Toilet training is an important milestone in every child's life, but parents of child with Down syndrome may have special concerns about when and how to accomplish the task. What signs of readiness are relevant when the child's pace of learning is different in other areas? As with most other areas of learning, psychologists, educators and other parents offer advice.
Determine Readiness
Step 1
Look for behavior signs of readiness for toilet training. Ideally, your child should be able to sit for at least short lengths of time, and show interest in toileting or wearing underwear. Children with Down syndrome may be delayed in showing these signs, and may need to begin training before these signs are in place.
Step 2
Watch for communication skills to develop. Ideally, your child should have some means (verbal, signs or gestures) to communicate the need to use the bathroom. Consider teaching signs for toilet or bathroom to a nonverbal child with Down's.
Step 3
Check for physical indicators of readiness. A child (with or without developmental delays) should show some control over urination by staying dry for a few hours at a time. Another sign is the ability to form a stream of urine instead of a dribble, since that shows control of muscles.
Create a Comfortable Environment
Step 1
Let your child's size and comfort level dictate the toileting tools you choose. Some children are more comfortable using a toilet seat insert to decrease the size of the hole. Some children prefer a separate potty chair or a specially designed seat with handholds on the regular toilet.
Step 2
Provide a small step stool if needed to help your child climb onto the toilet and to reach the sink for washing after using the toilet. A stool will help your child become independent more quickly and feel more comfortable while learning.
Step 3
Plan to occupy your child while waiting for elimination on the toilet. Favorite books or other quiet toys can be used to help your child learn to wait on the toilet until the goal is accomplished. Children with Down syndrome might need more attractive distractions to keep them on the toilet.
Use Behavior Management Techniques
Step 1
Complete a task analysis for toilet training. Make a list of all of the steps involved with the process, and plan to teach each step to your child in order. A task analysis will help you isolate problematic steps in the process for a child with Down syndrome and then be more intentional about teaching them.
Step 2
Spend a week or two learning the child's elimination habits. Most children settle into a consistent schedule of elimination, and you can schedule toileting accordingly. Nancy Grace, a psychologist who specializes in behavioral psychology, suggests that children be taken to the toilet approximately twice as often as they habitually eliminate.
Step 3
Find a way to reward success on the toilet. Some families have success with using small edible rewards, and others engage the child in a rewarding activity immediately after toileting success. Children with a developmental delay may need a more frequent reward schedule to maintain success.
Tips and Warnings
- Complete daytime training first, then tackle night-time training. If your child is having difficulty with the training process, consider using a wetness alarm. When the child starts to wet, the battery-powered alarm goes off and adults can take the child to the bathroom to run through the steps of toileting.
- According to Nancy Grace, children with Down syndrome may be delayed in toilet training. A common goal is to be toilet trained by age 4. While toilet training Down syndrome children is much like training children with normal development, a parent might expect to need more consistency over a longer period of time to accomplish the goal due to the developmental delay.
Things You'll Need
- Toilet seat insert
- Potty chair
- Step stool
References
- Potty Training Toddlers and Children, Boys and Girls
- "Toilet Training Children with Down Syndrome"; Nancy Grace; Pediatric News; December 2006
