Try This Simple Strategy When Your Child Refuses To Use The Toilet

I get a few calls every year from parents who have a neurotypical child between 4 and 5 that has said, very clearly, in words, that they refuse to use the toilet.  Often, it is pooping in the potty, not peeing.  Hesitancy is one thing.  Adamant refusal in words, clear words, is another thing.  The parents are not always stuck in a war of wills, and the kids aren’t usually trembling in fear of the potty.

What gives?

More often than not, there are a familiar batch of characteristics involved.  The child is not ill, constipated, autistic, or demonstrating any other issue.  They are not afraid of the toilet harming them, or afraid of falling in.  They are sensitive to criticism and failure, however.  This can be a key.  (Remember this for later)

The parents are often distracted with younger children or issues of their own.  It could be a newborn, a new job, a new home, or an ill grandparent.  They have no experience training anyone to use the toilet, or their other kids seemed to learn so easily that there was never any memory of real training going on.

There is rarely enough flexibility or freedom in a child’s schedule.  They have preschool, activities and lessons like soccer and musical instruments, or martial arts.  And they have to get there, then back for someone or something else, and so on.

SO……WHAT CAN BE DONE?

Well, the first step is to give a child more responsibility for their elimination.  At this level of performance, they can start wiping (an adult finishes the job), but gather everything that is needed for a diaper change, toss everything once it is done, and definitely in the bathroom with all the devices OFF.

At this stage, there isn’t even much chatter.  There are some kids that look forward to the “alone time with caregiver ” of being changed, especially in busy households.  This needs to end now.  There should never be shaming of any child for any reason.  Morals aside; it simply doesn’t work!  But there should be no reward for refusing to learn to use the toilet.  Stating that soon they will be able to do this fast and independently, and then they will be able to “X”.  This action or event might only loosely be related to not using diapers.  It could be something as simple as being able to get right back to watching their show or playing outside.  Remember; things get turned off during diaper changing.  This isn’t the same as a reward for learning.

Why?

Because of the common problem with fear of failure.  A child who is sensitive to failure rarely likes a challenge, and they don’t respond that well to praise.  For more on this topic, read  Sensitive Child? Be Careful How You Deliver Praise .  The better choice is to state matter-of-factly that accidents happen to every kid you know, and that even grown-ups do things wrong.

This needs to be a more visible part of a child’s day.  A child who might be sensitive to failure needs to see and hear an adult make mistakes and process their feelings in front of a child.  Not big feelings.  DO NOT tell your 4 year-old about your divorce!  But small errors, errors they can understand, and feelings like sadness or even being afraid you will do the same mistake again.  Then state what you do to make yourself feel better and do better.  Simple things.  Things like putting down the phone while you walk so you don’t trip, or making enough room for your glass so it doesn’t spill.

Once a child is managing their diapering quite independently and not getting much of a reward for needing help of any kind, it is time to get rid of the diapers.

I know.  This is really hard.

But kids that do great at school in underpants will hold onto their poop until they can don one of those diapers (I refuse to call them Pull-Ups.  They are diapers with elastic, and that is that) and do their business.  These kids have that much control.  It is rare that a child will never eliminate when they don’t have a diaper.  A nice higher fiber diet will make their poop smooth and full, and that helps significantly.  It should already have been obvious when their body seems to naturally need to eliminate waste, and pointed out to them.  We listen to our body’s signals and signs.  Farting is another sign.

Families have to restrict a child’s actions if they think their child will eliminate on non-washable surfaces.  Of course, accidents aren’t shamed, but they are cleaned up by both the child and the adult.  But these don’t usually happen all that regularly once kids realize that they are capable.  Do not cheer over their successes (see link above) but be mildly encouraging and move onto something fun that also recognizes their maturation.

Need more coaching about this tricky subject?  Make an appointment with me!  Visit my website Tranquil Babies  and book a consultation, and let me know what challenges in your household need more personalized assistance!

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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