The Potty Journey: Guide to Toilet Training Children with Special Needs, Including Autism and Related Disorders

by Judith A. Coucouvanis

Overview

Parents of children with autism or other special needs frequently struggle with toilet training their child. Toileting a child with special needs is more difficult because there are often additional challenges such as communication difficulties, sensory issues, behavioral concerns, resistance to change, inability to generalize a newly learned skill, and the need for routine.

Using traditional toilet training books and methods are not always helpful because the autism population does not think the same way a neurotypical child does. The child with autism may not care about pleasing parents or receiving verbal praise. Because there may be significant developmental delays, the toileting process may not be started until after the age of four. Using a diaper to eliminate has been the routine for several years and this can be hard to change. Children’s books to introducing toilet training may not be appropriate because the child is too big for a potty chair or using the potty chair then transitioning to the toilet becomes yet another change and obstacle in this process.

All of these concerns may feel insurmountable and overwhelming when making the decision to begin toilet training. Judith Coucouvanis has come to the rescue with her new book The Potty Journey: Guide to Toilet Training Children with Special Needs, Including Autism and Related Disorders that empowers parents and professionals with practical information to make this journey a success. I would recommend reading the book in its entirety first before starting toileting because Ms. Coucouvanis equips the reader with a plan and presents the overall picture for this process. She uses the concept of a journey/trip and all the things one would need to do to make the trip a successful one. It is these planning tips and manageable steps that make toileting “do-able”.

One of the biggest quandaries parents face is not knowing when to start toileting. Judy outlines considerations when to begin toileting in the second chapter. She discusses mental age which is not the same as chronological age, the ability to remain dry for 1 – 2 hours at a time, and being over the age of four when bodily functions are more mature. It is also important that you as the parent are emotionally ready for this commitment which takes several weeks, and that there are no additional life stressors such as a move, divorce, job change, or major illness.

One key to successful toileting is using a team approach. Everyone who spends time with that child should be involved in the toileting process. Children with autism don’t generalize from one situation to the next so for success to occur there has to be a consistent toileting routine and approach throughout the child’s day which may unfold in several places.

The author introduces the Daily Progress Record (DPR) in chapter 3 which is the foundation of the toileting process. She provides lots of examples and a template in the appendix. She teaches how to practice toileting, use rewards, and supports the child’s learning with visual examples. She dedicates two chapters to troubleshooting problems. The book is peppered with thoughts from parents and professionals who have gone through this journey. Their comments offer positive support and encouragement. The final chapter is dedicated for stories from those who have completed the toileting journey.

Ms.Coucouvanis also writes about creating independence with toileting – how to fade prompts and your presence in the bathroom. She also discusses bathroom use in other locations such as the school and public restrooms. The hidden curriculum rules for boys and girls public bathroom use are outlined. Most mothers are not aware of how different a men’s public bathroom is from a women’s.

There is a helpful appendix at the end which includes charts for determining toileting readiness, the Daily Progress Record, records for your team members (known as the travel crew), a checklist to prepare for this journey, suggested rewards, Sitting Practice Record, and a visual breakdown of the toileting steps.

The Potty Journey takes parents and professionals through the toileting journey which is a challenge but well worth the effort. Toileting with independence and confidence is a life-long skill; without this skill, a person’s choices are limited and they are dependent on someone else for one of their most basic needs.

Product Details

ISBN-13:	9781957984889
Publisher:	Future Horizons, Inc.
Publication date:	01/01/2008
Sold by:	Barnes & Noble
Format:	eBook
File size:	3 MB

About the Author

Judith Coucouvanis, MA, PMHCNS-BC, is a psychiatric nurse practitioner at the University of Michigan Department of Psychiatry, Division of Child and Adolescent Psychiatry. She has been a clinician for over 40 years, specializing in the treatment of children with developmental disabilities, severe behavior challenges, autism spectrum disorders and co-occurring conditions. She is a national speaker on topics of behavior management, social skills training, psychopharmacology, educational strategies, and toilet training.

Read an Excerpt

The Potty Journey is a systematic and comprehensive toilet training guidebook. It is not a book of “toileting tricks.” Step-by-step, it leads you, the tour director, all the way through the toilet training journey to its ultimate destination: successfully toilet training your child with special needs. Whether you have tried potty training in the past and given up or have never tried, this book is for you. The trip is plotted in detail and includes a comprehensive itinerary for the entire toileting journey. You will learn about extensive, yet simple-to-do data collection, how to use rewards, the importance of routine, the impact of a consistent schedule, and the significance of dry pants.

This book is about success, removing the barriers that can affect toilet training and embracing the child’s abilities in order to find the solutions that will help achieve continence. So plan to set aside time to read and study this book. Give this job the same value as other worthwhile activities in your life. After all, you don’t need me to tell you how important the successful conclusion of this journey is to your child’s future. His social acceptance by peers, school placement decisions, and eventual job opportunities depend upon it.

Table of Contents

Introduction
A Word to the Tour Director...........................................1
Chapter 1
The Potty Travelers: Children with Special Needs..........5
Children with Autism Spectrum Disorders..............6
The Typical Journey................................................11
Chapter 2
Signs and Signals on the Potty Journey........................15
Signs of Readiness..................................................16
When to Start the Potty Journey...........................16
Which Direction First – Bladder or Bowel Training?......................................... 20
Chapter 3
Packing Your Bags..........................................................23
Toileting Crew.........................................................24
Language: What to Say.........................................25
Travel Records..........................................................26
Clothing...................................................................30
Supplies...................................................................31
Potty Journey Countdown.....................................34
Chapter 4
Travelers’ Compensation: Using Rewards.....................35
Choosing a Reward.................................................35
Amount of Reward.................................................37
Access to Reward....................................................38
Reward Conditions.................................................38
Reward Frequency..................................................40
Variety of Rewards.................................................40
Reward Posters.......................................................41
More Thoughts About Rewards............................42
Chapter 5
Planning the Route........................................................45
Discovering Your Child’s Present Toileting Habits.....46
Plotting the Course: Determining the Schedule....... 48
Chapter 6
Avoiding Disaster...........................................................53
Practice Trips: Teaching Your Child to Sit..............55
Chapter 7
Final Preparations..........................................................63
Establishing a Toileting Routine............................64
Visual Supports.......................................................64
Chapter 8
Let’s “Go Potty”..............................................................69
Urination Journey...................................................69
Bowel Journey........................................................76
Chapter 9
Negotiating Accidents and Related Mishaps
Along the Way...............................................................79
Accidents.................................................................80
Positive Practice......................................................81
Washing Underwear...............................................82
Trouble Initiating Urine Stream.............................82
Withholding Urine..................................................84
Incomplete Emptying of the Bladder....................86
Chapter 10
Other Bowel Training Obstacles and Predicaments.....89
Constipation............................................................90
Hiding......................................................................92
Withholding Bowel Movements............................93
Chapter 11
Yield for Dry Pants: The Ultimate Triumph..................97
Pants Checks and Dry Pants Rewards....................98
Chapter 12
Creating Independent Travelers..................................103
Fading Prompts.....................................................104
Creating Self-Initiation.........................................104
Potty at School......................................................108
Where’s Potty?......................................................111
Chapter 13
Leaving Home...............................................................113
Public Restrooms...................................................114
Progression of Public Restroom Trip Schedule........115
The Hidden Curriculum of Public Restrooms..........116
Chapter 14
Potty at Night...............................................................119
Bedwetting...........................................................120
Chapter 15
Potty Journey Stories from Tour Directors Who Have Been There....................................................................123
Conclusion: Notes for the Road...........................131
Final Words: Did You Know?...............................132
Resources and References...................................133
Appendix
A – Toilet Training: The Journey..................................138
B – Daily Progress
Record.............................................139
C – Monthly Progress Record.......................................140
D – Travel Crew Journal...............................................141
E – Toilet Training Countdown....................................142
F – Traveler’s Reward Survey........................................144
G – Sitting Practice Record...........................................146
H – Toileting Routine...................................................148