Hi Shona – It is very common for a child with additional support needs to take a little longer to attain bladder and bowel control. In order for your daughter to succeed, she needs to be physically, emotionally and mentally ready. Physical signs of readiness include: reasonably predictable bowel movements, she needs to be able to independently get herself to the toilet and pull her pants down, she needs to be able to recognise the feeling that she needs to go to the toilet or can control the urge to go. Mental signs of readiness means she understands what you are saying and can follow simple instructions, can predict and communicate when she needs ‘to go’ or becomes uncomfortable and complain if her nappy is dirty or removes her nappy following a wee. Social and emotional signs of readiness include an increase in imitative behaviours, she demonstrates independence (often by saying ‘no’ to requests) or shows a desire to please you and other adults. If your daughter shows at least two or three of the physical, emotional and mental signs that I have listed here then she should be ready for toilet training – if not I would hold off. Many children find the toilet frightening so I would stick with a potty for the time being – perhaps you could get her to help you find a place for it to sit (obviously this will need to be mutually agreeable). Check with her that she likes the potty you have chosen otherwise take her shopping and get her to help you pick one out. You can start by encouraging her to sit on the toilet or potty after meals, you can make this a more pleasant experience by giving her a book to read or pop her in front of a favourite video. Behavioural reinforcement is typically your best option in encouraging the use of a potty or toilet. Some children respond well to verbal praise while others prefer some form of visual reinforcement like a sticker chart. Offer her a reward if she does go but do not make a big deal if she doesn’t as anxiety will only make the situation worse. Repetition and reinforcement are keys to successful toilet training – keep talking to her about how we do our poos and wees in the potty/toilet, read her books about toileting, let her watch you using the toilet (if you are OK with this). The key to successful toilet training is timing. The more ready your daughter is the smoother the process will be!

Regards,
Dr Cathrine

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