Speakup Blog

I am in a lot of parent groups on Facebook where I see this discussion come up repeatedly: "my son/daughter is nonverbal and not toilet trained, how do we start this". I thought to myself okay, that could be an interesting article for me to write, so thanks for the idea.

Before I start, I want to be clear on one thing. You need to talk with your child or student's doctor team to see if they have the ability to be toilet trained. I know that some people who use AAC might not have the ability, and that is okay. I have some ideas to help if you have someone who is like that. I want to make sure that you know I haven't helped anyone to toilet train, but I am, and have learned from some amazing people in the field.

The first thing that you need to consider is, is the child ready for this? Do they like to hide from you and anyone who is caring for them when they are peeing? This is the first sign that you can look for to know if they are ready. They know that if they need to go to the bathroom, they need to go somewhere where no one can see it. Another sign is if they hold it when they are taking a nap. These suggestions are for typical kids, but I think we can adjust these guidelines when teaching children who have a disability. For children in a wheelchair or with a physical disability, they might not be able to hide when going, but I remember trying to hold my pee until right before someone would change me, because I didn't like to be wet. I remember having awareness of what was happening in my body. For me, this happened when I was three.

Once you know they are ready, it is time to start toilet training. Pick a weekend when you have nothing going on and you have help doing this. Print out the symbol for the bathroom that they have on their communication system and put it everywhere around your house so they have the same way to communicate in the bathroom as on their device. You might like to decorate the bathroom with their favorite cartoon so they feel calm and relaxed in there. I know some people put a little TV in the bathroom. Personally, I don't like that idea because I feel that it could give your child the wrong idea, but please do what is best for them. I suggest you get a notebook to take good data on the following areas: what times they tried, how long they waited on the toilet, whether they went to the bathroom, and their accidents.  Note for school: try to get a bathroom near to the classroom that they are in most of the day. Especially when they are still learning how to ask for the bathroom.

It is time to get started! Have your child drink juice and water a lot more this weekend, so they need to go more. Don't worry about accidents at all, because accidents happen. Best practice is to take them to the bathroom hourly when they are up. If they can't go, please take them every 10 minutes to start, then you can work up from there. When they have any success, please celebrate with them because we want them to understand that the toilet is where you go to the bathroom.

For the people who might have additional issues to make toilet training harder, it is important to teach them how to ask on their device "I need to be changed please". This is important for at least two reasons. First, when you are trying to get a communication device, the evaluation report always asks if getting this communication device will help the person communicate medical care needs. Telling someone that they need to be changed is an important medical need. Additionally I have heard of some adult day programs that might not take someone who isn't toilet trained.

The last thing that I want to say about toilet training is be kind to yourself and your child. They will have accidents, miscommunicate, and not want to try the bathroom when it is offered to them. It will take time and patience, but if they can do it, it can be done.