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Down's Syndrome and toilet training

A guide to suppport toilet training in students to support their attendance at school

Needing to support a student with toilet training can be daunting. If a parent/ carer raises concerns, here are a few helpful tips you can pass on to encourage them to start toilet training with their child prior to starting school.

 

Children learn to toilet train when they are ready, this is no different for a child with Downs syndrome. They just may need additional support and encouragement to take those steps. A child may not be fully toilet trained on starting school but it is important to persist in giving support and encouragement so they can take the step towards increased independence in using the toilet.

Assessing a child’s readiness for potty training

It is important to gauge if a child is ready. Here’s a few things to look out for as indicators that they are ready.

  • They have started to show an interest in personal hygiene (washing hands, brushing teeth) and self-care (dressing, taking medications/being healthy)

  • Shows interest in others’ toileting behaviour

  • They can completely empty their bladder and stay dry for 1-2 hours.

  • Has bowel movements that follow a regular and predictable pattern

  • They notice when their nappy is wet.

  • They can communicate when they need to go to bathroom through facial expressions, gestures, visual aids, or words

 

Challenges

 

  • Going to the toilet is an abstract concept

Children with Down Syndrome relate to tactile, clear information. Sitting on the toilet to go to the toilet is a pretty abstract concept. To help them understand that going to the toilet is a way to release “wee” and “poo”, and this is controlled by tummy muscles, give your parents a ball of playdoh to use at home with their child. Ask them to hold the playdoh in their clenched hand over the toilet, and for their child to put their hand on top to squeeze their parent/ carers hands. The parent/ carer should explain to the child that as we squeeze the wee and poo comes out into the toilet.

  • Regression

As your student learns to toilet train it is possible that they may experience regression in another area. This is usually due to anxiety, grief or discomfort. It is important this is not seen as a setback.

 

Tips on toilet training

 

  1. Support the child to feel comfortable sitting on a toilet or potty. Supporting the child to sit on the toilet or potty at set times will help establish a routine. Be observant as to when your student needs to go to the toilet and work this into their toilet training routine.

  2. Praise – In the early days give lots of encouragement and praise when they sit on the potty or toilet. Never force them to sit on the potty or toilet as this will create a negative experience and they may resist doing it.  You can make this less stressful for them by making it fun – play a singing game or read a story to them as they sit on the potty.

  3. As they begin to get confident in sitting on the potty, it is time to help them make the connection between going to the potty/ toilet and using the potty/toilet.  You could introduce a reward chart such as getting a sticker for every time they manage to use the potty/ toilet moving to incentives for entire dry days. Toilet training does not happen overnight, so it is important to remain patient.

 

NDSS have useful information and resources to assess a child’s readiness for toilet training and resources to support a child when they are ready, visit:  https://www.ndss.org/resources/toilet-training-children-with-down-syndrome/ 

 

Reif has a good practical guide and tips for parents:  https://reifpsychservices.com/potty-training-down-syndrome/