Potty Training Resistance

While most children show signs of physical readiness to begin using the toilet as toddlers, usually between 18 months and 3 years of age, not all children have the intellectual and/or psychological readiness to be potty trained at this age. Signs of physical readiness can include your being able to tell when your child is about to urinate or have a bowel movement by his facial expressions, posture or by what he says, staying dry for at least 2 hours at a time, and having regular bowel movements. Signs of intellectual and psychological readiness include being able to follow simple instructions and being cooperative, being uncomfortable with dirty diapers and wanting them to be changed, recognizing when he has a full bladder or needs to have a bowel movement, being able to tell you when he needs to urinate or have a bowel movement, asking to use the potty chair, or asking to wear regular underwear. Things to avoid when toilet training your child, and help prevent resistance, are beginning during a stressful time or period of change in the family (moving, new baby, etc.), pushing your child too fast, and punishing mistakes (treat accidents and mistakes lightly). Be sure to go at your child's pace and show strong encouragement and praise when he is successful. Even after he begins to use the potty, it is normal to have accidents and for him to regress or relapse at times and refuse to use the potty. The process of being fully potty trained, with your child recognizing when he has to go to the potty, physically goes to the bathroom and pulls down his pants, urinates or has a bowel movement in the potty, and dresses himself, can take time, often up to three to six months for most children. Having accidents or occasionally refusing to use the potty is normal and not considered resistance. While it is recommended that you don't insist that he sits on the potty and you should be prepared to delay training if he shows resistance, at some point if his resistance to using the potty persists, especially after he is 3 -3 1/2 years old, then you should consider him resistant to potty training and you will need to change your methods. Early on in the training, especially if your child is less than 3 - 3 1/2 years old, resistance should be treated by just discontinuing training for a few weeks or a month and then trying again. At this age (18 months to 3 years), resistance is usually because your child just isn't ready to begin training. Potty training resistance usually occurs because your child has had a bad experience at some point during potty training, especially if he was started before he was intellectually or psycholgoically ready. Other times, especially with strong willed or stubborn children, it may have nothing to do with your technique or timing, and you may have done nothing wrong. Reasons for developing a resistance to potty training can include: being scared to sit on the potty chair flushing the toilet may have scared him from wanting to sit on the toilet being pushed too early or fast before he was ready severe punishment for not using the potty or being forced to sit on the potty inconsistant training, especially among different caregivers he may have had a painful bowel movement from being constipated. If this is the case, treat his constipation and wait until he is having regular, soft bowel movements before you begin training again. or he may just be stubborn and is involved in a power struggle with his parents and is using his control over where he has a bowel movement he may enjoy the negative attention he gets from not using the potty or from having accidents although rare, there are medical conditions that can make it difficult for your child to hold in or delay urinating or having a bowel movement. Discuss with your Pediatrician if there are any medical reasons why you may be having a hard time teaching your child to use potty, especially if he seems to have other delays in his development. At this point, if your child is totally resistant to being potty trained, then it is best to just make him responsible for when he wants to use the toilet. This includes not punishing him for mistakes and not reminding him to use the potty. If he seems fearful, you can try and discuss calmly what it is about using the potty that scares him. While you may get a lot of negative feedback from friends or family members about not being more aggressive with getting your child potty trained, you should be firm and let them know that you are working on it and remind them that not all children potty train at the same time. In addition, it can be helpful if you: establish a reward or incentive for using the potty. This should include lots of praise and attention when he uses the potty. It can also include a star or reward chart on which you child can place stickers whenever he uses the potty. After a certain number of days that he has stickers, then he can get a reward, such as toy, etc. have your child be involved in changing himself when he wets or soils himself. This can include getting a new diaper, taking the dirty diaper off, cleaning himself (although he will probably need help after bowel movements), and throwing the dirty diaper away. At some point you can change him into regular underware. You can talk about it beforehand and maybe have a ceremony where he throws away the left over diapers or you may just decide not to buy any new ones. Now, when he does wet or soil himself, you can have him help to clean out his underware in the sink or bathtub. You may even have him put them in the washing machine and wait with you while they are getting washed and dried. He should then dress himself. This method is not for everyone, but is usually very effective. You can also have him clean up after himself if he wet or soiled the floor. Limit him to having BMs in the bathroom. This isn't always possible, but is easy if he always asks for a diaper just to have a bowel movement. Next, have him sit on the potty to have a bowel movement, even if he continues to wear his diaper. Then work on getting his diaper off by opening it and eventually taking it off. During this process, you should give lots of praise and rewards during each step. If he is having a hard time learning to use the potty, but isn't necessarily resistant to the idea, then developing a regular daily routine of sitting on the potty for five or ten minutes every few hours may be helpful. Most importantly, avoid physical punishment for not using the potty, even in an older child. It can be appropriate to verbally let him know that you disapprove of his not using the potty, but this should not get to the point of yelling, shaming or nagging.

Potty Training 2

Starting Potty Training II

by Belinda Chou, MD

OK! We're ready to start toilet training! By the time you've finished with the preparation (discussions, videos, books), purchasing the potty chair and underwear/pull-ups, most children will have started making some associations between peeing/pooping and the potty. For some it may be peeing in his/her diaper, announcing that she needs to pee and running to the potty after the fact. For others, it may be actual successes on the potty. And yet, for others it may be the mere recognition of peeing in his/her diaper. This is the time to start watching your child's body signals closely. Most children will have a tell tale stance, facial expression ("the look"), or routine (running to another room) when having a bowel movement. When you notice that your child is about to have a bowel movement (especially helpful if there is a particular time of day your child does it) this is the time to say "Shall we go sit on the potty?" If willing, take your child to the potty. Sometimes reading books will help your child relax while sitting on the potty. However, this may also end up being a "reading fest" so I would try to limit the book reading to only what's necessary. Additionally, some children may want "privacy" and helping them sit on the potty and then leaving (letting them know that when they are done they should let you know) may prove the most successful. Recognizing when your child is urinating is a bit harder. Some children, especially as they get older and are voiding less frequently, will stop momentarily to pee. Some will even squat. Frequently watching their fluid intake is more helpful. If your child has had a large amount of fluid, taking him/her to the potty 30 minutes to an hour after drinking will maximize success, and help your child recognize the connection between bladder fullness and peeing. Every child is different, and some children will be "bowel" trained before being "bladder" trained and vice versa. Whichever may be first, keep in mind that it is usually one before the other and not both simultaneously. Additionally, day-time dryness almost always comes before night-time dryness and may precede it by several months. Now that the process has started, here are some additional things to keep in mind: Patience! Patience! Patience! Toilet training is a big process. Some experts feel that it is the first and biggest developmental step your child will take. The process generally takes several weeks to several months to complete. Two steps forward, one step back. Don't be discouraged if you have a few good days followed by a few bad. Again, it's a process that's going to take time. Also keep in mind that when your child is tired or upset this is the most common time for accidents or setbacks to occur. Know when to back off If you are pushing too hard, your child may "push" back with more accidents and/or resistance. Take the control out of the issue and step back. It is ok to take a few days or even few weeks "off" . Your child will recognize the power struggle is gone and relax and respond to it. A final word: As hard as it may be to admit or realize, toilet training is truly in the control of your child. All you can do is be supportive and encouraging and set the stage for success. Keep in mind that your child will probably be toilet trained when she is ready, NOT necessarily when you are ready. If you are experiencing major difficulties, it may be time to sit back, re-examine the situation and ask yourself if your child is truly ready (see article on readiness). If you are meeting up with a lot of resistance in a child that is ready, it is time to examine those issues.