Children who have sensory loss or sensory integration problems struggle with toilet training. Sensory problems are common in children who have developmental delays such as autism spectrum disorder or attention deficit hyperactivity disorder, ADHD. These children with sensory issues struggle with the earliest part of toilet training -- knowing it's time to use the bathroom.
Types
Toilet training issues occur from the sensory loss in children that have a developmental delay. Children with sensory integration disorder and autism cannot sense the feeling or urgency of having to go to the bathroom. Children with sensory integration dysfunction typically also have ADHD and may forget they need to go to the bathroom. These children may lack motor control and struggle with waiting or communicating their needs. All these issues add to the problem of toilet training readiness.
Prevention/Solution
Sensory loss can be improved with regular occupational therapy sessions, which work to correct sensory receptors by using fine and gross motor skills. Occupational therapists balance the five most common senses, plus three more lesser known senses: vestibular, proprioceptive and interoceptive senses. Interoceptive senses are responsible for aiding with toileting because they sense bladder movements and other signals from nerves in the viscera.
With children who are visual, a picture chart with the steps of toilet training can lessen anxiety and help them to learn the expectations. Photographs of the toilet, sitting on the toilet, the toilet paper and washing hands help set up the sequencing.
Expert Insight
According to Dr. Alison Schonwald, assistant professor of pediatrics at Harvard Medical School, "children with sensory processing differences may require interventions that optimize stool comfort and regularity and children with autism spectrum disorder will benefit from having visual tools displaying the steps and expectations." Feeding your child a high fiber diet will keep her needing to use the bathroom more frequently and make it more comfortable when she is ready for toilet training.
Dr. Lucy Miller, author of "Sensational Kids," a book about children with sensory processing disorders, states "it can do more psychological harm than good if they are not developmentally or physiologically ready to potty train." Children with sensory processing disorders need more time to be ready than typical children.
Considerations
Toilet training can begin once the child has motor control and feels the urge to go to the bathroom, knows to hold it in and communicates his needs to use the bathroom. For successful toilet training, children need to have the ability to push and the fine motor strength to wipe themselves.
Potential
Children with sensory issues resulting in delayed toilet training may train later than a typical child. However, with adequate occupational therapy, behavioral therapy and patience, they will be out of diapers. Intensive training can take a month to several months to complete, but having a fully potty trained child is worth the additional work.
References
- Consultant Live: Toilet Training Strategies for Success in Children with Developmental Disabilities
- Behavior Advisor: Autism and Toileting
- Sensory Processing Disorders: The SPD Companion issue 16-SPD -- Potty Training
- "Sensational Kids: Hope and Help for Children with Sensory Processing Disorder"; Lucy Miller, Doris Fuller; 2007.
