Once your child starts school, toilet training becomes a collaborative journey. The more environments involved, the better the communication needs to be between team members. Your team members will typically include a teacher, an educational assistant, and a resource teacher. Your school team may also have access to a Board Certified Behaviour Analyst (BCBA) that could be brought in to support the teaching of this new skill. Each school board differs in how to access this extra support. Your child’s school principal would likely be the one to help activate this referral for your child’s team.
Getting the plan ready.
Communication and planning are key when starting this process with your school team. You and your team should develop your plan prior to starting and should ideally be starting on the same day. Consistency is crucial to success! It is best for your child that all his/her environments have the same expectations and routines. The pieces of the plan that need to be developed prior to starting, include:
· Having at least one week of data between both environments indicating when your child’s diaper is wet or soiled. Knowing your child’s voiding patterns will determine when you and your team encourage your child to use the bathroom.
· Develop a list of items (toys, games, activities, and foods) that can be used as a reinforcer when he/she voids successfully in the toilet. This list should include only the items you are willing to save as a special treat for bathroom successes.
· Discuss the sequence of steps within the toileting routines as well as the hand washing routines. The more your child’s environments are consistent and aligned in the teaching strategies and the steps they follow, the easier the process will be for your child.
· Make sure that both home and school are ready to start this teaching adventure together. This means that both agree to stop using diapers at the same time for your child’s waking hours.
The plan is set and it’s time to start.
Things to send on the first day:
· several pairs of extra underwear
· pants (track pants or leggings are a good idea as they are easier for your child to work with in the beginning of learning this new routine)
· a few shirts
· an extra pair of shoes. If there are several accidents in the beginning, crocs (or easy slide on sandals) may be a good alternative to laced shoes for ease of changing and cleaning.
· plastic bags for wet clothes that need to go back home in the backpack
· wipes, if needed (sometimes these help in the beginning when your child is learning to wipe after poops)
When to go to the bathroom
Ideally you and your team are basing the timing on the data you have both collected. Whatever times you have jotted down, you and your team should aim to encourage the use of the bathroom at least 15 minutes before the time. For example, if your child typically wets his/her diaper around 9am every morning, the adults in each of the environments should aim to initiate the bathroom routine around 8:45am.
Your school team might also want to capitalize on naturally occurring bathroom times, such as before recess, before lunch and before a class that happens in another area of the school such as the library or the gym. This often helps prevents accidents when outside of the classroom. Find out these specifics in the school schedule so you can try to match as much as possible on weekends. You and your team will soon get a sense of how much time goes by between bathroom visits, which also helps you make decisions on prompting bathroom use.
Share with your team the signals that might indicate your child needs to “go”. This helps, especially when there are several children to supervise in a room.
In the bathroom, the routine might look like this:
Your child might have a step-by-step visual strip that helps clarify the expected steps. Visual instructions can help and increase independence when adults are not immediately beside them (they are often helping several children at once). It also helps make sure every member of the team follows the same sequence in the routine. You should ask the school team to provide you with the same visuals for your home bathrooms. The steps may include:
· Pulling pants and underwear down
· Sitting on toilet (this may start with a few seconds and working up to approx. 3 minutes)
· Pee /poop (if voiding happens, it’s a bathroom party; if no void happens, they will praise “good sitting or good trying”)
· Wipe (school staff will want the child to do this step to honour your child’s privacy therefore, it is important for you to teach this at home)
· Pulling underwear up
· Pulling pants up
· Flushing toilet
· Wash hands (teams should make sure these steps are also communicated and the same in both environments)
If sitting on the toilet is harder for your child, the school team may sing a song or read a book.
* A special note on peeing standing up: if teaching your child to pee standing up, it is important to teach pants staying on the bum as soon as possible to help with transferring into public bathrooms, especially if he will be using urinals. Have a male role model help with this if you have one available in your family.
What to do when there are accidents?
Your school team will likely adopt the following steps:
· Reassure your child that everything is ok, and it was just an accident.
· Go to the bathroom and change into dry clothes.
· Wash hands
· Have your child help with the process of cleaning up as much as possible. Typically, students will help with taking off wet clothes and placing them in a plastic bag as well as getting dressed as independently as possible. Sometimes they will also help place the plastic bag in their backpack.
These are all steps you can also adopt at home.
Traveling between home and school
It might be very tempting to use diapers while traveling from home to school for fear of accidents in the car. However, reintroducing diapers sporadically through the day may send mixed messages to your child and slow down the learning process. Some tips for traveling:
· Have your child go to the bathroom right before getting in the car.
· Consider placing an incontinence pad on the car seat to absorb any accidents.
If you must use a diaper for the car, your school team should immediately change your child into underwear as soon as he/she walks into the school. Students with visual schedules will often have either an image of underwear as their first item on their schedule or sometimes it will be a pair of their underwear in a small plastic bag ready to take to the washroom. If your child doesn’t use a schedule, you could give him/her a reminder to head directly to the bathroom to put on underwear when you are dropping them off with school staff.
Tips and Tricks:
· Stay in touch about extra clothing. Sometimes these supplies run out quickly.
· Have a communication book between school and home to share the specific times your child successfully voids and/or has accidents.
· Keep checking in with your team about reinforcers. Having a variety is important and helps maintain the motivation to succeed.
· Send preferred drinks in your child’s lunch to encourage a lot of drinking during the day. This helps create more voiding opportunities and therefore, more practice with the bathroom routine.
· Make sure both home and school have the same routines.
Want to try but not ready to fully commit?
· Start using pull-ups and go through all the steps of the toileting routine.
· Praise your child when he/she accepts to sit on the toilet and engages in any of the steps of the routine.
· Tell your team that you are almost ready to give up diapers and would like for him/her to be exposed to the steps of the routine, including sitting on the toilet. They will happily help ease into the process with you.
· Anytime your child happens to void in the toilet warrants a bathroom party!
If you are thinking about starting toilet training in tandem with your school or daycare team follow these strategies. If you feel you need a little extra help to get everyone on board or to problem solve, reach out to Children’s Wellness Centre for help! They will support you in any way you need.