Toilet Training for Older Children
UNDERLYING REASONS & TECHNIQUES
Why am I having so much trouble with toilet training? My other child was toilet trained by the age of 3, but my youngest is about to start school and isn’t there yet? I don’t know what I’m doing wrong?
Remember, every child is different. There is no set age
in which your child will be ready.
Sometimes there are other factors that are affecting their ability to
use the toilet appropriately, such as developmental delays, food sensitivities,
and anxiety.
Our Story:
I have a 5-year-old son who constantly defecated in his pants
and had frequent pee accidents. It was
driving me nuts. Most of the time, I
stayed calm and was patient and supportive, as I figured he would do it when he
was ready and I knew that there were other factors lending to this toilet
training delay (food sensitivities, anxiety, very mild developmental delay). But every parent has their moments and I must
say that I was starting to become extremely frustrated. I knew he understood that he was supposed to
go on the toilet and that he was capable of doing it, but he simply wouldn’t.
So, what changed?
I think that part of it was my perception of the
situation. I decided to trust in the
experts (Pediatrician, Occupational Therapist) and succumb to the fact that it
would happen when he was ready. You can tell
yourself all you want that they will do it when they are ready, but you need to
really believe it. Kids can pick up on
your frustrations even when you are doing your best to hide them.
By really believing that he would do it when he was ready, I
was able to truly exhibit patience and a supportive attitude. When he was successful, my praise was genuine
(Way to go! I knew you could do it! I’m so proud of you!).
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| White Board Toilet Training Chart ~ Customize this chart for your child! ~ |
I don’t often use external rewards with my children, but at
this point, I was willing to try anything.
I got a transparent container and filled it with little treats from the
bulk store. Every time he went pee on
the toilet, he got one treat and when he went poo, he got 5 treats. When the container is empty, we will talk
about how, HE DID IT and that he’s officially a big boy now who knows how to
use the toilet all by himself. So far, this
is working really well. Because I know
he won’t just help himself to the treats, he is allowed to count out his treats
on his own when he uses the toilet.
I’m sure you are wondering what I do when he has an
accident. With confirmation from his
pediatrician, I simply stay calm, take him to the bathroom, show him where the
poo and pee goes (we literally put the poo in the toilet and flush it), and put
him in the bathtub to get cleaned up (first he must try to clean himself, then
I help with the rest). I don’t scold him
or get upset, I simply ask him where he needs to go the next time he has to poo
or pee and encourage his ideas when they are appropriate.
Through this process, he is learning that the natural
consequence of going to the washroom in his pants is to spend time getting
cleaned up afterwards. If he didn’t make
it to the washroom because he was too busy playing, well now, he is learning
that he loses more play time cleaning up his messes than he would have by just
going to the washroom on his own. Eventually,
he will ask himself, is it really worth it?
As he got older and I realized that he understood that he
needed to use the toilet, but was still choosing not to (often because he was
too busy playing), I started a toileting schedule. I talked to him about how it's unhealthy to
go to the washroom in his pants. I let
him know that when he started making better choices (I asked him what some
better choices might be to let him be a part of the process), he won't have to
be on a schedule any longer. Our
schedule consisted of going to the washroom every hour and simply trying. I slowly increased the time to allow him the
opportunity to choose to use the bathroom on his own.
Another contributing factor was when he decided that he was
a big boy and didn’t want to wear pull-ups any longer. We had a talk about why he was wearing a
pull-up. I told him that we would try
wearing underwear, but then he would have to use the toilet all the time. When he had 3 accidents in a row, I switched
him back to pull ups. He was not
impressed. As he started showing me that
he could use the toilet using a pull-up, we switched back to underwear.
So, did all of this work?
YES!
Alex is now 5 years and 2 months old and for the past week,
he has been using the toilet regularly on his own with no accidents. I am one proud mother.
How Do I Help My Child Overcome Toileting Barriers?
Determine if they have a food sensitivity:
We were able to determine that our son had a sensitivity to
dairy products by looking at:
- Family History (I have a sensitivity, as well as my parents and sister)
- Frequency of Bowel Movements (runny and frequent is definitely not good and neither is waiting 2 days or more – this causes strain on the bowels)
- Looking at common food triggers and journaling their consumption and changes in bowel movements shortly after or the following day (common irritants: dairy, gluten, soy)
- Cramping, smelly gas, bloating (I felt it was odd that a child would experience bloating)
- Dry, rashy skin or swelling (we didn’t experience this, but my husband experiences this, which led me to think about family history and that irritants affect different people in different ways)
- Constant congestion, runny nose, and/or cough
- Fatigue (even with a healthy diet, he had unexplained lows throughout the day)
- Change in mood (he definitely can’t have sugar, he turns into a grumpy maniac)
Are they having anxiety around using the toilet?
Using the toilet is foreign to children. They don’t necessarily understand that their
feces and urine are dirty. They’ve been
going in their diaper all along, so why change a good thing? The toilet is scary; sitting doesn’t feel
nearly as comfortable as squatting (and is actually unnatural to our physiology
when expelling waste); and many children thrive off of routine, so changing
that can be stressful for them.
For these reasons, it’s important that you avoid scolding,
spanking, and forcing your child to use the toilet when they aren’t ready. Some parents find that their child will hide
their feces or try to clean it up on their own, ultimately making a much larger
mess. This is a sign that your child may
have anxiety surrounding washroom routines and may feel uncomfortable to talk
to you about it, especially if they fear reprimand. Talk to your child about why they are
behaving this way. Ask them why they
don’t want to use the toilet. Reassure
them that you won’t be upset with them and that you know it can be scary to
talk about this stuff, but you love them no matter what.
When children are young, try to make using the toilet a fun
thing. Show your child that Mom and Dad
use the toilet and then there’s no mess to clean up after (literally take them
to the bathroom with you when you go).
Start a new routine where they sit on the toilet and read stories and
have cuddle time (start with their pants up, then transition to pants
down). Part of your routine could
include a treat that they enjoy at the end to associate a positive connotation
with using the toilet. Ultimately, your
goal is to maintain patience and a supportive attitude.
Does your child have a developmental delay?
As a teacher, I knew from a very early age (7-8 months) that
something wasn’t quite right, but I certainly wouldn’t expect that the average
parent would be aware of the signs. One
thing you can do, is consult the Nipissing District Developmental Screen to determine if your child
is meeting developmental milestones. If
you think there might be a problem, then talk to an expert, such as a
Pediatrician or an Occupational Therapist.
These services are offered for free, but they often have wait lists, so
try to be proactive and do some of your own research while you are waiting. The Health Unit often offers home services to
help parents who reach out to them.
There are definitely support groups that are willing to help you and it
won’t cost you anything, so ask around.
Your local Early Year’s Center or School might be able to send you in
the right direction or make a referral for you to receive services.
What do I do if my child is starting school and they aren’t
toilet trained?
We encountered exactly this problem.
Since our son did have a developmental delay, we were able
to have his therapists and pediatrician collaborate with the school and
determine a plan of action. Our plan was
for an educational assistant to take him to the washroom on a schedule and deal
with any messes in a private room. We
started with pull-ups and transitioned to underwear as he improved.
Parents who advocate for their children can receive services
to help their children succeed. The school
can’t provide those extra services without the paperwork to back it up because
they need a paper trail indicating a need in order to obtain funding to pay for
the extra help. Educational Assistants
(EA) are allowed to help children who have an Individualized Education Plan
(IEP) with their toileting needs, but teachers are legally not allowed to help
your child (they can only talk your child through the process from outside the
bathroom). This is why you need to
advocate for your child. You need to
make sure that an EA is assigned to your child for a portion of the day. Talk to the principal and Kindergarten
teacher to indicate that you would like to set up a meeting to discuss your
child’s needs before school starts. The process
takes time, so try to get all of your ducks in a row at least a year in
advance.
Good luck, I know you can do it too!
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