Toilet Training Children With Down Syndrome

Learn when to spot the signs that a child with Down syndrome is ready for potty training.
National Down Syndrome Society

Step 1: Determining Your Child's Readiness

Many parents are eager to start a toilet training program for their children, but some parents may be ready before their children are. Starting before your child displays the necessary readiness signs will most likely increase the amount of time it takes for your child to learn this skill as well as decrease the amount of success your child experiences. Starting too early can also lead to other problems, such as an increase in undesirable behaviors related to toilet training and high frustration levels in the parent. To ease the toilet training process and ensure that it's a positive experience for everyone involved, it is recommended that parents assess their child's toilet readiness skills. We offer guidelines, below:

Age - This factor should not be the only one considered when deciding to start a toilet training program, but it is recommended that you wait until after the child's second birthday to begin considering toilet training. For children with Down syndrome, it has been found beneficial to wait until after the third birthday to begin the process.

Bladder Control - Your child completely empties her bladder when voiding and remains dry for at least one and one half hours during the day.

Predictable Stooling Patterns - Your child's bowel movements follow a regular and predictable pattern.

Motor Skills - Your child demonstrates the abilities to walk to and from the bathroom independently and to pick up objects.

Behavior - Your child can sit on the toilet (or potty chair) comfortably for two to five minutes. You may allow your child to look at preferred books or play with preferred toys while sitting on the toilet.

Instructional Readiness - Your child can follow a few simple directions (e.g., sit down).

Indicates Needs - Through facial expressions, posturing, gestures, pictures, or words your child indicates the need to go to the bathroom.

Step 2: Determining Your Own Readiness

Before starting a toilet training program, parents need to be ready to dedicate time and effort so as to implement an effective program. If your child displays the necessary readiness signs, but your schedule does not allow you the amount of time needed to take your child to the bathroom on a consistent schedule every day, you may want to consider waiting to start until your schedule permits.

Download the Toilet Training Readiness Chart, below, to help you assess your child's bladder control, ability to demonstrate a need to go, and voiding pattern. Every 30 to 60 minutes, check your child's diaper. Place a checkmark in each corresponding time slot that your child indicated a need to go. Keep the data for two weeks. If, at the completion of two weeks, the chart shows that your child consistently remained dry for at least one and one half hours, consistently indicated a need to go, and displays a voiding pattern, then your child may be ready for toilet training. If after two weeks, the data show that your child does not display the necessary skills, you can decide to continue taking data or to stop and restart at a later date.

Step 3: Get Set, Go!

  1. Your days should look like this: Wake up, take off wet diaper, go to the bathroom. Put on big-boy or big-girl underwear.
  2. Take your child to the bathroom when you anticipate her need to urinate or to stool. (Refer to your Toilet Training Readiness Schedule.)
  3. Make it fun! Allow your child to read a favorite book or play with a favorite toy while sitting on the toilet.
  4. Use a visual schedule to reinforce verbal directions to child.
  5. Use a reinforcer (books, toys, candy, etc.)
  6. Change your reinforcers from time to time.

Originally featured on National Down Syndrome Society (NDSS.org) and reprinted with permission. Copyright ? 2012 Meredith Corporation.

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