10 Expert Tips for Toilet Training With Disabilities

Learning to use the toilet with special needs is an atypical journey for children. It requires caregivers and parents to be adaptable, flexible, and problem solve along the way. We usually don’t give potty training much thought beyond toddlerhood because it’s thought to be a naturally acquired milestone.

However, when you’re caring for a loved one with a medical condition, disability, or a neurodevelopmental disorder like autism, potty training children can become a huge undertaking.

Using a toilet to any degree of independence is an important life skill and a goal for so many of us. We must never underestimate the many existing societal barriers and personal challenges that surround toilet training and toileting issues. 

The following tips are meant to honor and respect all journeys which differ from what is considered to be “the norm.” We also want to emphasize that the reality of incontinence, disability, and different levels of cognitive ability, functioning capacity, and independence are natural parts of being human which deserve to be acknowledged, seen, discussed, and accepted.

There’s truly no one-size-fits-all when it comes to education and learning. We’re all different from one another, and that is perfectly okay! These tips are meant to offer support, encouragement, and insight. Before you even begin toilet training, it's good to ask yourself some questions:

• Do you have enough time? Do you have the time, energy and ability to be consistent to put regular amounts of time aside for toilet training? 
• Are you feeling good? If you're really stressed or busy with other things, it might not be the best time to start.
• Do you have help? Do you have friends, family, or people who can professionally help you?
• Can you stick with it? Toilet training can be tough. Are you ready to keep going even when it's hard?
• Is your loved one ready? Look for signs like:
  • They pull off wet underwear.
  • They say they need to go to the bathroom (or, if they are non-verbal, they might gesture).
  • They act uncomfortable when they're wet.
  • They hide when they are having a bowel movement in their diaper.
• Are things calm at home? It's easier to learn new things when there aren't a lot of big meltdowns or changes happening.
• Are there big changes coming? If you're moving or changing schools soon, it might be better to wait.

It’s a good idea to consider the following points months ahead of deciding to start potty training:

• Check their food and drinks: Make sure your loved one is eating enough fruits, veggies, and water. This helps their stomach work well.
• Look at tummy health: If they often have stomach aches, constipation, or diarrhea, talk to their pediatrician first.
• Show them how: Let them watch you use the toilet. This can make them curious to try it themselves.
• Help them unlearn old habits: For someone who has always used diapers, using the toilet is a brand new idea. They need to get used to not wearing diapers all the time.
• Practice new things: Try doing other small new things, like eating in public. This helps them get used to changes.
• Understand challenges: For some people, remembering all the steps for using the toilet (like pulling down pants, sitting, and flushing) can be very challenging.

Once you’re both ready to start toilet training, use these hands-on tips.

Set a clear message with a location for toileting. The first step is to stop changing diapers or pull-ups outside of the bathroom! It’s important to send the message that (aside from accidents), poop and pee go in the toilet. If you do decide to use diapers and pull-ups for bedtime, drop the waste into the toilet in the morning and show your loved one that’s where it goes to reinforce the expectation. 

It’s time to ditch the diapers and pull-ups in the daytime! Dress your loved one in regular underwear and loose-fitting clothing, such as an oversized t-shirt or a beach swimsuit cover-up, if it’s helpful for changes. Girls can opt for summer dresses or elastic leggings. Boys can opt for elasticated waists on sweatpants.

Let your loved one choose their underwear. If it’s an option, you can take them shopping and let them choose their preferred underwear. Buy enough to last more than one week to plan for accidents and laundry. 

Remember that loved ones with developmental disabilities, sensory differences, and other medical conditions might need help getting onto a toilet seat comfortably. They may need grab bars or other aids to help with their balance if they are diagnosed with a mobility disability such as cerebral palsy. 

The toilet seat height may also pose a challenge for all small children, so you may want to purchase an insert toilet seat with secure sides, or a step stool that helps them reach the toilet safely and allows them to sit comfortably. You might also consider a potty chair.

Look for child toilet seats if you feel that is a more appropriate choice for your child when they start toilet training. Remember that this is not an appropriate option if your child is bigger, or if they struggle with transitions, as you are adding another step and transition to their daily life. 

When your child is in underwear all day, it’s important to take them to the toilet on a schedule – this is where a timer can come in handy. Take them to the toilet frequently throughout the day so they get used to spending time on the toilet. 

Start with setting the timer for every 30-60 minutes and adjust based on your child’s needs. When the timer goes off, let them know it’s time to go to the toilet. Remember to always give them enough time on the toilet, too.

If you know your child is a visual learner, you may want to use the steps of toileting and hygiene in a series of pictures on the bathroom wall at eye level for them to follow. This can:

• Set clear expectations.
• Lay out the steps.
• Create a sense of predictability and routine.
• Help ease feelings of anxiety and fear. 

On a side note, some kids respond better when you use photos of them or family members instead of a series of drawings or cartoon character images.

If it’s possible, turn the bathroom into a personalized, fun space for your child. You might want to use:

• Plastic drawers.
• Stickers
• Fidget toys or sensory toys.
• Simple picture books.

Remember that the fun items you bring in should encourage them to get used to sitting and staying on the toilet for longer, which will increase the chances of toileting success.

You might be able to motivate your child more using special rewards. This could be a special weekly outing of their choice or a new toy. This can help reinforce the idea that using the toilet is a good and exciting thing!

Praise your loved one for toileting attempts and successes. Sticking to any new daily routines, attempting new tasks, and working on new skills when it comes to potty training are all positives!

Don’t forget that you and your child are a team working together on life skills. Whatever the outcome may be, try to focus on taking it one step at a time, be present, and make it fun!

Once you start, here's what to keep doing:

• Stay calm: Accidents will happen. Try not to get upset or angry. Be kind and remind them you're on their team.
• Don't make a big deal about accidents: Even if it's messy, try to act like it's no big deal. They need to know it's okay.
• Be prepared for accidents: Use towels or waterproof pads on beds to make clean-up easier.
• Use pictures and routines: Put up pictures in the bathroom showing the steps for using the toilet. This helps them know what to expect.
• Ask for help: Don't be afraid to get help from experts like occupational therapists who know about toilet training for kids with special needs.
• Don't compare: Everyone learns at their own speed. Don't compare your loved one's progress to other kids.
• Talk to school/daycare: Make sure their school or daycare understands and helps with toilet training. If they don't, it might be time to find a new place.

Learning to use the toilet is a big step, and it looks different for everyone. Remember, you're not alone on this journey, and every little bit of progress is a win. Keep trying, stay positive, and celebrate all the hard work your loved one (and you!) are putting in. You've got this!

Disclaimer

Information provided on the Aeroflow Urology blog is not intended as a substitute for medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.