I’m surprised it took me so long to write about one of my favourite topics, but here it is!
There is an abundance of information on toilet training and toileting issues on various blogs, websites, and YouTube, not to mention the books, pamphlets and handouts! I think at times the differing (and often strong) opinions can overwhelm and confuse parents, teachers or therapists looking to support a child with toileting. Rather than repeating what has already been said, I want to explore toileting as an occupation and discuss two of my favourite tenets when it comes to talking toileting:
1. Every body is different.
I mean this as both “everybody” and “every body”. We are different genetically, biologically, physically, and psychologically. I don’t believe there is a one size fits all approach to toilet training, and I offer caution to any one claiming their way works for everyone, everytime.
2. Everyone can learn toileting skills.
I believe that everyone is able to participate in some aspect of toileting. Going to the toilet is one of the most private and intimate things we do each day, and I firmly believe that each individual is able to achieve as much dignity and control of the process as possible.
Before you start thinking about HOW to toilet train an individual, I think it’s important to examine how complex and challenging toileting is as an occupation. From day one, the need to eliminate waste from our bodies is a key component to our health and well being. We wee and poo before we walk, talk, eat, crawl, roll over, genuinely smile, laugh, etc etc. Essentially, it’s one of the first things we do, how many times have you heard the first few weeks of a babies life described as “sleeping, feeding, toileting”?
So by the time a child gets around to learning how to eliminate waste via a toilet, they are experts at doing it in their nappies (or if they’re not wearing any, anywhere at all). Going on the toilet is a new and bizarre experience. Have you ever driven in a country that drives on the other side of the road? It’s strange, scary, and takes a lot of brain power to make sure you don’t revert to your norm. This is because changing habits is not only hard, but can make us feel really uncomfortable. Add in the fear component (driving head on into incoming traffic for example!) and you’ve got a situation that really raises the stress levels.
Your child learning to eliminate waste on the toilet is like that driver in another country. Except they’ve never really driven a car, they might not know how to, they can’t reach the pedals and the directions are in a language they don’t understand. They are performing a skill they probably haven’t completely mastered, in an environment that is extremely different (in a bad way) from what they are used to.
Think about how it actually feels to be sitting on a toilet (without your phone or a magazine), compared to wearing your favourite pair of trackies whilst your warm on the couch watching TV. Seriously, next time you go to the toilet, really think about how the seat feels, that space where there is just nothingness, how hard and cold it is under your bum. It’s a strange feeling to be mindful of toileting, but as adults we’ve been doing it for so long we forget how it must feel for someone much less experienced.
And it’s not just the toilet seat: consider the whole environment too. Can the child touch the floor with their feet? Are there supports from the side? From the back? (try leaning back against the lid of the toilet, there’s not much support there). What colour are the walls? The temperature of the room? The smell? How often have they entered the toileting space previously?
Add in the complexities of actually using the toilet: can the child take off their pants independently or do they need assistance? Can they get on and off the toilet themselves? How long can they sit for? Consider the sound of wee or poo hitting the water, it might splash, it smells different to doing it in the nappy. How does toilet paper feel compared to wipes?
The list of differences between using a toilet vs nappy is long. I talk about it because although the end goal is the same (elimination of waste) the process is vastly different, and the first step to teaching a child to use a toilet is to acknowledge and address theae differences. My first tenet was “every body is different”. What skills an individual has, what they’ve experienced, their personal preferences, the environment they inhabit, these will all be different. This is why I believe there is no one way to teach a child how to use a toilet, where and how you start depends on all of the above. What worked for one child may not work for another, even if they are from the same family. Even if they are identical twins! No two people have lived the exact same life with the same experiences or perceptions. As supportive and caregiving adults it is our role to adapt what is needed for a child to succeed.
My second tenet was “everyone can learn toileting skills”. As I listed above, there are lots of steps involved in the task of toileting. Beside the physical task of using a toilet, toileting also includes being able to hold on to wee or poo for long enough to eliminate it in one place, recognising when the bladder is full or a bowel motion needs to take place, accessing a toilet (either physically or communicating their need to), and understanding the social norms around where elimination can take place. An individual may require varying levels of assistance with some (or all) of these components. However, everyone can learn some toileting skills, it is just up to us to teach them.