Occupational therapy and potty training
Angela Ou OTR/L
Potty training is a significant developmental milestone for children that signals independence and increased social participation. For some, the behavioral techniques typically used to potty train may not encompass all of what the child needs in order to be successful. Occupational therapy can help with some of the barriers for successful potty training. In this post, we will address the intersection of occupational therapy and potty training, and how skilled OTs can help your child through the milestone.
Occupational Therapy and Potty Training: Skills Needed
There are many skills your child needs to be able to coordinate in order to be successful with potty training. An occupational therapist can help your child increase their skills in each of these areas:
SENSORY PROCESSING
Toileting is a task that incorporates almost all of the senses. A child may have difficulty with one or more of these sensations, which can impact potty training. An important inclusion to note here is interoception, the sense of what is going on in our bodies. Here are how the senses are used during toileting:
Olfactory – the smells associated with the bathroom, such as air fresheners, waste, and soap
Auditory – the sound of a flushing toilet, the bathroom fan, of “going”; if in a public bathroom, the sounds of other people
Visual – how the waste looks in the toilet
Tactile – how the toilet paper feels, how a soiled diaper or underwear feels, the feeling of soap, water, and the towel while washing hands afterwards
Interoception (the understanding of feelings within the body) – the feeling of whether you need to go or not
Proprioception (the understanding of where the body is) – sitting down onto the toilet, knowing how hard to wipe
Vestibular (balance and movement) – maintaining upright position while sitting or standing, leaning forward
EXECUTIVE FUNCTION AND COGNITION
Toileting requires a lot of steps performed in a certain order. For some kids, the order and the time it takes to perform every task in that order may be difficult to manage. Here are some cognitive skills required for toileting:
Attention – maintaining attention in order to complete the entire process of going to the bathroom
Initiation – starting the process when you have to go and starting each step along the way
Memory – remembering what needs to be done in the bathroom
Sequencing – knowing the order in which to do everything and what to do next
Termination – ending each step and the whole process
MOTOR SKILLS
Toileting also requires physical skills such as strength, endurance, fine motor skills to manipulate clothing and toilet paper, and gross motor skills to maneuver the bathroom, stand, sit, balance, and weight shift.
How Occupational Therapy Can Help with Toilet Training:
Occupational therapy takes a holistic view of a child, their family, and their culture in order to support their success in toileting and toilet training. Occupational therapists can help with the functional development of skills, suggest adaptations to the environment and task, and provide parent or caregiver education on methods to try at home.
The functional development of skills in children who are potty training is primarily addressed through play. Sensory processing, strength, balance, fine and gross motor skills (including dressing skills), sequencing, and attention can all be incorporated in skilled therapeutic play. Through play, the child can build confidence in many of these skills. Of course, using these skills and practicing them during potty training is essential as well!
Occupational therapists can also offer suggestions for adaptations and modifications to the task or the environment to further support successful potty training. Some children may require modifications to the bathroom such as more accessibility, placing toileting supplies within easier reach, having a toilet seat reducer, unscented soap, a bidet, or a step stool for reaching the toilet or sink. Additional supports can include having the child wear clothes that are easier to take off.
Other methods for parents and caregivers to try at home include having a visual step-by-step guide to remind the child of the sequence of events, using video modeling along with potty training, and development of a toilet routine in order to support the cognitive aspects of toileting.
If you feel that occupational therapy may be helpful for you, give us a call to schedule a free consultation to see how we can help you!
Resources:
O’Brien, J. C., & Kuhaneck, H. (2020). Case-Smith’s occupational therapy for children and adolescents (8th ed.) Elsevier, Inc.
The OT Toolbox. (2022, June 8). Tips for potty training – occupational therapy & physical therapy. https://www.theottoolbox.com/tips-for-how-to-teach-kids-potty/