Extra Strategies to help with toilet training

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This is something of a personal issue for me since my 3.5 year old daughter has autism. She has twice shown an interest in toilet training and it was a disastrous affair since she simply lacked the interoception necessary to sense and control her bladder. At the time, she hadn’t been diagnosed and I simply accepted that she wasn’t ready.

I had researched toilet training by attending workshops, reading books, searching through blogs, and talking to other parents. I also wrote a series of articles myself which are aimed at neurotypical kids. These covered:

These are methods which will work for most families; however, some children need an extra level of support. For me, and others I know, it is because our children have special needs such as autism (ASD). Miss 3 struggles with sensory issues in a range of ways, including an awareness (and interpretation) of internal body signals such as the need to go to the bathroom. She’s not alone in this; many kids struggle with the leap from nappies to toilet for eliminating waste. Modern nappies wick away moisture and allow our little ones to stay comfortable without feeling a need to pause their play. We then place them in underwear and expect an awareness of being wet (sensory input) to result in a desire to be dry (perception) and a change in behaviour (action). In reality, these are all separate steps controlled by different regions of the brain and requiring different foundational skills; putting all of these together in a fluid and reliable manner is a complex change.

Extra Strategies to help with toilet training

Start by writing down all the challenges you associate with toilet training. Sort these into challenges for you (as a parent) and challenges for your child. Think about how you can address these challenges.

Write down goals for yourself and your child. Your long-term objective might be toilet training but there might be a number of short term goals that you need to address first (and this is where it comes in really handy that you’ve already written down all the challenges you need to work through).

Your child needs to feel safe and comfortable in the bathroom. It’s often a very functional room that adults spend little time in but the journey your child is embarking on means spending a lot of time in there. For those with autism and/or sensory issues, identifying triggers can be critical.

I knew my daughter didn’t like the bathroom but I thought it was because of associating it with nappy changing and discomfort as a result of very sensitive skin. I patiently worked as a detective to try and observe her behaviour and work out what she couldn’t tell me with words. One morning, I sat down with all the towels on the floor and struggled to find the right questions to elicit a response. I could see the progress in sensory integration and vocabulary work we’d been doing for months but she finds it impossible to answer general questions. At last I narrowed down my questions to ‘Which colour makes your body feel most safe and comfortable and still?’, ‘Which colour makes your body feel most muddly, shaky, and unhappy?’

Through a mixture of words and gestures, we were able to establish that a warm palette of soft sandstone and mocha were acceptable (as were accents of pink, white, and gold) but the jewel-like mix of towels in brightly coloured greens, red, and blue were highly upsetting. Other triggers, included the bright light (with the noisy ceiling fan powered by the same switch), the strong smelling soap, and the toilet paper (which to her felt like sandpaper).

I needed to identify which of these I could change (like the soap and towels) and which ones I could only minimize (like using the light in the adjacent room unless we were having a shower).

Sitting on the toilet requires both proprioceptive and vestibular skills; your child needs to be able to sense their body’s position in space and be able to balance. Consider sending time practising activities like naming which body part you are touching while they have their eyes closed, running, jumping, climbing, and walking on a balance beam.

The sensory feel of the potty or toilet seat is important. Some kids are happy balancing on an adult toilet seat, others are terrified by the feeling of space beneath their bare bum and the fear they might fall in. There are lots of options available on the market, my favourite is a cheap one – buying a toilet seat with an integrated flip-up junior seat.

Help your child understand how they need to be positioned on the toilet (and this requires modelling by a parent or sibling). Show them how they need to sit or move for each part of the process. For a girl, I’ve needed to teach her that her bottom needs to sit near the back, her knees need to be together, and her pelvis needs to be tilted down. I have a large textured sticker on the toilet seat (rear-middle) which she can feel with her hand to help guide her bottom. I also bought a super cheap mirror which we decorated together in colours she chose and which I hung opposite the toilet so that she could see herself and how she was positioned. The mirror also has the advantage of keeping her entertained!

Be aware that using the toilet is a complicated process; you can help your child by breaking down the steps into manageable tasks. Consider making a social story for potty training and putting visual reminders on the bathroom wall.

“Our sensory integration occupational therapist handed me pages of pictures showing the individual steps for using the toilet. Frankly, I felt overwhelmed. It’s such an automatic task that it hadn’t occurred to me how many micro-steps there are!”

“One game we play is ‘What’s under my bum?’ She stands with her eyes closed while I put a tiny plastic animal on a chair behind her. I guide her into sitting and she has to try and feel which side the toy is, roll her pelvis, and reach with her hand for it. She thinks it’s hugely funny; more than a game, we’re building skills she will need for the toilet – sitting, balancing, and movements associated with wiping.”

Help your child understand how using the toilet will fit into their daily routine; for instance, needing them to sit on the toilet as soon as they wake up in their morning. Communicate what your expectations are and consider making a poster about how the toilet fits into their daily routine. Some parents find it helpful to use a digital timer or a smart watch with vibrating alarms (like the FitBit) to help remind children to take regular toilet breaks. Teach kids phrases like ‘pause my play‘ for going to the toilet; this is less frightening (and less likely to cause a power struggle) then ‘stop’ as it means they can return to their task after sitting on the toilet.

Create an elimination diary so that you can get a feel for how often they are eliminating; this is incredibly useful for identifying patterns. You may also want to seek advice from a nurse if they are regularly holding urine for 6-8 hours or have no bowel motions for four consecutive days or more. Constipation can become a vicious cycle when combined with dehydration and anxiety; it hurts when they eliminate and so that makes repeating the experience seem like a bad idea! There are great articles on how to help strong willed children who may have anxiety around bowel motions; this one includes a template for an elimination diary. These child friendly resources from Continence Foundation of Australia explain how the bowel and bladder work and can be helpful to support discussions.

Think about your stance on motivations vs rewards. A motivation is something that encourages your child to do something (a behaviour or action), a reward is something that comes after an action is successfully completed. Often parents use rewards for toilet training, this may include everything from stickers to jellybeans. Instead, consider creating a special toilet treasure box as a motivation for sitting on the toilet and tying reward charts to keeping underwear dry (rather than eliminating waste). Be consistent with your child that the treasure box can only be played with while sitting on the toilet.

An ideal treasure box will have a lid and can be decorated with the child’s name and any potty party theme you are using. It’s a good idea to include several books (including at least one relating to using the potty / toilet). Give careful thought to your child’s interests and sensory needs. Try to include a few small toys they can choose at the shop; pictures they can look at; things they can manipulate with their hands; things that make sounds. Get inventive!

“We found a dog toy that looks like a rubber zebra and makes a hilarious laughing noise when it’s squeezed hard enough.”

“She has a few princess dolls that sit on their own potty while listening to the music from a wind up jewellery box.”

“We got one of those dinner trays with a bean bag base, painted the top black and added white lines. He zooms cars around the race track.”

Find underwear they feel comfortable in. It’s a big step moving from nappies to something which feels completely different; this is even more true for children with sensory issues, sensitive skin, or eczema. Some children find it helpful to have a breathable material, no elastic, and to be seam free. Lulu Funk is one such online retailer specializing in New Zealand made underwear for sensitive bottoms.

Accept that accidents will happen. They do and sometimes in the most ridiculously awful of places; remember that if you are calm and matter of fact about it that your child stands a better chance of internalizing this without getting weighed down by shame. It can also be helpful to focus on praising them for keeping their underwear dry (rather than focusing on eliminating in the toilet).

“One exercise we did was to bring out a favourite soft toy, two identical pairs of underwear, a bowl, and some room temperature juice. Elmo put on some dry underwear and a pretend Elmo did a ‘wee’ in the other underwear. We practiced touching ‘dry’ and ‘wet’; I talked about how sometimes it can be difficult to feel warm wee when the weather is really hot. I froze the wet underwear and later we practiced ‘wet’ and ‘dry’ again.”

It’s a good idea to teach your child where they should touch their underwear to check if they are wet or dry; boys are often wet higher at the front, whereas girls tend to be wet lower down.

Consistency, consistency, consistency. Having worked out your game plan, share it with everyone else involved in your child’s toileting. It helps to have teachers at daycare, kindy, or school following the same methods and routines as at home (as much as possible).

Decide what success looks like to you. It can be easy to assume that every family has an easy time toilet training but I promise you that there are plenty that struggle. As adults, we may have a reasonable expectation of using a toilet 100% of the time whereas lots of young kids simply get excited or distracted and forget. Think about your child’s developmental age, temperament, and the challenges you wrote down. Success may involve focusing on a single micro-task and then adding a second step once that has been reasonably mastered. Remember that the long term goal is not only to help your child master a skill that gives them another step towards independence, it’s also about helping them to feel positive about themselves and successful along the way.

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How Anxiety Leads to Disruptive Behavior

A child who appears to be oppositional or aggressive may be reacting to anxiety—anxiety he may, depending on his age, not be able to articulate effectively, or not even fully recognize that he’s feeling.

“Especially in younger kids with anxiety you might see freezing and clining kind of behavior,” says Dr. Rachel Busman, a clinical psychologist at the Child Mind Institute, “but you can also see tantrums and complete meltdowns.”

Check out this article on “How Anxiety Leads to Disruptive Behaviour” by Caroline Miller, editorial director of the Child Mind Institute.

The more commonly recognized symptoms of anxiety in a child are things like trouble sleeping in his own room or separating from his parents but it can also present as temper tantrums, or disruption in school, or throwing themselves on the floor while out running errands. It may present as violent outbursts, being easily provoked, or difficulty regulating emotions, just as easily as it can present as isolation, clinging to the familiar, and avoidance tactics.

It can be difficult to identify when it presents in young children or where communication is limited. Anxiety may be mistaken for ADHD, Oppositional Definance Disorder, or aggression. It may also be present in addition to other conditions such as Autism / Aspergers (ASD).

Everybody gets anxious sometimes but clinical anxiety can put the body in permanent Fight or Flight mode and severely restrict quality of life. It’s important to discuss concerns with teachers and doctors; advocate referral to a pediatric mental health unit for assessment and support.

The Ultimate List of Gifts for Sensory Seekers

Check out the link for a beautifully put together list of toys and equipment that can be used at home for kids with sensory processing disorder; it has tons of photos and is conveniently sorted by sensory systems (vestibular, proprioceptive, oral, tactile, visual, auditory).

Source: The Ultimate List of Gifts for Sensory Seekers

Adventures with Upcycling: Dining Room Table

Table restoration project

The table after it’s all been cleaned up. The oil, dirt, ink and everything else has been removed. It’s just the drill holes left that really mark it 🙂

So…for the last three years I’ve been eating my meals at an upcycled pink princess table. It’s beautiful, has white wooden legs, and matching white wooden chairs.  It is, as Goldilocks would say, ‘just right’. Of course, things being an issue of perspective, it’s just right if you’re aged 18 months to 4 years. As an adult, it meant sitting on the cold ’70s vinyl flooring which isn’t too bad in summer but was a pain in the arse in winter.

Over time, this requirement to sit on the floor (or perch on a low plastic foot stool) began to understandably pall. This was assisted by the fact that Miss 3 is very tall for her age (currently around 103cm) and prefers to stand / be in movement when eating (depending on what kind of sensory / ASD day she is having). The princess table had suddenly become a bit inadequate for her.

The quest began to try and find a table that would fit into our teeny tiny kitchen on our teeny tiny budget achieved by selling some old gardening stuff out of my parent’s garage. I lament my country’s lack of IKEA as I probably could have found something brilliant there! I scoured websites and secondhand listings for something that couldn’t really be bigger than 75cm square. It looked like I wasn’t going to find anything that would fit the space and our budget.

They say God moves in mysterious ways. Apparently, this includes ancient formica tables who’s retro orange perfectly matches the ’70s lino.  Driving along with Miss 3, I spotted an abandoned table by the side of the road not far from home. It would be exciting to suggest it had been shot up in some kind of Wild West saloon; the reality (based on the dirt and oil) was that it had been based in someone’s garage workshop before being deemed a waste of space.

One’s man’s waste is another man’s treasure (and other such common sayings). By dint of great effort (and demonstrating to Miss 3 the importance of perseverance, grit, and treating the car like a giant jigsaw puzzle), it was eventually carried home. More jigsaw puzzling finally squeezed it into the kitchen.

After the initial wipe down, it’s had multiple cleanings with Jiff, water, fly spray, and antibacterial spray. It looks much improved and the old wooden chair in the bedroom with clothes dumped on it, although a bit rickety, fits it just right. It turns out there’s a matching one, in unknown condition, squirreled away in the back of my parent’s garage; Mum had rung about it only this morning so it’s a happy coincidence to find a table to go with it!

I have to say I’m quite fond already of this dinged up orange table; it’s faced it’s challenges and come through as a survivor – just like us. It also allows me to sit with my laptop and a cup of tea while supervising Miss 3 in our rickety fenced little lawn; I don’t have the words to express what a dramatic improvement this is to sitting in the , doorway with a blanket wrapped around me to avoid shivering in the breeze!

I’m open to suggestions on how to proceed with the table. It’s clearly suffered some water damage underneath and I wonder how best to preserve it. I thought I’d set the dehumidifer running tonight. I wonder whether to get some sort of wood stain or polish to rub over it, or whether I should paint over it?

Thoughts?

Table restoration project

The under side of the table has clearly suffered water damage.

Table restoration project

Hmm, what to do about the underneath?

Rewards for Potty Training

Reward Charts can help potty training.

Reward Charts can help potty training.

When starting potty training it’s a good idea to think about how you’ll keep your toddler motivated. Some toddlers will simply want to be ‘just like my big brother/sister’; others will respond to lots of praise; others need something tangible to work towards and that’s where reward charts can be useful.

Potty Training! It’s something that we all experience as parents as we help our children transition out of nappies. I’ve posted previously on:

Reward Charts

Sometimes toddlers need a little extra positive reinforcement to start (or stick with) potty training. Reward charts can be a great way of helping them to see progress, learn about delayed gratification, and learn about working towards achievable goals at a young age.

There are lots of great ideas online for printing out your own reward chart that you can stick on the fridge (like these free to print charts). The important thing is to choose a theme that will tie in with your toddlers interests. I liked this magnetic one from Kmart because I knew Little Miss would like moving the magnets around.

Tip: If you have multiple children, it’s a good idea to instigate reward charts for siblings as well to prevent tantrums, jealousy, and rivalry! If your 2 year old is toilet training, maybe your 5 year old can have a reward chart for homework or chores.

Rewards

These need to be relevant to your child’s interests, realistic for your budget, and appropriate in scale. A trip to the park, a book, a small toy, are more realistic then promising a trip to Disneyland! Also, keep in mind that a reward comes after the action has been successfully taken (and a bribe comes before).

Sit down with your child and be really clear:

  • what they will receive points for (i.e. stickers on their reward chart),
  • what rewards they are working for, and,
  • how many points they need to obtain those rewards.

Encourage your child to brainstorm with you what those rewards are going to be. Possible rewards include:

  • Items (toys / books)
  • Activities (trips to the park, library, the zoo)
  • Food (jellybeans, McDonalds, restaurant)

You may want to start off with reward stickers for:

  1. each wee / poo in the potty (or toilet), and then move towards
  2. stickers for staying dry at home that day,  then,
  3. staying dry at kindy, then,
  4. staying dry overnight.

The important thing is to scaffold your expectations and help your child towards success at a pace that’s realistic to them. Remember that every child is different.

Items

Toys or books can be easily tailored to your child’s interests. It’s a good idea to have a mix of rewards that they can work towards (with larger or more expensive items requiring more points).  If you take them to a store to choose rewards, it’s a good idea to guide their choices by offering them a few options and letting them select one.

It’s also a good idea to guide them towards choosing toys that you were thinking about getting them anyway and which you can afford. Consider items that will encourage open-ended imaginative play and remember that you don’t need to buy ‘branded’ items for your kid to have fun.

We chose a (non-branded) My Little Pony and a wooden pizza – each slice and topping has to be earned so it has a good mix of short and long term gratification.

Activities

Again, these can be easily tailored to your child’s interests. You may want to have activities close to home, or that are free, cost fewer reward points and then have costly activities be something they have to save more points to earn. Not all activities have to be away from home either!

  • At home: build a tent out of sheets & chairs; make a collage; parent play with cars / dolls / animals / trains for 20 mins without distractions; have a tea party with toys; invite a friend over for the afternoon.
  • Free: go to a park; feed ducks; favourite playground; go to a beach; bike ride; art gallery; museum.
  • Paid: go to an indoor attraction (like a playground or trampoline park); go to zoo; go to observatory to see stars; movie.

Food

Food can be a controversial choice because it risks weighting food choices to show that some foods are inherently more desirable than others. In saying that, plenty of parents have chosen to use a jellybean or other small treat as a reward.

For more creative options, why not choose food related activities instead. Reward points could be saved towards things like:

  • doing baking together,
  • helping to make dinner (or choosing from a list of dinner options),
  • buying and planting vegetable seedlings, or micro-greens for the windowsill,
  • going to a cafe for a fluffy or scone,
  • going to a restaurant for lunch / dinner.

Rainy day play: Making a spider

Easy to make spider

Make a simple spider!

Kids love playing with craft materials. Why not spend a rainy afternoon making spiders, insects, or monsters; you could tie it in with a trip to the library to find some books for inspiration!

Materials

  • Pipe cleaners
  • Milk bottle lid
  • Googly eyes
  • Sellotape
  • Craft glue / glue gun
  • Scissors

 

Directions

  1. Cut your pipe cleaners to length and sellotape (or glue gun) them to the base of the milk bottle lid. Bend them to give them knees / feet so that it can stand.
  2. Glue on some googly eyes.
  3. Take the spider exploring!

 

Why not share with them 20 Fun Facts about Spiders for preschoolers or watch a short educational video clip about spiders aimed at preschoolers and kids.

How to make an easy and cheap instrument at playgroup (Musical Maracas)

Making musical maracas

Making musical maracas

Making musical maracas

Making musical maracas

What you need

  • Paper plates (small).
  • Felts, crayons, paint, stickers etc.
  • Wooden beads, sea shells, bells etc.
  • Stapler.

Directions

  1. Help your children to decorate the outside of the plates (don’t forget to write their names on!).
  2. Fold the plate in half (like an empanada) and staple along the edges. Leave a gap at the top.
  3. Hold it upright with the gap at the top. Help your children to drop beads, bells, shells etc. inside their musical instrument; one big toddler sized handful will be about enough.
  4. Staple up the gap, put on some music, and shake!

Note: This is a great activity to do on a rainy day or with a playgroup. For younger toddlers choose larger items to put inside and play with under supervision only; i.e. keep choking hazards in mind.

Making a magical felt crown

Easy sewing projects - making a felt crown or tiara!

Beautiful glittery felt crown

Making a beautiful glittery felt crown or tiara is an easy sewing project. You can do it all in an afternoon either hand sewing or using a sewing machine and glue gun. Toddlers will have fun choosing all the colours and decorations! Older kids can be supervised to make this themselves 🙂

Materials

  • Felt
  • Buttons
  • Chalk / dressmaker’s pencil
  • Ruler
  • Scissors
  • Thread
  • Optional: glitter
  • Sewing needle / sewing machine / glue gun

Directions

  1. Using your ruler and chalk, draw a pattern on the felt. You need the crown / tiara + two rectangles for straps. The straps bed to be long enough to tie at the back of your child’s head.

    Measure, draw, and cut your fabric

    Pieces of felt cut out for the crown

  2. Let your child choose decorations for their crown. You can choose whether to handsew buttons on (stronger) or hot glue gun them. Sprinkle on done rainbow glitter for extra magic! (The glitter will stick to the felt, at least for a while).
  3. Sew the straps on each side. You can either use a needle or a sewing machine.
  4. Ta da!

    Finished felt crown

    Beautiful crown ready to wear!

 

Making a drawstring bag

 

Making a drawstring bag

Making a drawstring bag for marbles

Making a drawstring bag is a fun and easy project to do with kids! I still remember the soft nubby green cloth of the drawstring bag of marbles my brother and I shared as kids. I wanted to make something similar for Miss 3 and gaining access to a sewing machine at kindy seemed like a great opportunity.

There is an easy project to follow in this book by Jane Bull, My Sewing Machine. I didn’t think to look so I actually designed my own project for this bag. My daughter’s sensory sensitivities mean she doesn’t like being in the same room as the sewing machine when it’s operating but she likes looking at the sewing book and she liked helping me with the pattern, cutting, and pinning.

Making a drawstring bag (for marbles)

Materials

  • Paper, sellotape, pencil
  • Fabric
  • Cord or ribbon
  • Ruler
  • Pins
  • Chalk / fabric pencil
  • Scissors (paper, fabric, pinking)
  • Safety pin

Tip: Shop around to find good prices for fabric. Sometimes you’ll find fabric in unexpected places – I bought a giant polyester fleece blanket for NZD$3 / USD$2. It was perfect for making a drawstring bag for marbles (though I wouldn’t use it to make a dress).

Design

I made up a design template using paper, scissors sellotape, and pencil. I could see there were two different ways of approaching the bag and decided to have the fold at the bottom and seams up the sides; this results in the cord being on on two sides (instead of one) which I thought would be easier for Little Miss.

Making a paper template

Making a paper template for the drawstring bag

Once I’d worked out the design, and order of sewing seams, I transferred the template into the fabric. My fabric pencil didn’t work on the fleece but chalk did 🙂

Fabric cut and pinned for the drawstring bag

Fabric cut and pinned

I kept my seams about 1.5cm from the edges, allowed plenty of space for the cord, and made sure the fabric was ‘wrong side’ facing out (not as important with this fleece but good practice).

Sewing the bag

I made sure the threads were all set up and then my sewing order was:

  1. Sew short end (for cord).
  2. Sew other short end (for cord).
  3. Loop silky cord through safety pin. Miss 3 loved helping wriggle the silver fish (safety pin) through the ‘tunnel’. We did that on both sides and then I tied the loose ends.
  4. Sew each of the long sides. I started with a curve at the bottom and then went up to the drawstring (enough to just go over that seam but not go over the cord). Then I turned the fabric around and did a small zig-zag back to reinforce.
  5. The nice thing with this fabric is that I didn’t need to hem or worry about fraying like I werewolf with cotton. I did use the pinking shears to cut the bottom corners off (being careful of the curved corners I’d stitched).

    Drawstring bag sewn (wrong side facing out)

    Inside the bag

  6. Turn bag right side out!

    How to make a drawstring bag!

    Drawstring bag for marbles

Bag of marbles

Next week we can go on a treasure hunt expedition to buy marbles for the bag we made!

Rainy day play: Make a fishing game!

Make an indoor fishing game!

Make an indoor fishing game!

Indoor fishing can be a great way to develop fine motor skills and imaginative play! You can buy fully stocked Gone Fishing kits or you can make your own. We picked up our fish very cheaply (as they were factory seconds) and then let our imaginations run wild with the materials we had at home.

The Fish

We were fortunate enough to pick up our fish cheaply. You could also use a saw or sandpaper and glue gun to fashion a vague fish shape from scraps of wood. The metal eyelet is the same as what’s used when stringing up net curtain cords.

We decorated our fish with: several colours of paint, glitter glue, googly eyes, coloured feathers, and plastic gems.

Tip: This is a great craft project for teaching your toddler patience. We worked on ours over about 5 days. We needed to do the base colour on one side and then let it dry overnight; flip it over the next day and repeat the same. You need more time to let things dry when you’re using craft glue but can speed things up by using a glue gun.

The Fishing Rods

You can make these with lengths of dowling. Use an electric drill to make a hole about 1cm from the top and thread some twine through that has a paper clip tied to the other end. Alternatively, you could glue gun the twine to the rod (if you don’t have a drill).

The paper clip is surprisingly effective; I can catch my fish with it and Miss 2 will normally ‘manually’ catch her fish but will also attempt to catch it without ‘helping’ the hook.

Our rods have multiple shades of paint and glitter glue on them (as well as plastic gems) and also needed drying each night in the hot water cupboard. I stood them upright in a small glass baby food jar (we have several that we use for crafts).