Low Tone and Toilet Training: The Importance of Dry Runs (Pun TOTALLY Intended)

In my posts about choosing a potty seat, How To Pick The Best Potty Seat For Toilet Training A Child With Low Tone  then picking clothes and learning to wipe, Low Tone and Toilet Training: Teaching Toddlers to Wipe,  planning and preparation for potty use was emphasized.  Kids who are unsteady and struggle with coordinating actions need to have really good skills under pressure to use the toilet successfully.  I am going to give you my best strategy yet for potty success:  dry runs.

It is exactly what it sounds like.  Nobody has to “go”.  It is practice managing the clothes, the toilet paper, and the movement transitions (sit, stand, turn around) of toileting.  Some kids are old enough to understand the concept of pretending, and some may be a little confused.  Even if they are uncertain about it, you should still work on these skills at times when they don’t have to toilet.  You can say explicitly that we are pretending, practicing, or phrase it however you wish.  In my private practice, I use “work clothes” for dressing practice.  Kids change their clothes at the beginning of our session, and then change back into their original outfit at the end of the session.  Once it is our routine, kids don’t complain much.  It doesn’t hurt that the activity I offer right after putting on “work clothes” is one of their favorites, and so is the activity we do after taking them off at the end of our session.  Twice the practice, but also no stress to get out the door to daycare, no fatigue at the end of the day.

Dry runs do not have to be a full dress rehearsal.  You can break it up into just practicing pulling pants down/up, or standing up and sitting down smoothly.   For kids that cannot handle changing routines but aren’t ready to do a full dress rehearsal, perform some of the steps for them at first, rather than leaving them out.  Talk about what you are doing, and try to keep their attention on you as you perform some of the actions.  Children at all levels of skill need to be at least aware of each step.

Each child will have their own specific challenges, but there are some aspects of toileting that can challenge kids with low tone:

  • Where to grasp clothing, how to place fingers for a stable grip, and how far to pull pants down need to be clear.
  • Where to place their feet for a stable stance.  Kids that have poor proprioception won’t automatically place their feet in the right spot, and splints/braces can give them stability but remove even more proprioceptive and tactile input.  They might need a marked spot for foot placement on the floor or on the step stool.
  • If they are standing up to wipe or pee, they may need to hold on to something with one hand.  Be very clear where that spot is and what objects are bad choices to hold onto.
  • Children who also have language, memory, modulation and attention issues may need very specific, very short and very familiar verbal cues.  The same cue that is said  in the same way helps them to stay calm and focused.  Figure out what prompts are understood quickly and use them every time.

Dressing skills in general are important to learn for all children, even kids with global and profound delays.  Independence changes a person’s self-image, and kids with low tone often stay dependent in many skills long after toddlerhood.  Make it clear that you are proud of them and value their emerging abilities.  Children want to please, even the defiant ones, even the kids with cognitive and behavioral issues.  They all want to please adults in their lives.  Even when they don’t seem to, they do.  They also want to be independent and control aspects of their daily lives.

Go have some “dry runs” and see if it moves your child’s toilet training forward this week!


Want more assistance than just reading blog posts?  Visit my website tranquil babies and purchase a video or phone session!   You can ask questions, get a review of your set-up and your equipment, and learn new techniques.


By Cathy Collyer

I am a licensed occupational therapist, licensed massage therapist, and certified CBT-i sleep coach in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment. It has been a joy to help people of all ages improve their ability to grow and thrive! Occupational therapists are focused on enhancing a client's functioning in everyday life. We are practical healthcare providers, interested in teaching, adapting actions and environments, and building a client's useful skills for living their best life, regardless of their challenges. I am the author of five books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training the Autistic Child". I lecture on many subjects, including sleep, trauma, and development. Contact me to learn more about how I can help you achieve YOUR goals!

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