If your toddler already fights you about eating his vegetables and getting ready for bed, you really don’t want potty training to be another battle. Before you end up frustrated or comparing -- “Why can’t my child be more like my friend’s potty-trained angel?” -- consider the possibility that your child might have difficulties you don’t know about or that are outside of the “norm.” Sensory integration disorder is one issue that could cause problems when it comes time for toilet training.
Sensory Integration Disorder
Also called SPD for "sensory processing disorder," sensory integration disorder refers to a problem with the way incoming sensory stimuli are processed by the brain. According to occupational therapist and neuroscientist A. Jean Ayres, Ph.D., sensory integration disorder is like a traffic jam in the brain, and sensory input is not interpreted correctly. If your child seems abnormally clumsy, does not like certain stimuli -- such as the sensation of urinating -- or does not seem to respond to extreme stimuli like hot or cold, he might have difficulty with sensory integration. A medical professional can diagnose sensory integration disorder.
Understanding the Challenges
Your child has sensory integration disorder -- so what does that have to do with toilet training? Some children with sensory issues might be unresponsive to sensations, such as the feeling of a wet or soiled diaper. Other children might find the sensation of urinating or having bowel movements to be extremely uncomfortable, so they might withhold toileting to avoid these feelings. A less direct problem might be your child has an oral or tactile sensation problem, so he doesn’t like certain high-fiber foods that allow for healthy bowel movements.
Preparing for Toilet Training
According to developmental psychologist Dr. Rika Alper in an interview for Care.com, you should break down toilet training into micro-steps for children with sensory issues. Prepare for toilet training by moving potty-related items into the bathroom. Take your child to the bathroom with you to demonstrate proper toileting. Explain every procedure, including pulling down your pants, toileting, wiping, pulling up your pants and washing your hands. Use a routine, so you use the toilet at a particular time each day, such as right after waking, after lunch and before dinner. Dr. Alper also suggests starting by encouraging your child to sit on the potty even while wearing a diaper.
Dr. Alper suggests you start slow and take one step at a time for toilet training. After you prepare your child for training, start following your routine and tell your child to use the potty at the same times each day. You might need to hold your child’s hand or provide encouragement. Even if your child gets just one drop of pee in the toilet, celebrate it like it’s a big deal. Try tricks like the bare-bottomed method, meaning your child goes without a diaper or pants for an entire weekend -- this might help your child sense he needs to use the potty. If your child’s diet causes constipation or withholding, you might want to consider using a laxative to jumpstart a bowel movement.
In the case of one of Dr. Alper’s patients, the child with sensory issues liked the sensation if his diaper pressing against his body. Even when the patient transitioned away from diapers, he used a belt around his waist to provide that sensory feedback. Use reinforcement such as verbal praise or a treat your child particularly likes, such as a trip to the park. Show your child “special underwear” he will get as a reward for toilet training. Also, if your child has sensory integration disorder, toilet training is likely not his only obstacle. A “sensory diet” in which you incorporate many activities that stimulate all the senses throughout your day will help improve sensory integration.