How to Potty Train a Child With Low Muscle Tone

No parent wants any condition to hamper her efforts to potty train her child. Problems like low muscle tone, also called hypotonia, are caused by disorders like muscular dystrophy or Down syndrome and could easily get in the way of independent living activities, including toileting. Potty training a child with low muscle tone follows a similar structure of standard training but requires more patience and practice.

Determine your child’s readiness to use the toilet. Children who poop in their diaper at the same time each day or show an interest in your toileting might be ready. Psychologists from suggest that your child’s intellectual disability, a common cause of hypotonia, might delay potty training until around age 3 or 4 1.

Take your child with you to the toilet and let him observe the process. Point out each step -- turning on the light, pulling down your pants, toileting, wiping, pulling up your pants, flushing, washing your hands and turning out the light. You can even encourage your child to watch videos, such as “Tom’s Toilet Triumph,” several times a day.

Show your child a potty training chair and let him play with it so he gets used to this strange new object.

Take off your child’s diaper completely during the day. Let him wear pants or go naked below the waist around the house and keep towels and other cleaning supplies ready for accidents. Developmental psychologist Dr. Rika Alper says children with low muscle tone are less responsive to sensations like wetness, and the diaper reduces these feelings. Wearing wet pants or feeling pee dripping down his leg will help your child respond to toileting.

Take your child to the toilet at certain times every single day to practice potty timing, which is a bit different from training. Tell your child it is time to go to the potty and bring him to the bathroom. Make sure he uses the toilet, even if it is just a bit of pee. Give praise to your child to reinforce the action of using the toilet. Walk him through the steps of flushing and washing his hands.

Ask your child often if he needs to use the toilet. Give your child plenty of water or diluted juice to ensure he needs to go and allow more opportunities for training. A child with low muscle tone might have difficulty sensing his bladder filling up or holding urine in when he needs to go. Frequent reminders ensure your child has opportunities to realize he needs to urinate. If your child says he needs to go, whisk him away to the toilet quickly, as his difficulty clenching his muscles to hold his pee might result in accidents. Again, give praise for his use of the toilet.

Practice abdominal-strengthening exercises, such as sit ups, with your child. Pushing out feces requires a great deal of abdominal strength, so exercising helps your child with low muscle tone learn to use these muscles.


Use reinforcement often when potty training. Simple verbal praise is often best, and Dr. Alper suggests giving your child “special underwear” as incentive for weaning off of diapers or an opportunity to do something your child enjoys, such as going for a swim. Your child might show success with potty training during the day but might still have accidents at night. It is normal for all children to require training pants at night until they decide they are ready to wear underwear or stay dry throughout the night.

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