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Your sweet toddler has shown all of the signs for being ready to potty train, and you are excited to get started when you realize they are going to fall right off (or in) the toilet.  Toileting and potty training is often challenging with typical kids, but can be even more challenging when there are limitations that make the normal techniques impossible.  I have a post about some little strategies to use during regular potty training, but this post is about modifications that may be needed in more specific circumstances.  Some of the more difficult situations may include limiting factors such as weakness, spasticity, limited range of motion, etc.  This post is also part of a group of posts about potty training by multiple therapists, so don’t forget to go to the bottom of the post and visit the links to the other articles.

During potty training, what are some areas that limit success?  We will start with the small limitations and work up to the bigger limitations.  I will list the limitations and then the general modifications with a list of more specific modifications to try at the end.

Photo Credit: Dollar Photo | kfleen

Limiting Factors to Toileting Success

Hand Weakness and Fine Motor difficulties

If you have hand weakness and fine motor problems, you may find it difficult to pull pants up and down, fasten pants, ad wipe yourself afterwards.  Some modifications that may help are clothing modifications and practicing wiping off different surfaces.

I will have kids put plastic over their pants and then we put something sticky on the plastic that they have to practice wiping off.  This way they can practice the movements needed in a safe way.  We also work on pulling stickers off the back of their pants in order to work on range, strength, and positioning.

Sitting Ability

A student may have weakness in their body, muscle tightness, or something similar that limits their ability to maintain sitting long enough in order to be successful on the toilet.  In these cases you may need some seating modifications.

Fear

There are some kids that have the physical ability for toileting, but they are afraid of it.  For these kids, you may need some sensory and behavioral modifications, depending on what the source of the fear is.

Modifications

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Clothing Modifications

• loops on pants
• elastic waist pants
• loose clothes
• modified buttons and snaps
• zipper pull or ring

Seating Modifications

• Sit backwards on toilet
• use potty chair
• reducer ring on toilet seat
• foot rest/step stool
• hand rails
• full toileting seating system

Wiping Modifications

• use wet wipes
• extended reach wiping tool
• practice reaching stickers on pants

Sensory Modifications

• cover the auto flush sensor
• headphones
• lights off
• good smelling air freshener

Behavior Modifications

• reward chart
• potty toy or book
• make it fun
• use a schedule
• talk about the process

You can print the modifications infographic in color or black and white.

This post is part of the Functional Skills for Kids series. You can read all of the functions on childhood HERE.  Read all of my monthly posts in this series HERE.

Looking for more information about Potty Training in childhood? Stop by to see what the other Occupational Therapists and Physical Therapists in the Focus on Function series have written.

Potty Training Readiness: 10 Signs It’s Time to Ditch the Diapers  | Mama OT

Potty Training, Toileting and Fine Motor Considerations  | The Inspired Treehouse

Gross Motor Skills and Toilet Training | Your Therapy Source

Toileting and Sensory Processing   | Miss Jaime OT

Potty Training with Attention and Behavior Problems | Sugar Aunts

Modifications For Potty Training  | Therapy Fun Zone

Preparing Your Child & Environment for Potty Training | Growing Hands-On Kids

Potty Training Instruction Tips  |Kids Play Space

Teaching Concepts for Potty Training Through Play |Your Kids OT