potty training {part three: parent directed approach}

Disclaimer: As in all parenting advice I give, you should always do what you feel most comfortable with when it comes to anything with your child.  Just because someone swears by one method, does not mean that will be the best, only way it will ever work for any child, anywhere.  Take the information and tips given and adapt them if you need to what works best for you, your family and, of course, your child.  I am a strong believer in mommy-sense!

link

 I'll be honest.  This approach by N.H. Azrin and R.M. Foxx in 1971 to potty training was originally developed for "The Institutionalized Retartded." However, since then, parents have been intrigued by the idea of having their littles potty "trained in a day."  The "in a day" aspect is HIGHLY subjective and dependent on the child, the environment and so much more.   

Side note: as a rule of thumb, if any program is promising a major behavior change in just a day or two, it is probably full of you know what.  

Back to Azrin and Foxx.  I will just be pointing out the basic steps to a parent directed approach to potty training.  If you are interested in the full procedure, you can find the book here.

Again, the child needs to be physically and psychologically ready to be potty trained (refer to when to start).   

Their method includes:

• Administering more fluids in an effort to increase the need to go to the bathroom as well as "elimination alarms" alerting when accidents occur

• Scheduled potty visits-depending on the child, it could be every 15 minutes or every hour.  Starting with more frequent visits, then gradually increasing the amount of time between visits once the child has demonstrated they can remain dry.

• Rewarding with food, drinks, praise, hugs and attention when the child uses the bathroom.  Really, whatever is reinforcing for the child.  

{I am not a huge advocate of food as a reward, but if you feel comfortable with that, do what you need!}

• Having the child clean up their own accidents as a natural consequence for not using the toilet.  The idea being that it is easier to use the potty than it is to not use the potty.

They also included some modeling to show the use of the toilet and how to complete the task. 

Again, the lure of having your child trained quickly draws many to this approach.  In my experience, this approach is best when the child's nature needs a little more structure and clear cut "rules."  

This might also be the way for you if you are a person who likes control.  It also requires a bit more dedication during the training time. 

Take what you like, tweak it to you and your child's needs, have a little humor, patience and love.  This is a time when finding the joy in imperfect parenting is a really useful tool!

references:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1310676/pdf/jaba00072-0020.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307553/

potty training {part two: child oriented approach}

Disclaimer: As in all parenting advice I give, you should always do what you feel most comfortable with when it comes to anything with your child.  Just because someone swears by one method, does not mean that will be the best, only way it will ever work for any child, anywhere.  Take the information and tips given and adapt them if you need to what works best for you, your family and, of course, your child.  I am a strong believer in mommy-sense!

On to the fun stuff!

link

 Back in 1962, a pediatrician named T. Berry Brazleton developed a potty training method that caught on like wildfire that was perfect for the hippie time period in which it was publicized.   This approach based strong emphasis on "child readiness."  In other words, when the child showed readiness and both he/she and the parent had interest in potty training, the process commenced.   In his study, Brazleton addressed the fact that parents were feeling "pressured" or "unfit" to train their child.  Anxiety that made the whole experience miserable, needless to say stressful, for both parent and child. 

Enough with the boring research stuff that I, sadly, find very interesting.  You are here for the tips!

If you choose to go the child oriented route, here's the breakdown:

• When the child shows physical readiness and desire to go, a floor potty chair is introduced as the "child's chair."

• Routine "potty times" are scheduled
• during these routine visits, the child is taken to sit on the potty chair, fully clothed with the caregiver right there reading them stories or singing songs or whatever, for the first week or so.  The child is in control as to how long he/she wants to sit on the potty.
•  If the child was cool with the fully clothed sitting, they are then invited to sit with diaper off.  No attempt to "catch the stool" (as Brazleton so eloquently phrases it) is made.  Basically, the first couple weeks are used to get the babes comfortable sitting on the pot.

• Once comfortable with the diaper off sitting phase, the dropping-the-diaper-poo-in-the-toilet phase begins.  After going in the diaper, the child is taken to sit on the potty and have the diaper changed, watching the poo go into the pot, thus demonstrating the function of the potty.

• Once interest is peaked on the child's part to use the potty for its designed purpose,  diaper is removed throughout the day(letting the kid run free willy-nilly or in underwear), the potty chair is placed wherever the child is and encouragement, but not pressure, to go on his/her own, begins.  Praise and excitement are given when they "go."

And, wah-lah!  The theory is that the child is in control, thus less pressured to succeed, less fear of failure, more motivation to  use the potty.  He does point out that nap and night time training should not be stressed until daytime dryness has been achieved.  At which point, the potty is just placed in the child's room with scheduled late evening and early morning wakings with encouragement to try to go potty.  He also stresses that if a child becomes frustrated or agitated about "failing" when accidents happen, to reassure them that they are not "bad" and that "Someday he will co-operate when he is 'ready.'"  Please use more informal wording than Dr. Brazleton to encourage your child when accidents happen.

There you have it.  The child-oriented method of potty training as developed by Dr. Brazelton.   Many have had much success with this approach and prefer it to others because it focuses on the child and making sure they feel confident and safe in this new venture.

Again, take what you like/think would work best, adjust to your family, child's personality, environment, etc. and, as always, find the beauty in being an imperfect parent.

references:
http://www.ohsu.edu/xd/health/services/doernbecher/research-education/education/residency/upload/Child-Oriented-Approach-to-Toilet-Training_Brazelton-1962.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307553/

potty training {part one: when to start}

Ah, potty training.  A time that every parent looks forward to with excitement, anxiety and confusion.  As a behavior interventionist, I have potty trained my fair share of children of all different ages, levels of development and disabilities.  Over the years, I have researched potty training methods in an attempt to find the best way to accomplish this crucial life skill.  Bottom line, there is no one way that is "THE BEST!"  But, there are aspects of each method that can be used to fit each child, their needs and personalities.  Thus, the Potty Training Series of this blog was born.  A hopefully enlightening attempt to assist the parenting world in the realm of toilets.

This is how the series will go down:

{Part 1} will address the age old question, "When should I start potty training my child?" 

{Parts 2 & 3} will delve into the different methods

{Part 4} is all about my gathered thoughts and experiences on potty training throughout the years

I don't have any experience with Elimination Communication or Infant Training, so those will not be covered.  Maybe one day I will be that ambitious.

Without further ado-doo (please forgive that pun if you found it completely inappropriate, but if you chuckled, don't be ashamed):

{Part 1: When to Start}

People often think potty training is just a natural, physically developmental process that always happens around 2-years of age.   They also think that potty training should happen quickly, without stress. 

Sorry to burst your bubble if you think this way, but this is not how it happens for most families.  Congratulations to those with prodigal children who just sat on a toilet and trained themselves.  Chances are, those people will not be reading this post.

First of all, we need to clear up the fact that potty training is just as much, if not more so, behavioral as physiological.  Think about it for a minute.  We are trying to teach a human being that has, up to this point, defecated free willy, whenever they very well pleased, to now control said defecation until they are sitting, not just any sitting on the floor or on any old chair, but on the appropriate porcelain throne.  That is a HUGE skill to learn. 

For this reason, many studies are showing that it is best to wait until the child is showing signs of readiness rather than having a hard fast rule that we need to train our children at 24 months.

Here are some of the key signs that your child is ready to take this giant leap of independence:

• Little one can walk to the potty and be stable while sitting on the potty (we do not want any Tommy-tippees happening)

• Has the ability to follow 2-step commands (such as, "Go over there and pick up that book.")

• Capable of communicating the need to use the toilet (does not need to be vocal, just able to communicate the need in some manner).

• There is a desire for independence 

• Enjoys doing things that please caregivers

• Recognizes when they have defecated in their diaper 

• Able to pull down pants

Just as each child has developed skills at varying ages up to this point, they will develop that ability to be potty trained at different ages, as well.

I have also found that children will express an interest in the toilet and want to try "Going."   They may not ever actually "go" or even want you take off their diaper, but this is another sign that they may be at a good point to start the potty training process.

It is crucial that we do not push our children to start potty training if they are not ready.  This can have adverse effects such as incontinence and infections.  This is not a race.  If your neighbor's kid was potty trained at 24 months and your darling is just starting at 30 months, that is fine as long as you feel it is the right time for your child.

Some last minute things to remember when starting this journey:

• Girls typically potty train sooner and faster than boys

• Most children in Western civilization have bladder and bowel control by 24-48 months of age

• On average, it takes 3-6 months for a child to become completely independent in toileting

• Patience and consistency are key

That wraps up part 1 of the Potty Training Series!  I know you are all on the edges of your seats waiting for the next installment.  I promise it will come soon.  Until then, find the beauty in being an imperfect parent!


References:
Pediatrics and Child Health
Among healthy children, what toilet-training strategy is most effective and prevents fewer adverse events (stool withholding and dysfunctional voiding)?, Mia E Lang
When and How to Train, Darcie A. Kiddoo