“Activities of Daily Living” don’t have the cache’ of kineseotaping or therapeutic listening, but helping families improve the little things in life is something I haven’t ignored. The basics of life are still the basics, and when they are a struggle, life gets harder. Every single day.
Sometimes using SI techniques like the Wilbarger Protocol Can You Use The Wilbarger Protocol With Kids That Have Ehlers-Danlos Syndrome? makes self-care activities better, but sometimes you need a targeted approach. This post describes some of my best strategies to make face-washing, tooth-brushing, dressing and bathing easier for kids to tolerate and they also help them to become independent at these important skills. After all, one of the best techniques to reduce defensiveness/aversion is to have a child do the task independently. They can control the pace, the amount of force and the timing. And they are empowered. So many kids with special needs develop the impression that they don’t have the ability to do things for themselves.
So check out my post on Therapro, and then go shopping for some of their terrific materials for your child or for your therapy practice!
Over the years as an occupational therapist, I have been giving parents hints here and there. Writing my e-book this fall, and preparing an e-course (coming soon) to support families makes me realize that some clients did not ask me very many questions while they were toilet training their child.
So….Are there aspects of therapy that can help you with toilet training? Yes indeed! Does getting more therapy mean that your child will automatically be trained earlier and more easily? Unfortunately, not really.
Here is a list of what therapy can do to support you and your child for toilet training. If you haven’t heard your therapists discussing these treatment goals/approaches, you might want to share this post with them. They may be more focused on other very important skills right now, but always keep your discussions open and inform them that you are planning on training. Most therapists are very eager to support families whenever they can with whatever goals the family has.
Core stability for balance, abdominal strength and safety on the toilet. Most kids with low tone do not have great core stability, and this is where the rubber meets the road. A weak core will put a child at greater risk of falling or feeling like he will fall. It is harder to relax and pee/poop if you are afraid you will land on the floor.
Clothing management and hand washing. No child is really independent in using the toilet if someone else has to pull clothing up and down. Washing hands is a hygiene essential. Time to learn.
Good abdominal tone. See #1. Helps with intestinal motility as well. That is the contraction of smooth muscle that moves the poop through the colon and on out. My favorite hack is the use of kineseotape in the classic abdominal facilitation pattern. All but one of my clients have had a nice big bowel movement the next day after taping; no pain, no fuss. Regular taping along with strengthening can improve proprioceptive awareness internally (interoception, for those of you who need a new word for the week!)
Transfers and equipment assessment/recommendations. Therapists can teach your child how to get on/off, up and down safely from a toilet or potty seat. They can teach you what to say and do to practice transfers and how to guard them while they practice. They can also take a look at what you already own and what you might need to obtain. Children with significant motor issues may need an adaptive toileting seat, but most mildly to moderately low-toned kids do not need that level of support. What they do need is safe and correctly-sized equipment.
Proprioceptive awareness for balance and stability. Some therapists use balance discs or boards, some use other equipment. Swings, climbing, jumping, etc. More body awareness= more independence.
Sensory tolerance for the feeling of clothing, using wipes/TP, the smells and the small enclosure of a bathroom. If your child has sensory sensitivity issues in daily life, you have to know that they are going to be issues with toilet training.
Effective vestibular processing. Children that have to turn around, bend and look down then behind their bodies to get TP or pull up their pants need efficient vestibular systems. Vestibular processing isn’t just for walking and sitting at a table for school.
Practicing working as a team and following directions. Your child needs to be responsive to either your praise, your rewards or both. Therapists that support independence (all of us!) and develop in your child the sense that the she is a part of the therapy plan will make it easier for your child to work with you on toileting!
My e-book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone is now available at Amazon.com as well as Your Therapy Source ( a terrific site for parents and therapists) and on my website, tranquil babies . Families are telling me that they have made progress in potty training right away after reading my book!