If advised by consulting physicians and specialists to toilet train the child, a great deal of patience and a longer time frame may be necessary. Many other skills accompany even simple routines for children with physical or mental impairments.

As a parent, you are the only one who knows your child’s abilities. You can gauge whether or not they are even near being able to grasp the thought or tasks involved in potty training.

Just like with all other children, you need to be sure that your child is fully able to understand his or her’s bodily functions and what to do with those feelings when they arise. You have to let your child dictate to you when the time is right.

Once you reach that point, use the same techniques we’ve outlined throughout this whole book. Just because your child has special needs doesn’t make them all that different from every other child. As you are well aware, potty training special needs children just requires a little adaptation.

You need to do a clear task analysis of each process that trainers and parents often take for granted. This may involve actually writing down every step taken in order to go to the toilet. The tasks might include some of the following:

• Recognizing when she/he has to go to the bathroom
• Waiting to eliminate
• Entering the bathroom
• Manipulating clothing closures
• Pulling pants down
• Sitting on the toilet
• Eliminating in the toilet
• Using paper correctly
• Pulling pants up
• Flushing toilet
• Washing hands
• Drying hands

You may notice that many of the signs outlined above are the same as any other child who is ready to begin potty training. Your special needs child is no different. You need to be aware of what to look for before taking on this difficult task and then start with the right attitude for both you and your child.

To see if your child is ready to learn toilet training, answer the following additional questions.

• Can the child follow simple directions? (“Come here.”)
• Can the child sit in a chair for five minutes?
• Can the child wait at least 1-1/2 hours between elimination times?

Recognizing the signs that your child is ready for the potty is the best way to know when it’s time to begin. You are no different than any other parent at this point in your child’s development. Sure they might a little older, but you still have to help your child travel this road with as little disruption and distraction as possible.

When you are focused on the job, they’ll be focused on the job too. That will make the job easier on both of you!

What about multiples? When you have twins or even (gasp!) triplets, the issue of potty training becomes even stickier. But in actuality, you are going to have an easier time than you might think.

Some of these events may include:

• Starting school or day care
• Moving to a new home
• Divorce or separation
• Birth of a new sibling
• A parent going to work outside the home

Please realize that this is not unusual and many children experience this type of setback. However, the setback is usually temporary and can be rectified within a reasonable time frame and actually quite easily.

At this point, if there are no other problems, you may just need to offer reminders to use the potty so that the bowel movement is done there instead of going on the floor. This is easy if he or she has BMs at about the same time each day, but even if he or she doesn’t, you might have him or her sit on the potty for 4-5 minutes right after waking up and after meals. Those are times when most children are likely to have a bowel movement. Even if he or she doesn’t go, you can offer praise and extra attention simply for the fact that they tried.

Treat accidents lightly and avoid negative reactions. That means cleaning them up matter-of-factly and reminding your child that they are supposed to go in the potty. This is not a situation that generally requires any kind of punishment.

Be sure that you “don’t overreact.” You want to be careful that you don’t reinforce the behavior, since any negative attention your child gets for doing this can reinforce it. And you don’t want to make it a power struggle. With strong-willed children, reinforcing unwanted behavior will make them want to continue doing it. Yelling or punishment is reinforcing. Even though it’s negative, it’s still attention, and that’s what they want.

Figure out why they are regressing. Talk to your child in a matter-of-fact way and ask them why they don’t want to use the potty anymore. Children are very honest, and they will probably be “itching” to tell you!

If you feel you need to discipline, learn more about using effective discipline. Discipline isn’t to be confused with spanking or time outs. Discipline is when the parent does what they plan and have said they would do. They follow through and remain consistent in encouraging desired behaviors. Routines will help during regression as well. Go back to where you were when you first established your potty routine and put it into play again. Stay positive and re-introduce the motivations you did before they were fully potty trained.

Talk to your child and listen to them even when you are not addressing them directly. Discuss their responsibilities for their waste and the consequences for not following through on those responsibilities. Be clear and matter-of-fact. Minimize your words during clean-up and stay calm. If you let this process become emotionally charged, that’s where the focus will be and that is ineffective and negative. Make it clear that this is their responsibility and simply instruct them about what needs to be done during clean-up and then when they have to go potty again.

Often, distractions are a big part of regression. Some children get so involved in projects, books, TV shows, etc. that they “forget” to go and it just doesn’t make much difference to them if they are involved in these activities. For example, if they are watching “The Wiggles” and getting completely involved in dancing to “Do The Monkey” that they don’t go to the bathroom, make them go before the show is on and tell them that way they won’t have to worry about making an accident. If they have an accident after that, turn off the program until they can control their behavior.

Taking away something from a child when they have done something that is not a desired behavior can be a powerful motivator. Some parents think it’s mean and unfair, but we’re talking about a child here. They have to learn somehow, and this method works – mean or not.

Always follow up any discipline conversation with hugs and at least one “I love you”. Remember that your child wants to please you. If they think that you might withhold love, you could have the opposite effect of what you want. Your child needs to know that you love them but are not happy with their behavior. This happens throughout raising a child, so practice it often.
As we’ve said before, learn why your child has stopped using the potty. It is easier for a child to learn the mechanics of going to the bathroom, but not so easy for him to accept some of the emotional issues that may come along later. And not all children are capable or willing to discuss it.

If your child wants to talk, be there for him or her. It may help you decide how to proceed if the accidents continue. If he adamantly does not want to talk, respect his feelings.

Maybe he or she is afraid. It was fun during the early stages, but now that they are trained, their little brains could start to introduce unfounded fears in their psyche.

Common toilet fears include fear of seeing his poop go down the toilet and losing that part of him, fear of getting hands dirty when wiping, fear of seeing or hearing a toilet flush, fear of painful bowel movement. Other reasons may include lack of desire to stop playing to go, loss of the excitement of this new ‘game’, associating toileting with ‘growing up’ and deciding it is more comfortable to just stay little.

There are some cases where children use toilet issues to express anger and aggression. For this, seek professional help.

A reward chart or chart where you place stickers for the days when he doesn’t have an accident can also be helpful. As can reading some of the potty training books for children. Since he has been potty trained for so long, this is likely not a time to go back to diapers or pull-ups. You should also avoid anything else that makes him feel ashamed for having accidents. Remember that it is normal and common for children to have set backs with potty training.

If you have come to the realization that the accidents are not stopping and you have given your child the chance to work through it by themselves, you need to take a step back and look at all the information you have compiled throughout this process. Return to the days when you were just beginning potty training and start from square one.

You have choices. You need to decide how much you are willing to do in order to work this problem out. Do you want to obsess about it for weeks on end or just downplay it and let your child work his or her own way through the problem and get back to no-diapers or pull-ups?

Each child is different. What works for one may not be successful for another. That is why you need an arsenal of tools and tricks to get your youngster interested and keep him or her with the program until you have achieved that goal of independence.

Some children really want to continue toileting. Sometimes the parent is willing to do whatever it takes to keep the child with his toileting routine. If you decide it is best to try to keep your child on track, then gear up for retraining in a positive, loving and supportive way.

Prepare yourself for what can become a long, frustrating time. Your attitude is important – keep it fun and upbeat if you can. Never blame the child. Even the most even- tempered, devoted and selfless of parents have found their limits tested.

Frustrations can be minimized by planning to spend extra time with your child (preferably at home) observing when and why the accidents occur. Expect to deal with accidents and try to find a way to avert them. Could your child simply miss all that attention he used to get for toileting successes? If you find yourself becoming too frustrated with the situation to cope in a positive, loving and supportive way, consult your pediatrician, read and take parenting classes.

Do not allow a significant other, mother-in-law or neighbor (however well-intentioned) to interfere with your parenting choices. Pick your battles, and realize this one in particular can be a tough one.

If you decide to go for retraining you need to be prepared to follow through in a positive way. Read up, get support. If you decide this is not the best time to try to work through it that is OK. You and your child should decide together how to handle accidents. Whatever you decide, this is just one of many parenting decisions we must make with no clear-cut answer. It will work out no matter how you proceed, as long as you have the child’s best interests in mind.

Above all, just have fun with this process – both during potty training and during regression. As you know, your child is growing rapidly before your very eyes. Focus on enjoying this age and stage with your child.

If you can keep a good attitude through all the trials, you will have given your child much more than basic toilet skills. Your child will learn he or she can trust you. They will know that they are important. They will learn how to communicate better. He will understand how you can help him when he is troubled. He will learn you will always love him, even when he messes up. That is what is really important.

If any concerns come up before, during, or after toilet training, talk with your pediatrician. Often the problem or problems are minor and can be resolved quickly, but sometimes physical or emotional causes will require treatment. Your pediatrician’s help, advice, and encouragement can help make toilet training easier. Also, your pediatrician is trained to identify and manage problems that are more serious.

A routine will help in making your toddler more confident and comfortable during potty training. In fact, having your child on a schedule before potty training time can actually make the transition easier.

By the age of one, your toddler should be on a regular schedule of eating, sleeping, playing and having diaper changes. These regular diapering times will prepare your toddler for a regular potty schedule in the future. This doesn’t mean that you have to maintain a rigid schedule for years, but your toddler should know that he or she has a regular, natural pattern to each day. This sets your toddler up to succeed when the time is right for potty training.
Make frequent trips to the bathroom. You can’t force your child to urinate or produce a bowel movement, but you can encourage him to practice. Have your child sit on the potty for 2 to 4 minutes every hour or so. Schedule these sittings close to times your child usually has a bowel movement or urination, such as just after a meal, snack or nap. Remember that you cannot control when your child urinates or has a bowel movement.

You really need to know when it’s time to stop. Don’t expect performance at first. If your child can’t urinate or produce a bowel movement after 2 to 4 minutes, it’s time to try later. If your child protests strongly when you suggest s/he return to the potty, don’t insist. Such resistance may mean that it is not the right time to start training.

Let your child learn from you and those around him or her. Children are often interested in their family’s bathroom activities. It is sometimes helpful to let children watch parents, older brothers and sisters, trusted friends, and even relatives when they go to the bathroom. Seeing these people use the toilet makes children want to do the same.

Make sure your child is an active participant in getting himself or herself dressed and undressed. Let your child practice lowering and raising their underwear or training pants sometimes, or putting them on and taking them off.

As far as the bathroom is concerned, take steps to keep the door from closing or locking. To prevent children from locking themselves in the bathroom or closing the door on their fingers, put a towel over the top of the bathroom door. This will stop it from closing.

Potty training boys can be much easier than potty training girls. Have them try sitting on the toilet before making them stand. This will minimize sprays and dribbles on the walls and floors – not to mention all over the potty chair!
You should take steps also to respect your child’s feelings and privacy. Even though they are little people, they do have these feelings. Potty training focuses on the most personal and private parts of your child’s body so proceed in a dignified respectful manner. Some children need privacy and will not go if anyone is looking or is in the bathroom with them. Respect this.
Expect some fooling around by toddlers. For example, when they go through the phase of saying “no” to everything, their “no” does not always really mean “no.” In short, if you ask your toddler if s/he needs to go potty and are met with a resounding “no,” this response may sometimes have little to do with your question. This is all part of learning to read your child and becoming familiar with all forms of communication.

In the beginning phases, take your child to the bathroom every hour and then after meals, snacks, and sleep. The obstacle a lot of parents face is that they get into the habit of asking their child if they have to use the potty. Instead, try telling them and then take them. Initiating is often the last step in the process.

Remember that this is probably not going to be an overnight process. Be patient with your child and back off if it really doesn’t seem to be working.
We agree with experts that a reward system is almost necessary during this important time.