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potty training

Lack of sensation or muscle strength
We know that the limbs are affected because we can visually see that, but what about what goes on inside their bodies? They may have problems with the muscles that control the bladder and bowel movements. It is possible that they may not be able to actually feel when they have to go and it may take them time and practice to learn what this sensation feels like. Longer dry spells between diaper changes, and when bowel movements take place on a somewhat consistent basis are both signs that the muscles are strengthening.

Cognitive abilities 
If your child is not able to understand the terms involved in potty training, or is unable to follow simple instructions, potty training should probably be put on hold until they are able to. Also; if your child can only concentrate on one task at a time and has difficulty processing their thoughts from one thing to another, you may have to use constant reminders or set a timer which will help both of you to remember that it is time to try to go. Even if they don’t go at that time, it will still reinforce the fact that they should use the potty and not go in their diaper.

Stability of potty chair
Finding the "right" potty chair is extremely important due to the balance issues the children may have. There is nothing scarier than the feeling that you may fall in! There are many potty chairs that are made to start on the floor and then can be adapted to the regular toilet when the time comes. Some of them also have rails on the sides so they are able to hold on.

Placement of toilet paper roll
If the toilet paper roll is located on their affected side, if possible, have it changed so it is easily accessible for them to reach using their non- affected side.

Pulling pants up and down
Start practicing this before you begin potty training. Many times not being able to do this quick enough will cause unexpected accidents. Many children do this one handed by alternating from one side of the pants to the other and adding a little wiggle in to help.

Clothes
Stay away from any pants that have zippers, buttons, or snaps. Loose fitting elastic waist pants allow them the freedom to get them up or down much easier by themselves. You may even want to consider just letting them run around in their underwear when first starting. Talk with your child about the big boy/girl underwear and take them to the store and let them pick out their favorite ones, this way they also feel proud of the fact that they picked them out all by themselves.

Rewards
After they do go, or even if they didn’t but sat on the potty chair, offering them assurance in the form of a reward makes them feel that they did a great job. Rewards can come in many different ways, some of them are: using a sticker chart, putting a cute stamp on their hand, some use M&M’s, skittles, etc., even just a big hug and high five work.   

These are just a few suggestion to help with potty training. Last, but not least, sometimes it is better to not put so much stress on yourself as a parent and on your child. You may also think they are potty trained and all of a sudden they regress, this is normal. You may notice this especially after they have become sick or something happens that changes the normal routine they have been used to. It may take longer for you to potty train your child because they have so many other obstacles to overcome, but one day, all of a sudden, it will click for them and the diaper days will be something of the past.

Article content by Jackie Haley.

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The information contained in this Children's Hemiplegia and Stroke Association (CHASA) Web site is not a substitute for medical advice or treatment, and CHASA recommends consultation with your doctor or health care professional.