By Mrs. Charlotte Fudge, MSN,RN,CCM,BCBA
The answer – Right now! My philosophy is that it is never too early to start toilet training. Children need to be prepared for this big transition, be familiar with what will be expected of them, and also have the prerequisite skills to be successful. This is especially true for children challenged by a developmental disability. Although your child may not be ready to start on a training schedule, there are many other self-care (i.e. dressing), hygiene (i.e. hand washing), and language skills (i.e. following direction) that need to be targeted.
Schedule training is stage two of the toilet training process in which the caregiver takes the child to the bathroom on timed intervals to increase the likelihood of the child making it in the toilet. Typically, the ready signs for schedule training are as follows: the child can follow basic directions, such “sit down” and “come here,” the child can comfortably hold themselves on the toilet for an extended period of time, the child is compliant, shows some sign of awareness they need to go, such as the pee-pee dance, and they can be accident free for over an hour when put in underpants. It is also important that schedule training not begin during big transitions, such as moves or medication adjustments.
These ready signs are not required for schedule training, but they are definitely recommended. The prerequisite skills will make the process easier for both you and the child with less frustration and time spent. The last thing you want to do is condition the bathroom to be a negative place. Pushing a child who is not ready, could result in tantrums every half hour, which is no one’s idea of a fun day. In addition to being exhausting, this type of behavior also poses a safety threat for the child in the bathroom environment.
Just because your child is not ready for the schedule training does not mean that you can’t get started with pre-training exercises. Begin by familiarizing your child with the bathroom routine. Keep an open door policy and allow them to observe your bathroom behavior if comfortable. Try conducting role plays with their dolls, pretending to take them through the bathroom process.
Also, spend time making the bathroom a comfortable place, so when you do start, it will be ready for them. If your child has sensory issues, dim the lights, put downs rugs to warm the floor, make toilet seat modifications, etc. Then, focus your efforts on teaching them other skills needed to toilet independently, such as turning on/off the light, pulling up and down pants, washing hands, etc. If your child has compliance issues, definitely address them with a behavioral assessment by a professional with an action plan to get them under control.