The Potty Training Post #noshame

I am right in the middle of potty training both children, so this subject is first and foremost on my brain.  First, a warning:  this is not a post for people who find the subject of potty training boring or gross, or both. (No judgment!  This was me a few years ago, and will hopefully be me again soon.)  This is a post to discuss 1) the pros and cons of late training (late = after they hit their 3rd birthday) with a non-special needs kid, and 2) a few thoughts on special needs potty training.

Pros / Cons of late training with a medically and developmentally typical kid:
Pros:

• When they finally go along with it (and that part took at least 6 months - see cons, below), they get it really fast - Zoey (mostly) got it in about 2 days, and from what i hear, this is not unusual for 3 year old trainees.  We are still doing some finishing touch training, but she is mostly done.  
• Their bodies are sufficiently grown that they can hold it for long stretches of time, not have many accidents, and be able to remember to go without a bunch of prompting from the parent.  Training at this age is child training rather than parent training (meaning, once they get the concept, they will remember to go on their own and not need the parent to keep track and check in with them every hour for the forseeable future), and that is a lovely thing.
• Diapers are just way more convenient than the early months and years of the potty trained.  If your kid needs a diaper change when you are in the middle of Costco, or you're finishing up a cooking project, or you're driving home - it can wait.  If your kid is not in a diaper, it can never wait, and this can sometimes be really difficult or even affect what you are willing to try to do (i'm not sure how we're going to do Tahoe beach days this summer, for example).  

Cons:

• The big and obvious con is the cost (financially and environmentally) of using diapers for extra months.  The sooner you can eliminate this cost, the better.
• The less obvious con is that if you wait until after age 3, your kid will be hitting an age of independence and verbal skill where they can resist whatever it is you want them to do with great passion and many words.  I imagine a 1 or 2 year old would be more cooperative because they haven't yet learned that they can fight back.  When potty training books suggest that you take your kid to the toilet every 30 minutes and be consistent about it, they are assuming that your kid has not yet hit the stage where they will enter into a 20 minute negotiation and/or a full meltdown of resistance.  The potty training difficulty at this age is mostly about getting them to cooperate, but that's a big thing.

For us, the determining factor on when to start was not anything on this pro / con list, but rather life circumstances.  If you have a lot going on in other parts of your life or you have a big transition coming up, you might just have to wait until the timing is better.  The reason we didn't start earlier with Zoey was because our life was in a constant state of transition and craziness during her 24th - 36th month of life: months of staying with family, 2 different major water leaks and contruction projects, and 2 house moves (one across the country).  So we waited until things calmed down, and by then we were dealing with the pros and cons of training a threenager.  

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Special needs training:

Special needs potty training is a whole different thing from developmentally typical potty training, and it's one of the most challenging developmental things we've faced.  All the potty training books seem to assume that a special needs child has just one challenge, most commonly that they are non-verbal or sensory sensitive or unable to walk - but the books don't contemplate that they might have multiple things going on, or might be showing some signs of readiness but not others.  Our biggest challenges were:  low muscle tone (which affects the ability to hold it and to feel when you have to go); sensory challenges (which affects so many things that i don't even know where to start); and strong resistance to change in routine.  It was such a relief to connect with other 4Q families and learn that, with Joshua's particular deletion, it was reasonable to expect training to happen between ages 4-6 (at the earliest).

Your plan of attack and age to start is going to depend completely on your child and their needs, but here are the best pieces of advice I received or learned through this process:

• Wait until they're ready, and by ready I mean:  1) they're showing most of the signs of readiness, 2) they're willing to cooperate with training at least some of the time, and 3) you're ready and able to help with the things that they can't do on their own.  I hate this advice every time I get it (they will discharge from NICU when they're ready!  They will start eating orally when they are ready!  etc!), but it is always very true.  At some point, we tried 4 days of underwear training with Joshua way before he was ready, and it was probably the most frustrating 4 days of all of our lives.  We had zero successes, dozens of accidents each day, lots of meltdowns, and lots of discouragement all around.  In hindsight, we could have seen within a few hours in underwear that he wasn't ready (wasn't interested, wasn't noticing or giving any signals before he had to go, wasn't able to hold it, etc.), and we should have halted it then.  And that's what we did going forward - we would try an underwear day every few months to gauge where he was at, and go quickly back to diapers if there were no signs of readiness.  If you push them too hard before they are ready, it can create a negative association with the bathroom and make it even harder for everyone.  
• Don't listen to those books claiming that any child, no matter what the extent of their special needs, can be trained in a week.  Like so many things in the special needs world, I think potty training happens on a spectrum - some will train quickly, some won't be able to train at all, and others will train but on a slower timeline.  Because many special needs kids are going to need longer than a week to train, it's best to be prepared and have strategies or compromises in place. For example, even after you've switched to underwear at home, you might need to keep diapers and pull-ups on hand for outings, even if they are just to go over the underwear.  [Note:  all the books advise against this, so this might be really bad advice, but I think you need to trust your instincts, do what works best for your whole family, and recognize that you're living in the real world and not in the fantasy potty training book world -- there are some places where it just won't work that well to risk having an accident, and you might not be able to avoid all these places for months at a time.]  Also, knowing from the beginning that it might take many months helps the parents to not feel discouraged as things move along in fits and starts.  
• Try not to get hung up on things like how old your child is.  (This was a hard one for me!)  They will get there when they get there.  Public schools have to accomodate for toileting needs if your child is on an IEP, and many other places will accomodate if you are willing to work with them (like church nurseries).
• But do find ways to keep potty training in the mix in as many low pressure ways as you can.  We checked out every children's book on potty training that the Virginia Beach and then the Reno libraries had, and we tried to read them often.  We kept the potty chair out and would suggest trying before bath, because that seemed to be a time he liked to try it.  We have a picture chart on the wall of the different steps in the toileting process.  We talked about it frequently -- basically, the same strategies that parents use with typical kids, but for years rather than weeks.  
• For us, it was really helpful to get other people involved in the training.  Specifically, Joshua's preschool teacher developed a routine of having him try the bathroom every day, and it took about 6 months to see any success with this, but the school training caused the break-through - he started having success at school before he had success at home, and now he is having lots of success in both places.  Both parents and all grandparents are also helping in the effort, and it seems to help to have encouragement from many sources.  

Our day training is not fully done yet (and I haven't even started to think about night training), but we are making really good forward progress after waiting years to see any progress in this area.  Thank you to those of you who have listened to me moan, and given prayers and encouraging words towards this effort!  What other good tips have you heard / learned?