Day four of the potty training segment and I think we are going to end on something you will find extremely helpful. The past few days I have been providing information from The Best Practices Newsletter of The Interdisciplinary Council on Developmental & Learning Disorders. Today I am taking a first hand account a councilor working with a child named Jason on potty training. Along with the step-by-step schedule they followed, you will also find here in the post a task analysis for toilet training (figuring out what your child is capable of) and a recommended sequence for fading prompts (a sequence of tasks to follow in order to develop correct toileting skills).
Here is the step-by-step schedule Mr. Cole and Jason took for his individual potty experience…
1. Mr Cole set a timer for thirty minutes.
2. When the timer rand, Mr. Cole moved toward Jason and got his attention by saying his name. Then Cole decided to have Jason point to a photograph of the toilet to indicate his need to go to the bathroom. A photograph or line drawing, or instructing the child to say or imitate “potty”, for example, are all acceptable ways to communicate. The goal is for Jason to eventually use the photograph to signal that he needs to use the bathroom.
3. Mr. Cole showed Jason the photograph of the toilet, gestured toward the photograph and used hand-over-hand physical guidance to help him point to the picture to communicate that he needed to use the toilet. This and other prompts were faded slowly using and approach similar to that provided in Table 10-10 (see below)
4. Once he pointed (prompted or unprompted), Jason was praised (“Nice asking to use the toilet”) and instructed to go sit on the toilet, again using a verbal instruction (“Jason, go to the bathroom”)and pointing to the bathroom while gently guiding.
5. Once in the bathroom, Mr. Cole gestured toward the toilet for Jason to sit down and used gentle prompting to ensure compliance (verbal instructions were minimized at this point).
6. Mr. Cole required that Jason sit on the toilet for three minutes or until he voided, whichever came first. If he voided in the toilet, Mr. Cole gave him a super reward. If he did not void bu the time the three minutes were up, Mr. Cole would say “Nice trying” in a fairly neutral voice and instruct Jason to stand up.
7. Mr. Cole continued to use gestures and gentle prompts through the rest of the sequence (see below for more about prompts).
8. Jason was then told that he could leave the bathroom.
9. If Jason voided during the three minutes on the toilet, the timer was reset to thirty minutes. If he failed to void, the timer was set for fifteen minutes.
TASK ANALYSIS FOR TOILET TRAINING:
skill target: independent toileting
1. Phusically recognizes need to eliminate.
2. Initiates or communicates to adult the need to use bathroom.
3. Locates and ambulates to bathroom.
4. Enters bathroom.
5. Pushes pants or skirt and underpants down.
6. Sits on toilet.
7. Eliminates in toilet.
8. Wipes self with toilet tissue.
9. Pulls up underpants and other clothing.
10. Flushes toilet.
11. Moves to sink to wash and dry hands.
12. Leaves bathroom and returns to task.
RECOMMENDED SEQUENCE FOR FADING PROMPTS:
(Goal of fading prompts is to help the child become fully independent with toileting)
Phase 1: (level of prompt) Verbal instruction + gesture+ touch or gentle physical guidance. Example: Parent says, “[Child's name], go to the bathroom” and points to the bathroom while touching child’s shoulder or gently guiding to the toilet.
Phase 2: (level of prompt) Verbal instruction + gesture. Example: Parent says, “[Child's name], go to the bathroom” and points to the bathroom.
Phase 3: (level of prompt) Reduced verbal + gesture. Example: Parent says, “[Child’s name}, bathroom” and points to the bathroom.
Phase 4: (level of prompt) Further reduced verbal + gesture. Example: Parent says, “Bathroom” and points to the bathroom.
Phase 5: (level of prompt) No verbal + gesture. Example: Parent points to bathroom and motions with head.
Phase 6: (level of prompt) Reduced gesture. Example: Parent points to bathroom with arm partially extended and motions with head.
Phase 7: (level of prompt) Further reduced gesture. Example: Parent motions with head toward bathroom.
And there you have it! Our four day segment on potty training. Obviously this and the previous information is not a one size fits all, but I am positive every one can take at least one helpful tip or suggestion. You would think after going through potty training twice now and reading through this information yet again, I would be confident and certain potty training isn’t all that bad. Yeah, right!! Still dread it and still don’t want to go through it again! But I guess that is part of what I signed up for;)