Toileting Training Considerations

 The bathroom should be a calm and relaxing environment in order to encourage independence and success with completing the toileting routine. 

• Try to remove all distractions which are not associated with toileting (i.e. by storing additional toiletries) to help your child understand what is expected of them.
• Make sure the toilet and area around the sink is accessible. Encourage independence by ensuring that everything in the bathroom is at the right level for your child (i.e., toilet roll, soap and towels for handwashing)
• All bathroom environments will be different compared to the one set up in your home. Your child might need additional time to complete the tasks when in a new bathroom. 

Toilet training should be made as easy as possible, and this includes dressing your child in clothing that is easy to remove.  

• Lots of comfortable, loose clothing with elasticated waists or skirts is ideal! Try to avoid tight clothing with lots of buttons or fastenings. 
• In early stages, if training at home its best to keep it simple with pants with a loose t-shirt or pyjamas.
• To help your child toilet train, they need to feel the wetness of their clothing if they have an accident. It might be helpful to use pull ups instead of nappies. If your child is attached to nappies, try using them outside of pants and gradually cutting them away. 
• As they start to get more comfortable with the toileting routine, you can encourage them to practice pulling up and down their trousers/pants.
• Training pants can also be used to ease the transitions from nappies to pants. 

Modelling

Watching someone else (i.e. parent or sibling) complete a task or routine correctly can be a useful way to learn. However, make sure you focus your child’s attention to the parts of the task you want them to copy. 

Backwards chaining approach

Backwards chaining approach can be used to teach complex sequences of behaviour. Start with the last step within the sequence. With toilet training, you follow all the steps in the toileting routine first and teach your child the final steps (e.g. flushing, and then you reward them). When you child can do this, teach him to pull his trousers up and flush, and then reward these two steps (completing the previous steps yourself first) and so on. 

Visuals

Use of visual schedule if appropriate for your child. Using sequences of objects, showing your child the steps in pictures or using written lists are all ways to help your child understand

Make sure to display each step clearly in the schedule. Once your child has moved into the bathroom, you need to let them know what each step is, when toilet time will be finished and what happens when it is finished. 

Providing a feeling of stability on the toilet is extremely important. If a child is well positioned, relaxed and balanced when seated on the toilet, this helps create a calming environment for pelvic muscles to relax and help the body to eliminate successfully. 

Make sure your child can sit comfortably on the toilet with hips and knees flexed at or slightly above 90-degree angle and feet flat on a secure object such as a stool.

Other Seating Ideas

• Padded toilet seats (with or without handles)
  A ring reducer decreases the size of opening on toilet seat allowing little ones to feel more safe and secure when sitting on toilet.
• Standalone potty chair
  Make this low to the ground so child is able to use independently. These are easy to transport and can be aesthetically less intimidating than full sized toilet seat
• Adapted toilet seat with step
  These are seats placed over an adult toilet to increase accessibility for little ones. Having handles can help with feeling stable when sitting on an adult sized toilet
• Stools
  Stools can help support your child to adopt the ideal seated position with their feet placed flat on the floor. They can also help children to step up to access toilet or sink area for handwashing

If your child is fearful of sitting on the toilet: 

• Make sure your toilet seat is child friendly. Refer tips of seating and adaptations (above) for some options that can work best for your child. 
• Keep all items nappy related/toileting in the bathroom and if possible, change them in there as well to help them establish the routine. 
• Model sitting on the toilet to your child to emphasise that there is nothing to fear.
• Make the toilet bowl a less scary experience by using food colouring and experiencing with the changing water.
• Distract your child with bubbles, their favourite book or listening to music to calm them. Bubbles also help with deep breathing to help them push.
• Gradually introduce your child to sitting on the toilet using these steps:
  1. Sits on covered toilet seat with trousers/pants up
  2. Sits on uncovered toilet seat with trousers/pants up
  3. Sits on uncovered toilet seat with trousers/pants down
  4. Attempts to pee/poo
  5. Successfully uses the toilet 

• Approaching toileting in a playful way can ease anxieties. 
• Books are a great way to discuss topics that might be difficult to understand including using the toilet. See Toilet Training Books, Apps and Songs Programme for more information
• Some kids respond well to singing and music. You can make up songs that you can sing together when going to the bathroom. 
• You can practice the toileting sequence using dolls and play pretend ‘toilet training’