worn out!!

My son will be four next month and has SI and language disorder. He is my third child , my other two children were potty trained before age three. I realize he has special needs but I am beyond confused as how to get him fully potty trained! He has been fully pee trained for about 4 1/2  months. I threw ALL diapers away after about two weeks of him being pee trained and he has been in underwear even at night.  He refuses to sit on potty to poop and he also poops in his underwear MANY times a day. I call it micro-pooping!

I am so tired of cleaning poop out of underwear. I have tried to offer reward , done social stories , he is encouraged for sitting and peeing. I even tried to make him clean his own undies but it did not seem to bother him at all.

Any suggestions???

thanks so much

Jen

When it comes to toilet training, it is an issue with many parents of children with or without SI or language problems.  There is a huge amount of pressure from society for children to adapt to using the toilet by a certain age.  Society is far more accepting of babies or toddlers who are not toilet trained.  We can ask, is there a “best”method to teach the skill?

When your child has sensory issues, there are a number of problems that can arise when teaching this skill.  He could have difficulty with imitation skills or motor planning.  So watching someone go through the motions may not be enough.  He may be stuck in certain routines and habits that become fixed.  He may fear giving up the diaper completely.  There are sensory input considerations.  Having a bowel movement is a tactile experience.  He may not recognize the physical cues, or enjoy the sensation in the diaper.  He may have negative feelings about a cold toilet seat, loud flush, or feel unstable on the elevated seat.  A lot of these considerations relate to readiness skills.  Your son may not relate to the social significance of using the toilet like you do.  But, the longer your child goes to the bathroom in the diaper the more it becomes routine.  Some signs your child is ready to give up the diaper are:

Staying dry or unsoiled for longer periods of time

Your child’s facial expressions may indicate he has to have a bowel movement

They show more interest in others who use the toilet.

He participates in the tasks of dressing, undressing, changing, washing hands.

Your child has a 5-10 minute attention span for activities.

Your child may not have all the signs but make note of those you notice.

To begin a program, rule out any medical problems getting in the way.  Keep a record of your child’s bowel habits (how often each day, what time of day, etc). See if there is a pattern.  Either check his pants at the scheduled time or take him to the bathroom when he usually goes.   Think of events or items that really motivate your child to want to work for it.  Food may work for a while but soon loses its ability to motivate.  Make a series of pictures that depict the steps needed to use the toilet. ( a picture of a child saying they have to go, walking to the bathroom, pulling down pants or diaper, sitting etc )  Use these to teach the steps. Practice, guide and reward immediately for appropriate responses.  Be calm.  Do not react to negative responses.  Continue to redirect him to the pictures showing the correct steps.  End with wash your hands and follow through with the promised reward immediately.  If they are only able to do the first step of sitting on the toilet reward this and try going to the next step the next time.  Baby steps.  Consider if you have to adjust the experience with a smaller seat, low lights, hand rails, foot stool etc.  If your child has a language problem you may need to devise a system by which he can easily communicate the need to potty.  Use visual picture or signs that states the words. 

Remember keep all toileting activities in the bathroom.  That includes changing pants, putting on a dry pair of big boy pants, requests and teaching.  This will help him to correspond toileting behavior with the appropriate environment.  Remember, your child needs to be working harder than you do.  Have them change wet pants, clean themselves and put on dry pants.  And be aware that the normal sequence of learning to use the toilet includes leaning to urinate in the toilet during the day, having a bowel movement in the toilet during the day, the ability to hold their urine through the night and the final step, the ability to keep from having a bowel movement during the night.

Don’t give up.  Hope this helps.  If all fails and you live in SE or SW Florida we also offer in home instruction for toilet training issues.  See contact information on home page.

Allyson Galuska, Butterfly Effects, LLC

Hey Jen,

Ally's recommendation of collecting some baseline data would be a good starting point to determining trends.  I would also recommend looking at his diet.  The fact that he is "micro pooping" may indicate digestive issues; it also may not be a strong enough sensation for him to feel the urge to go.