Learning to use the toilet is a big developmental milestone for toddlers, and a big challenge for parents! How can parents successfully navigate this age and stage, especially when you add hearing loss to the mix? Here are some important things to keep in mind:
Readiness. With or without hearing loss, the number one thing to look for when deciding when to help a child become potty trained is “readiness.” If the child has begun to show signs of knowing when he has a wet or soiled diaper, or indicating that he needs to use the restroom, this is a good predictor that the child is physically and developmentally ready for this task. I see so many parents who feel pressure to have the child toilet trained by some arbitrary deadline, regardless of the child’s developmental stage. More often than not, this just ends up putting lots of stress on both parent and child with limited success. When the child graduates from college, will it really matter whether she was fully potty trained at age two or at age three? Not really. Obviously, if the child is falling far outside of developmental norms, this is cause for concern, but parents are much better served by waiting for the child to be ready than by pushing the process because of some artificial timeline. It will be a quicker and smoother stage for everyone this way.
Language. This is one are of potty training where conventional wisdom may not be as applicable to children with hearing loss, if the child has a speech and language delay. It is important to consider two levels when determining a child’s readiness for this task — overall developmental level and language level. If the child is “just deaf” and has no other delays, then developmental readiness is key and we can work around the language issues. If the child has both language and global developmental delays, you may be better served by waiting for developmental/physiological readiness for this task. For a child with significant language delays, it may help to use a picture schedule (e.g. first we pull down our pants, then we sit on the toilet, wipe, flush, pull up your pants, wash your hands, etc.). When you see signs of readiness, use language to identify them! “You look like you need to go to the bathroom. Let’s go try!” “Oh, your diaper is wet? We need to get you a new one.” Help the child learn to label her feelings and articulate her needs. Books are another great way to introduce vocabulary and concepts — either commercially available books from the library or experience books you make yourself. One caveat for teaching language around potty training is this: While I usually like to see if the child can stretch his language, when you’ve gotta go, you’ve gotta go! I’ll accept any attempt, verbal, gestural, whatever, that the child uses to communicate the need to go to the bathroom. We can polish up this language later, at a less urgent time. If you’re telling me it’s potty time, let’s go!
Clear communication and routines. Children thrive on consistency — for potty training and for pretty much everything else. I find that parents have the greatest success if they “just do it” in terms of potty training. Really commit and stick to it for a week, even if that means staying home more often and dealing with some messes along the way. This is much easier for the child to understand than the in the diaper/out of the diaper dance that some families do when potty training halfheartedly. The first approach (consistency) is much harder and requires a greater commitment at the outset, but it tends to yield success more quickly. One rough patch, and then you’re done. Children can also be helped in this by the use of routine, familiar language to describe each step in the process.
Setbacks are normal. This is a big developmental step! Things like a change in daycare situation, a week or poor sleep, vacations, or other disturbances in routine can throw the child for a loop and you may see temporary regression. It’s frustrating, but not unexpected. If you know to expect this, the disappointment is less for everyone involved.
Keep it positive! The way we speak to and about the child will become the way he thinks about himself. Potty training can be a really frustrating time, but it’s important to remember that we’re frustrated with the behavior, not the child. Take setbacks in stride, rather than shaming or embarrassing the child about his bodily functions. Remember that he is working to gain full mental and physical control of his body — that’s not an easy task, and, as much as it may seem that way, he’s not doing this to you “on purpose.” Praise effort, not outcome. Have a sense of humor. This phase will pass soon (even if it seems it’s dragging on forever), but the emotional legacy you give your child lasts a lifetime.
Health and safety. A discussion of potty training would not be complete without some other important reminders for parents and caregivers. First, this stage presents a great opportunity to teach another important skill — good hand washing habits. I like to use the following song, to the tune of “Row, Row, Row Your Boat” to help children learn to wash their hands for an appropriate amount of time (and sneak in some vocabulary!):
Wash, wash, wash your hands
After work and play
Scrub, rinse, shake, and dry
Keep the germs away!
On a more serious note, the second important topic to cover during potty training is physical safety. Unfortunately, we know that children with disabilities are at a higher risk for abuse, and that, sadly, abuse is a risk for all children. No child should ever have to experience this, and we have a duty to equip them with the language and skills they need to be as safe as possible. I feel it is very important to teach children the correct words for their anatomy in a shame-free, factual way. It’s also important to express that using the bathroom is a private event. Help them learn to close the door (maybe not lock it at this stage), or, as the parent or caregiver, step outside the open door until the child needs your help, once he is sufficiently able to handle the task on his own. Toilet training is also a good time to talk about safe and unsafe touch and the importance of not keeping “secrets” from parents, even if instructed to by another adult. I hate that we have to talk about this, but we do — it is crucial to empower our children!
Elizabeth A. Rosenzweig 