Low muscle tone is a symptom that makes potty training harder than anyone expects.
Even experienced therapists don’t anticipate all of the challenges that arise.
My most popular blog post is, and has always been, Why Low Muscle Tone Creates More Toilet Training Struggles for Toddlers (and Parents!) . There are good reasons for its popularity. It is a symptom in so many genetic and developmental disorders. Experienced therapists can be stumped, and new therapists haven’t the first idea where to begin solving this problem. Using the toilet independently is an essential life skill, but a complex one. A complex sensory-motor skill that has behavioral components. This is where psychologists get stuck as well. If you don’t understand the motor and sensory issues and needs of the hypotonic child, then all of the resistance and accidents look like withholding or defiance.
An inexperienced OT might even tell parents and teachers that toilet training isn’t part of their treatment domain.
Of course it is!!.
Any OT should be able to address all of a child’s self-care skill needs. The proof is embedded in the very essence of our profession and our profession’s name:
Self-care skills are a vital human occupation.
So instead of taking on my colleagues, I decided in 2016 to write a book that would help parents and anyone else who needed to support a child with low tone on their toilet training journey. Since the first edition was published, I have lectured on this subject, done numerous consultations in person and online, and written another “practical guide” for kids with autism.
What’s new in the second edition? A lot!
- In addition to an expanded readiness chapter, the second edition adds a readiness checklist that can function as both a toilet training evaluation and as a treatment planning tool for therapists.
- A new section on pre-training introduces the concept of Collaborative Diapering. The strategy allows every caregiver (parent, nanny, teacher, aide, and therapist) to build their observational and communication skills in preparation for formal potty training. Special needs kids at any age and level of development will build training readiness during Collaborative Diapering, even the kids who are years away from formal potty training!
- Descriptive vignettes of the potty training journeys of 3 families illustrate the principles in each chapter with warmth and understanding for the stressors of this task.
- The second edition adds detailed information about the physiology and psychology of living with low muscle tone.
- There are specific equipment recommendations that make toilet training easier and safer.