Modifications for Toilet Training

Modifications for Toilet TrainingModifications for Toilet Training

In order for a child to be completely independent and physically ready when using the toilet, it requires a significant amount of higher level gross motor skills.  If a child has delays in gross motor skills that are affecting toilet training, you may need to provide modifications for toilet training.  Here are a few tips:

  1. The child can sit down to unfasten clothing. Use a potty seat on the floor for little ones.  This eliminates the ability to step onto a stool and sitting balance is easier to maintain.  It provides a stable base of support for the trunk to remain upright.
  2.  When using a regular size toilet seat, use a toilet seat insert ring with handles on it.  The child can hold on to the handles to assist with sitting balance.  Make sure a step stool is available to provide a stable base of support.
  3. Place grab bars near the toilet to help with sitting balance and transfers.
  4. If the child uses any assistive devices or a wheelchair, make sure that the bathroom is accessible.  Can the child fit through the doorway and move throughout the bathroom with the assistive devices?
  5. Position the toilet paper close to the toilet.  This will decrease the amount of weight shifting necessary to reach for the toilet paper.
  6. If necessary, provide adaptive seating on top of the toilet to allow a child to relax completely while trying to void.  There are adapted seats available that mount onto the toilet, over the toilet or a free-standing commode style.  The child should have slightly forward positioning of the upper body with the knees slightly higher than the hips to help encourage bowel and bladder elimination (Noble, 2014).

Being able to use the bathroom independently, requires many steps.  If you are a therapist helping a child to toilet independently and need to track his/her progress check out Personal Hygiene Rubrics to collect data on the steps of toileting.  If you need more modification ideas for school-aged children, check out Modifications and Interventions for School.

Read 10 Tips to Help Children with Potty Training.

Read Toilet Training and Gross Motor Skills.

Reference: Noble, Elena MPT. (2014) Achieving Optimal Toilet Positioning for People with Disabilities. Retrieved on 2/16/16 at http://www.rifton.com/adaptive-mobility-blog/blog-posts/2014/february/optimal-toilet-positioning-special-needs.

If you need more information to help children with toileting check out these resources:

The Practical Guide to Toilet Training Your Child With Low Muscle Tone (digital document) written by CathyAnn Collyer, OTR, LMT,  provides a complete explanation of the motor, sensory, and social/emotional effects that low muscle tone has on toilet training. It helps parents and therapists to understand whether a child is ready to train, and how to start creating readiness immediately.  You will learn how to pick the right potty seat, the right clothes, and how to decide between the “boot camp” or gradual method of training. A child’s speech delays, defiance or disinterest in potty training are addressed in ways that support families instead of criticizing them.  FIND OUT MORE.

Bathroom Social Stories   This digital document created by Thia Triggs, OTR,  provides 7 book covers, 76 separate book pages with a corresponding visual to aid understanding, and eight visual sequence strips for posting. Pick only the pages for your student’s needs. Specific sensory aversions that make it difficult for children with autism or anxiety issues to use new bathrooms are included. Clear, consistent visual expectations, as well as specific accommodations, help make bathroom use successful!  Editable text is available on one cover and four pages so that you can add your student’s name and specific circumstances that are important in your situation.  Available for boys OR girls.    FIND OUT MORE.

Modifications for Toilet Training