at once.
    • Get creative and adapt your training methods to your child's interests and motivations. For example, if your child has a favorite cartoon character, try to buy underwear with that character on them and make a game out of trying to keep that character from getting wet. Making it fun for your child and connecting it to something they are interested in will ease the stress of change.
  6. Key to potty training a special needs child with and intellectual disability, developmental delay, or a developmental disorder is the understanding that the time to achieve successful training may be significantly longer than expected. [20] Your child may need the process broken down into smaller tasks and may need more time to master those tasks. Be patient and consider the following.
    • Cater to your child's verbal level and ability. If they have a lower verbal ability utilize facial expressions and modeling to help.
    • Keep each portion of training simple and concrete. Utilizing visual aids each step of the way can help your child develop the concrete ideas into actions as well.
    • Use rewards, such as treats or play time to increase the likelihood that they will repeat the behavior. Avoid using punishments or reprimands as it may cause a regression or further delay in successful toileting.
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Method 4
Method 4 of 5:

Seeking Assistance

  1. Hopefully, you have been consulting with your child's doctors to determine if your child is ready and to deal with any issues involved in your child's digestive or urinary health. If you have been trying and are having little or no success potty training your child, consult with the doctor again. Your doctor may be able to provide you with a referral to a specialist in the field that correlates to the child’s special needs. [21] These professionals can provide tips and guidelines to help the parents and may be able to suggest plans that have not be attempted before.
  2. Your largest source of support and information will likely be other parents of special needs children. It might be helpful to join a group or organization of other parents that have children with the same special needs in order to share your experience or ideas. The parent groups can also be a great source of emotional support for a parent of a child with special needs. Search for groups in your area by trying the following.
    • Search for groups specific to your child's special need.
    • Search for parenting groups through any doctor or specialist you visit with your child.
    • Search for organizations or groups online.
  3. Caring for a child with special needs can be stressful, emotional, and difficult. Your mental, emotional, and physical health are just as important as your child's. Furthermore, in order to provide the best care for your child, you need to make sure you are taking care of yourself as well. Consider making an appointment with a counselor or individual therapist so that you have someone objective to talk to while you are raising your special child.
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Method 5
Method 5 of 5:

Preparing Yourself

  1. Chances are, if you are a parent of a child with special needs, you have already adjusted your expectations for life with your child. [22] Consider however, that all children with special needs are different from each other as well. Not only do they vary by what types of special needs they have, but even children with the same type of special needs, such as blindness, might differ in how they approach new tasks or how well they cope with them. Think about your child and how their needs may alter the course of potty training. Consider the following.
    • Since potty training is started at a young age, children with any type of special needs might have more trouble understanding or doing what is expected of them.
    • Prepare yourself for the likelihood that your child may need more support, encouragement, and reminders to use the toilet than other children.
    • Understand that your child may have a different timeline for potty training.
  2. During potty training, it may be difficult for you to remember that accidents will happen as potty training is a learning process, just like any other. Remind yourself that these bodily functions naturally and automatically occur when organs in the body reach capacity. Potty training is actually teaching the child how to sense when these organs are nearing their capacity so that they can choose to use a toilet instead of a diaper.
    • Try to understand the difficulty for the child if they have trouble recognizing their body’s signs. When accidents happen, try not to yell or ridicule your child for these accidents. Negative adult reactions like these can actually cause the child’s progress to slow down, stop, or even regress. [23]
  3. Try and remain positive, calm, helpful, consistent, and patient when in front of your child while potty training them. If you are stressed about the lack of progress your child is experiencing, it may show. Your child may pick up on the fact that you are upset with them, causing more difficulties. [24] It's important to express and feel that frustration, but do so in a healthy way. Confide in your partner or another adult, somewhere the child is not able to hear.
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      • One thing that is very important to keep in mind when attempting to potty train any child, but especially one with special needs, is the fact that it does take time and patience. Some children with special needs might not be successful at independently using a toilet until they are several years beyond the standard age for accomplishing this task, and it might not be possible to potty train some children at all.
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      References

      1. ↑ http://www.rifton.com/adaptive-mobility-blog/blog-posts/2011/september/potty-training-special-needs-children
      2. ↑ http://www.rifton.com/adaptive-mobility-blog/blog-posts/2011/september/potty-training-special-needs-children
      3. ↑ http://www.rifton.com/adaptive-mobility-blog/blog-posts/2011/september/potty-training-special-needs-children
      4. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      5. ↑ http://www.parents.com/toddlers-preschoolers/potty-training/basics/step-by-step-guide-to-potty-training/
      6. ↑ http://www.parents.com/toddlers-preschoolers/potty-training/basics/step-by-step-guide-to-potty-training/
      7. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      8. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      9. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      1. ↑ http://www.rifton.com/adaptive-mobility-blog/blog-posts/2011/september/potty-training-special-needs-children
      2. ↑ http://www.rifton.com/adaptive-mobility-blog/blog-posts/2011/september/potty-training-special-needs-children
      3. ↑ http://www.familyconnect.org/info/multiple-disabilities/independent-living-skills/toilet-training/235
      4. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      5. ↑ http://www.rifton.com/adaptive-mobility-blog/blog-posts/2011/september/potty-training-special-needs-children
      6. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      7. ↑ http://www.rifton.com/adaptive-mobility-blog/blog-posts/2011/september/potty-training-special-needs-children
      8. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      9. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      10. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      11. ↑ https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx
      12. ↑ http://www.med.umich.edu/yourchild/topics/toilet.htm
      13. ↑ https://depts.washington.edu/isei/iyc/barnett_16_3.pdf
      14. ↑ http://www.rifton.com/adaptive-mobility-blog/blog-posts/2011/september/potty-training-special-needs-children
      15. ↑ https://depts.washington.edu/isei/iyc/barnett_16_3.pdf
      16. Respectfully Connected: Nine Tips on Toileting for Parents

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