Toilet training

Toileting can be one of the most emotive and stressful phases of parenting. Try to be relaxed about it – as with all other areas of children’s development, there is a huge variation in the age at which children with Down syndrome achieve independent toileting and a similar range in the length of time, effort and energy that has to be put in by parents to achieve it. And there is no single fail-safe way in which to do this, although everyone has met people who know that their way is the definitive way! Try to ignore any pressure you may feel from others, focus on your child and his or her stage of development and progress. Gather all the information you can and use it to help you consider what may work for your child and your family. The resources listed below should provide you with a good basis from which to start and the links will help you access additional help if you feel you need this. Talk to parents of children of similar age or slightly older to compare notes about what has worked and what has not for other people. Please also contact our Family Support Coordinator, Sue Modra, on 1300 658 873, if you need further assistance.

*Publications marked with this symbol are available for DSV members to borrow from the DSV Resource Library.

Holroyd, Nancy Pressure to toilet train unnecessary
Written by a parent who adopted a child-led ‘toilet awareness’ approach and recounts the progress of her three children, one of whom has Down syndrome. Lots of useful advice and strategies.

*Continence Foundation of Victoria (2000) One step at a time. Toilet training a child with an intellectual disability
Comprehensive and detailed reference guide, which, even if you don’t want to follow the suggested steps, will provide a wealth of useful information.

Toilet training for children with disabilities
Paediatric Continence Association (PCAA) parent education fact sheet

Moulden, Annie (1997) Pelican Diary 
Royal Children’s Hospital booklet circulated by PCAA which contains information, advice and chart templates to help you track toileting progress. Currently under revision and available shortly on www – watch this space.

Rogers, June (2004) Talk about going to the toilet
Resource for both parent and child with step by step guidance through using the toilet accompanied by child-friendly drawings and simple text – the illustrations can be used to make your own book or create your own visuals for the bathroom. Great resource to start talking about using the toilet with your child.

*Uncle Bobs Child Development Centre Toilet training
Summarised information from One Step at a Time with all the main information points, 4-step process and useful visuals.

Grace, Nancy (2006) Toilet training children with Down syndrome Pediatric News December 2006 p 40

Moreno, Kent (1996) Toilet training made semi-easy  
Describes a protocol, which centres on the development of a toileting schedule, which has been used successfully with people with a developmental disability of all ages. The author is a behaviour analyst and father of a child with Down syndrome.

*Baker, Bruce L & Alan J Brightman (2004) ‘Toilet training’  ch 10 in Steps to independence. Teaching everyday skills to children with special needs (4^th ed) pp75-101
This chapter of this useful book gives a detailed and comprehensive overview of the whole toileting process as a systematic procedure. Lots of useful information.

*Newman, Sarah (1999) Toilet training  in Small steps forward ch 9 pp210-214
Brief overview of some of the more important considerations involved in deciding to toilet train.

*Dodd, Susan (1994) Toileting in Managing problem behaviours pp 109-112 (at home) and 153-155 (at pre-school)

Mary White and June Rogers (2002) We can do it: helping children who have learning disabilities with bowel and bladder management: a guide for parents 
'This is a very useful booklet for parents or carers who are looking for guidance in relation to toilet training their child who has a learning disability. It is informative and helps the parent tailor a program to suit the needs of their child.’

Children with disability and toilet training Victorian Continence Resource Centre

Heerensperger, Donna Toilet training your child with Down syndrome Canadian Down Syndrome Society information series
Suggested steps to successful toilet training, containing lots of tips and information including a readiness checklist.

Boswell, Susan and Debbie Gray Applying structured teaching principles to toilet training
Note that the material is aimed at parents of children with autism, but many aspects of the process described and the visual approach will be of use to parents of children with Down syndrome. Includes a list of children’s books which deal with toilet training.

Other useful links

Raising Children Network
Good comprehensive information site which will answer many general questions about toilet training.

Paediatric Continence Association of Australia

Resources and children’s books to help

Tom’s toilet triumph  DVD 
This animated DVD won an international award as an educational film and is recommended by countless parents who have used it.
(Will shortly be available to borrow from DSV resource library.)

Are you ready?A toilet training package for people with intellectual disability  Intellectual Disability Services Council (SA) and Minda Inc
‘A toilet training package for people with an intellectual disability that can be used by parents and carers to help children and young adults through the toileting process. The package is divided into four parts, firstly with an animated video called Tom's toilet triumph outlining the signs of wanting to go to the toilet and the toileting process. The second video discusses toilet training through the eyes of a mother of a teenager with intellectual disabilities and is designed to give parents, carers and teachers an idea of what to expect when toilet training. A step by step booklet and a set of cue cards taken from the animated video help reinforce the program.’

Toilet time parent packages: toilet training for young children with developmental delay Emily (for girls), Tom (for boys) (2004) Intellectual Disability Services Council (SA)
‘A toilet training package for girls/boys, that can be used by parents to encourage their child to use the toilet independently. A parent information manual offers practical strategies that can be used when toilet training a young child. In addition, cue cards and picture books going through the various stages of toileting help encourage the young child to independently go to the toilet.’
(Will shortly be available to borrow from DSV resource library.)

Jane Whelan Banks Liam goes poo in the toilet: A story about trouble with toilet training

Andrea Pinnington Big girls use the potty (with stickers) Doring Kindersley

Virginia Miller On your potty

Fred Ehrlich Does a pig flush?

Tony Ross I want my potty (little princess)

Alona Frankel Once upon a potty (boy) and Once upon a potty (girl)

Boardmaker - Down Syndrome Victoria have developed a range of illustrated step by step routines on cards which are designed as a teaching tool and may be helpful when toilet training.