I’m in the middle of potty training. Well not really. We buy Pull-Ups and wait for the magic to happen. And honestly, I’m trying to (in this case) not treat my son’s potty training as if he were a client. So far, he’s been part of Gross Motor Imitation trainings, early morning speech-language with mom for little boost…so mom as therapist is becoming highly influential.

But, potty training I just didn’t want to pull out the Azrin and Fox in my personal life (my child is not my client).

Riding in the car with husband this morning and subtly explaining to my husband that Pull-Ups are not the toddler substitute for diapers and we need to become serious about potty training.  My husband  responded “He just needs to be a bit more verbal and he can tell us when he has to go”. I then put on my therapist –mom super cape (LOL) and decided…My family is my client and a-potty-training we will go.

Here are some things I added to my husband’s parent training class (He indulges me and let’s me go on).

1. Verbal Behavior is not a prerequisite for Toilet Training Independence.  Toileting is motor. It is the act of feeling and responding. Walking, Pushing Down, Sitting, Pulling Up, Washing Hands. It is not something we discuss as much as something that we DO. This knowledge can be applied to sequential play (rolling cars, pushing trainings, playing drums, stacking blocks). These are motor acts and movements. They require individual thought driven to the point of need and corresponding action.  So if your child with emerging vocalizations, uses sign, or a communication device.  There is much hope here.

2. Pairing Verbal Behavior with the Motor Action needs the pairing procedure and modeling. I typically begin with pairing the act of toileting with my own short focused utterances as the action is taking place.

• Walking to the bathroom “Go to bathroom”
• Sitting on toilet “Sit on toilet”
• Urinating “Pee Pee”
• Pulling up Clothing “Pull up pants”
• Washing hands “Soap. Water. Wash hands.”

I leave out all extra language such as “yeah, you did it, awesome, hooray…bathroom bathroom bathroom (accompanied by a little rumba dance)”. And it is effortful for me to edit my language. I want my client(s) to know what they did, what they are doing, and I pair their act of going to the toilet (with the high reinforcers).  Reinforcers…we cannot say enough about them.  AND used correctly with the right perspective and language are not to be confused with bribes.   Using reinforcers that are HIGHLY PREFERRED and we only have access to during toileting (sitting).
**ASL and AAC communication devices can be used here**

If your child is having real issues with toileting (number one and/or number two).  Your senior therapist should be on the case with some evidenced based practice NOT the “let’s see and try” method.  Truth is, diapers are expensive and we would rather use those funds towards a parent vacation.

Toileting Toolbag Resources:

1. Azrin and Fox are legendary in methodology.  They also have lots of literature.
2. Occupational Therapy from a sensory perspective
3. Speech and Language for communication
4. Behavior Observation specifically for toileting and creating the Task Analysis
5. Reinforcer Assessment

Here is my honesty to parents. There will be tears involved.  Yours and Theirs. For a time.  Keep those reinforcers and become your idol (the Supernanny) and stand firm in getting this done.

Let’s all drink our morning tea and toast to NO MORE DIAPERS and PULL-UPS!

Thriving with You in mind,

Landria Green, MA., CCC-SLP

The SLP GURU