OT on the toilet (...training!)
Updated: May 24, 2021
Occupational Therapy and Toilet Training:
Potty training can be shitty......
I'm just going to say it.
It takes time, commitment, and consistency.
There are so many ways to try it (just have your kid run around naked OR use pull-ups OR give your kid M&M's every time they are successful OR put the M&M's in the toilet for target practice...The list goes on....I've heard them ALL!).
Toilet Training and Zones of Proximal Development:
For a few days, I've been posting on Instagram about Zones of Proximal Development. This is a way to describe how we can teach humans skills or implement behavioral changes. The theory is that there are 3 ZONES.
FIRST when the teacher/therapist/parent needs to support the person by DOING the task for them. NEXT when the teacher/therapist/parent needs support the person by HELPING them complete the task. FINALLY when the person can INDEPENDENTLY complete the task.
Toilet training is the perfect example of this scenario. Let's use the Zones of Proximal Development to dive deeper.....and maybe not rely on pressure from blogs (mine excluded, obviously), social media, Google MD, etc.
At first, as parents, we are completely responsible for changing an infant/toddler's diaper. This is ZONE 1.
Next, as parents, we help our child learn how to understand their body's cues (interoception), sit on the toilet, use the toilet, manage physical hygiene (wipe), flush the toilet, and hand hygiene (wash hands). This is ZONE 2. There are a lot of steps and a lot of factors to consider. As a therapist who works with families to help their children by independent with toileting....here's my advice:
Develop a plan.
Use an investigative lens when seeing the bathroom environment (through the eyes of your child).
Understand if your child's body is physiologically ready.
Share your plan clearly and consistently with your child.
Start your ZONE 2 (Helping) when you and your child can be home together.
Know that there will be accidents.
Give your child time to practice.
Have a few positive responses/reinforcements "in your back pocket" that seem appropriate to you. (As an occupational therapist, I don't like using "good boy/girl" or treats or gifts....)
If it all seems really hard and confusing, or things aren't working. Call your nearest pediatric occupational therapist!!!
Finally-ZONE 3...Your child is using the toilet independently. Enjoy your child's newfound INDEPENDENCE. I promise you they are SO proud of their accomplishment, and you should be proud of your commitment and consistency.