Friday, January 24, 2014

Oh poop! A discussion about toilet training

Discussion Topic: Helping your child to learn to poop in the toilet

Top Recommendations:  See Me Potty app, Reducing fear of the potty, Consulting with your OT or pediatrician

Continue reading for the specific discussion question and the list of ideas.

Over on our Facebook Fan page, we hold a regular discussion time, where you can ask all our fans for advice. If you have a question to ask, please head over to our Facebook page where you can easily enter your question for discussion by using the Questions tab.

Aspen asked: I work with a six year old with mid-functioning autism. He was potty trained about a year ago. He is still sleeping in diapers, and holds BM until bedtime to go in a diaper instead of the toilet. We would like to transition him away from diapers completely, as he wakes up dry every morning. Any suggestions?

Quite a number of our fans also had this problem with their children, or children they have worked with.  Luckily I didn't have this issue with Giggles and Chatterbox, but I have experienced it when I was working as a Nanny with a Neurotypical 4 year old.  What the family tried with that little boy did NOT work -- they just stopped using all nappies and this caused him to become constipated.  I wish we had had the following list to work with then!

General Recommendations:
Zoe commented: My child used to do this we were told to give a laxative

Amy mentioned: Lots of young children are afraid to poop in the toilet. It can be the sound, or the feeling, or whatever. Do you think that's it? If you can home in on the "why," maybe you can use strategies to address it. Like a pile of toilet paper under him in the toilet, if the sound bothers him. Otherwise, maybe just hold out -- you know, keep him on the toilet before bed till he poops. (yeah, I know, easier said than done!) We used to rehearse a little story: I'd go through every cartoon character he liked, saying, "Dora poops. Elmo poops. Blue poops. Kailan poops. Caillou poops. Everybody poops! And it's okay!" After a while, he'd recite the list himself.

Heidi said: I had a kid where he wore the diaper but sat on the toilet. Once he was going in the diaper on the toilet we started cutting holes in the diaper bigger and was a long process but it worked.

Jennifer shared: I tried everything with my son. Social stories, charts near toilet, lots of positive reinforcement. All important but at end of the day he stopped pooing his pants when HE was ready not me! This little boy is only 6. Even compared to neurotypical he's doing very well! Be very happy with his accomplishments so far. He will get there with your help. I think the thing with my son that worked best was finding something he REALLY wanted that motivated him enough to try. Cars for my son. Trips to car dealerships so he could talk to salesman, sit in cars, collect brochures. He's been to all in our area as rewards! Find his motivator and it might help.

Amy mentioned: My son did the same thing (he was four and typically developing). He ended up getting really constipated so his pediatrician had me give him small doses of Miralax and then glycerin suppositories and then putting him on the potty. Once he finally went once or twice on the potty and the initial anxiety was gone, the cycle was broken and he was fine. We still ended up having to go back to pull-ups a few times at night for bed wetting, but that eventually stopped too.

Juliana suggested: Don't put the nappy on him until he actually falls asleep. Hide the nappies. And get a good mattress protection... Good luck.

Bri thought: I wonder would visuals help as well.

Jana commented: Lady Gaga potty trained my boy. He was completely fascinated with the Bad Romance video (we're ok with nearly anything but violence). He was pee trained, but would ask for a diaper to poo in, so If he used the potty instead, he got to watch the video. Jennifer is right, find their motivate, and stick to it. Luckily, it didn't take long for the switch. ps make sure he is comfortable on the toilet and feels 'safe'- knows he won't fall in, or get flushed down (our toilets are almost like an airplane toilet- scary sounding and loud), Has privacy if needed; someone there if needed. Good luck.

Emma said: I recommend a visit with your OT to address this issue specifically. We had set poo in toilet as a 6-month goal for my boy, saw the OT and mentioned it. We followed her advice and he pooped a tiny bit on the toilet that night, held on the next night and the night after (with a really frightened look on his face) with lots of reassurance from us he went again on the toilet and has daily ever since. Within a few days he was going and wiping independently. He was definitely hanging out for the night nappy to poop in, so I put it on him after he fell asleep. A month later he said no more nappies at night and has never had an accident or wet the bed. OT advice involved jumping on trampoline alternating feet wide and narrow with each jump to activate the pelvic floor (i.e. so he knows he has one, as he obviously has bladder and bowel control) for 5-10mins before his usual poo-time such as after dinner, then go sit on the toilet. Sit on toilet with feet supported on a step; show PICTURE of reward (my boy would meltdown if I showed him the real thing and then took it away); keep it fun with lots of blowing toys - whistles, balloons with faces and animal shapes, blowing bubbles, bubble mountain in a glass - anything to get him to do a valsalva manoeuvre (i.e. to bear down while exhaling as this is the natural action for pooping). I also showed my boy Youtube video's of cats pooping on toilets and Youtube toilet training songs (e.g. Poo's are happy when they are in the toilet and get flushed away to Happy Poo-Land. Do you want to make a Happy Poo? Sounds silly but it worked). Reward any little brown speck in the bowel like it is the real thing, ring everyone up and tell them about it and tell everyone you see for the next week. Make is a big positive deal. Good luck

Tamara's Tips for Toilet Training

Some simple tips for helping a child with special needs get started on potty training, especially for those with sensory processing challenges:
  • • Can your child touch the floor when sitting on the potty? Consider buying a stool for your child to rest his/her feet on while sitting on the potty. This can help a child feel where his/her body is in space and feel more secure sitting on the potty.
    • Is your child afraid of the flushing sound? Consider telling your child that you can flush for them after they are done and out of the bathroom. Take your child to public restrooms when you are out and about so he/she can get used to all of the different sounds and automated flushes, whirls and faucets. Many children feel surprised or frightened by all of the automated devices in public restrooms.
    • Seat too cold or uncomfortable? Some children benefit from sitting on a child's potty seat that you can put on top of your toilet seat.
    • Is your child nervous about where it all goes? The Human Body app actually shows kids! Some children feel that their poop is part of them and are afraid if they "let it go" that they are losing a part of themselves.
    • Does your child need a visual schedule to help he/she be more independent in the bathroom? Consider making a visual schedule in an app, such as Choiceworks.
    Book recommendation: The Potty Journey: Guide to Toilet Training Children with Special Needs, Including Autism and Related Disorders by Judith Coucouvanis

App Suggestions

** Please note: Some of these apps have in-app purchases, but they can easily be disabled in the settings of your device. There are also ads and social network links in some of these apps. Only the app's developer can control when an app is free or not. All apps that we post as free are verified to be free at the time of this post. We make no guarantees otherwise.**

See Me Go Potty.
Janet suggested: You've got to try the iPad app I've mentioned before--See Me Potty. There's a "poo-poo" section that shows the poop plopping into the toilet, and the little boy wiping until the toilet paper is clean. It has worked for one of my students very, very well! Good luck!

Jennifer added: We have the "See Me Potty" app. My 3 year old likes to have the avatar have accidents.

From iTunes: The unique, distinctively useful, and exceptionally fun potty trainer. 

How it works
1. Use a simple menu to create a cartoon avatar that physically resembles your child/children.
2. Let your child repeatedly play the Go Potty narrative showing him/herself successfully complete the whole process of using the potty step by step.
3. Show your child the Accident Scene narrative to teach what an “accident” is. 

You’ll be hearing “I did it!” in no time. 

Important features

Fifteen actionable potty training tips included: The app includes concrete advice about preparation, behavioral reinforcement, behavioral shaping, when to continue vs. take a break, and more. 
Teaching with positive reinforcement and fun: The Go Potty scene ends with your child’s avatar happily celebrating a successful “I did it!” potty experience. In contrast, the Accident Scene ends with your child’s avatar being disappointed by the “uh-oh”.
Personalization and connection to kinesthetic learning: Children immediately joyfully recognize their cartoon selves, closing the gap between watching someone else do something and visualizing oneself doing something. The supplemental motor area (SMA) of the brain is responsible for learning and planning motor behaviors (actions). Quite amazingly, neuroscientists have shown that imagining oneself doing something involves similar activity patterns in the SMA as actually doing it. 
Visual learning is powerful: This app is a great teaching tool for typically developing children as well as children with developmental delays and communication disabilities. The layout is intentionally simple and free of distractions. Your child’s attention will be focused on him/herself using the potty. Parents who have a “neuro-diverse” family know that the teaching techniques we rely on to teach our children with developmental delays also work like a charm with our typical kids. Many kids on the autism spectrum, in particular, are very visual learners, but the power of visual learning is certainly not restricted to them. 
Auditory learning and read(/write) learning via simple narrative accompaniment: The animations are accompanied by a simple step-by-step script that your child can readily adopt and transfer to real life. Most children of potty training age cannot read yet; they will simply hear and then mimic the verbal labels for each step. However, many children on the autism spectrum, who are relatively late to potty train, may be able to recognize sight words surprisingly early. A 3–5 year-old child may be able to “read along”, further reinforcing the behavioral sequence. 

If you would like to purchase this app, please support Smart Apps For Special Needs by clicking this button:

($0.99, iPhone/iPad)

Potty Time with Elmo
From iTunes:
When it’s time to potty train your little one, Elmo leads the way! The Potty Time with Elmo app is a fun way to ease the transition from diapers to big-kid underpants. Developed for children ready to potty train, this charming app features everyone’s favorite furry red monster, Elmo, helping his toy Baby David learn to use the potty. Also included are animated stickers, a reward chart, puzzles, and 5 fun songs:

+ When It’s Potty Time, You Feel It
+ I Am Waiting on the Potty
+ Flush Goes the Potty 
+ I Wash, Wash, Wash My Hands
+ Boom, Boom, Ain’t It Great to Be a Big Kid 

With familiar tunes and instructive, easy-to-sing lyrics, the songs provide a super fun way to learn good bathroom habits.

The Potty Time with Elmo app will engage, encourage, and delight even the youngest kids. Learn the basics of potty use by listening to the story and interacting with it. Wait for the giggles to start! Tap around to hear fun sounds and Elmo’s encouraging words. Tap Elmo’s radio to hear catchy potty-time songs and sing along. Find stickers to collect on every story screen and add them to the sticker book. And track potty progress with the Sticker Reward Chart.

This comprehensive potty-training app includes:

+ Elmo, a favorite Sesame Street friend!
+ Elmo-voiced catch phrases and positive reinforcement
+ Lively storybook narration, with sound effects
+ 5 fun-to-sing potty-time songs
+ 15 animated stickers that are collected in a sticker book
+ Sticker Reward Chart to track your child’s progress
+ 5 potty-themed puzzles
+ Helpful training tips for parents of would-be potty-goers
+ 3 reading modes to choose from

If you would like to purchase this app, please support Smart Apps For Special Needs by clicking this button:

($2.99, iPhone/iPad)

Once Upon a Potty:  Boy or Girl
From iTunes:
If it's time to potty train, "Once Upon a Potty: Boy" is your new best friend. For decades, Alona Frankel’s toilet learning classics have been helping parents and children conquer the developmental leap from diaper to potty. Narrated by his mother's voice, Joshua learns about different body parts and functions, and figures out what the potty is (and isn't) used for. This patient, loving and humorous Boy edition encourages children to learn through play and empowers parents and caregivers of all ages. Follow Joshua through his stages of discovery, and enjoy the many delightful hidden audio surprises throughout the story. 

If you would like to purchase this app, please support Smart Apps For Special Needs by clicking this button: ($1.99, iPhone/iPad)

Once Upon a Potty Girl

Once Upon a Potty Boy

The New Potty - Little Critter
From iTunes:
Join Little Critter's sister in this interactive book app as she learns how to use her brand new potty! Explore pictures, learn new vocabulary, and personalize the story with your own narration. This charming tale of common potty training frustrations encourages children to keep trying.

Explore the Story:
- ENCOURAGE literacy skills with highlighted narration
- LEARN new vocabulary with tappable words and pictures
- RECORD your own narration & share it with others
- SELECT a scene with easy-to-use navigation
- KEEP kids in the story with parental controls 

Designed for children ages 2-5

If you would like to purchase this app, please support Smart Apps For Special Needs by clicking this button:

($1.99, iPhone/iPad)

I have to go!!
From iTunes:
Going on the potty... It's not always easy! Especially when you really need to go and you cannot find it. But when you do, everyone is happy!
Excellent for ages: 2 to 5 years old.

How it works: 
- The language of the book automatically sets to the language of your preset iPhone / iPod/ iPad language. You can change the language in the options screen. 
- Swipe the pages right to left to go to the next page or swipe to the right to return to the previous page. There are also directional arrows for those little fingers that may have trouble swiping. 
- Touch the objects in the book like the kids, animals, food, and other objects to discover story sounds! 

- Automatic Read function in 3 different languages English, Español, and Nederlands. 
- Language switch.
- English version has three different voices (American English, British and Irish!).
- Sounds on every page of the storybook. 
- Option to mute narration. 
- Extra: coloring pages.

If you would like to purchase this app, please support Smart Apps For Special Needs by clicking this button:

($0.99, iPhone/iPad)

If you have your own question to ask, please head over to our Facebook page where you can easily enter your question for discussion by using the Questions tab.

Odd Socks Mummy is so glad that her toilet training days are behind her, but wishes that she had had these apps to help at the time!

Tamara provided her tips and a lot of apps for this discussion question post.  She is the toilet training information Queen! 

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