Author’s note: These strategies will be most successful for children with a cognitive age of at least 36 months, and receptive language skills of at least 30 months. Children with severe quadriplegic CP most likely will always need physical assistance for toileting, even if they can direct their caregiver’s actions. That will be another blog post.
Although my upcoming book and online class in toilet training for a variety of special needs children is still in the works, it seemed that there is so little written about training kids with CP that I shouldn’t wait until I release the book.
Parents are still struggling.
Here are some basic principles to remember before you create your plan:
- Know if there are medical problems that are complicating things. Seizure medications can be constipating, as can dietary restrictions. If your child’s neurologist has good reason to believe that continence is not possible, then you need to understand what your options are.
- Motor control isn’t a full deal-breaker unless it is severe. There are ways for people with spasticity to inhibit tone, and some of these techniques can be used for toileting. Not all. And some kids cannot learn them until they have developed the cognitive, language, and emotional maturity to use them as needed.
- Never assume that sensation is fully intact. Explore whether there are tactile and interoceptive (internal sensation) sensory deficits, and add that information to your plan.
- Accidents happen when a child is unable to get to the potty in time, and undress in time. Work on dressing skills and mobility skills until you are 100% certain they have reached their potential. And accept that teaching a child with CP to “go” before they are 100% certain that they must run now will reduce accidents. They aren’t really accidents if the choice to wait was made, right?
- Clothing choice is key. If you have ever been caught up in a pair of Spanx, or in overalls, when you needed to use the bathroom, you know exactly what I mean. Pick clothing as if you were in a Broadway show and had 20 costume changes before intermission. Read Toilet Training? Your Child Needs the Right Shorts! for a bit more info.
- Stability and accessibility in bathroom equipment is important. Require a lot from your child’s therapists in this area. Their training will save you time and money.
- Urinals of many kinds save the day. Lose the discomfort, and embrace independence. Try camping suppliers for helpful items like the Pee Cloth and foldable urinals for every type of body.
- Using pads and pants for incontinence are not failures of training, they are options to build independence.
- Do not be hoodwinked into thinking that risking dehydration or using fasting is the answer to continence. Ever.
Need more information about raising your child? Read How To Pick A High Chair For Your Special Needs Child and Lakeshore Scissors for Toddlers That Only Cut the Paper, Not the Toddler