Diapering and Toilet Training O’Brien-Chapter 9

Organizing… Cleanliness during diapering is of the upmost importance washing hands using plastic, disposable gloves disinfecting solution 1:1 interaction, individualized care Diapering infants should have their diaper changed before going to feeding area or before they go to sleep Diapering & toilet training toddlers learn to go potty through observation, practice, and trial & error success in toilet training depends on providing toddlers with many opportunities Handout-Diapering Poster

Diapering & Toilet Training Routine for Infants & Toddlers Step 1: get Ready all supplies ready (diapers, wipes, ointment), hands washed before putting on gloves, clean changing pad Step 2: invite/bring children to the diapering/toileting area specific announcement to child, give 2-minute warning so they can prepare themselves call 1-2x before another teacher physically brings the child to the diapering area child should never be picked up and taken somewhere without being told in advance what is happening to them Step 3: respond individually to each child give each child individual attention & cuddling time Step 4: involve children work on skills: dressing/undressing, toilet flushing, hand washing Step 5: clean up track “outcome”/record keeping child who is going to use the toilet will do so within 2 minutes dispose of soiled items, disinfect diapering table, potty seats * Handout-Diapering (Soc/Emot Tips for Providers)

Toilet Training Toddler Stages Stage 1: Pre-training children wear diapers not expected to be able to control their bladder or bowels or to have dry pants teacher can talk about the difference between wet/dry pants give the child a chance to sit on the potty if they ask (with/without diapers, fully dressed, etc). teacher should encourage them to sit for a brief period at least 1x day bring 2 children to the area at once—one who is close to being toilet trained & one who is just beginning…why??? Stage 2 criteria is that the child frequently asks to sit on the toilet or the child is 23 months

Toilet Training Toddler Stages…Cont’d Stage 2: Familiarization should begin at 23 months old, at least goal=accept the routine of sitting for a brief period of time in order to have an opportunity to use the toilet good time to teach sign or word for “potty” major task=to be cooperative in sitting on the potty calmly & without protest child should sit on potty for 2 minutes Stage 3 criteria occurs when the child sits for 2 minutes at least twice a day for 10 consecutive days & is successfully at least once

Toilet Training Toddler Stages…Cont’d Stage 3: In Training should wear heavy training pants (plastic pants should cover cloth) this new underwear is a sign to the child that CHANGE has taken place tell me your thoughts on “Pull Ups”… should be reminded to “go potty” & taken to the potty frequently should not be expected to be dry when they come to the toilet area express acceptance even if/when they are wet some form of tangible reward--a sticker, small toy, or cracker--for success helps to focus the child’s attention on the task at hand impossible to give too many hugs or to express too much pleasure in a child’s accomplishments in this stage Stage 4 criteria occurs when the child is successful at least twice a day for 10 consecutive days

Toilet Training Toddler Stages…Cont’d Stage 4: Transition to Independence demonstrating regular success still need many reminders to “go potty’ goal=recognize, before it’s too late, when to use the potty should receive teacher’s attention for using the toilet, but also for staying dry and going potty expected to have frequent accidents encourage them to dress themselves (parents: dress them in user-friendly clothes) What are “user-friendly” clothes? Stage 5 criteria is when the child is dry for at least 8-10 consecutive days

Toilet Training Toddler Stages…Cont’d Stage 5: Independence children at this stage should have mastered the toilet routine can manage themselves in the toilet area with little help from adult can wear regular underwear teachers still need to remind children to use the potty, but teachers should TRUST children when they say they do not need to use the toilet children at this stage should only receive a sticker if they come to the toilet area independently, without being reminded (gradually phase out the use of rewards, but continue to praise enthusiastically) regression is normal in this stage stressful situations may be a factor if a shows a persistent change over several weeks, this may be a symptom of an illness or complication. Tell family members and ask them to consult a doctor

Analyze a video Watch the video: Lessons in toilet training! http://www.youtube.com/watch?v=-20lcOg3jok&feature=share&list=PL07BCDE1E97CF355A Knoah is now 2 years old!! It is time to potty train him! This is a brief view into what the day was like when just introducing the idea of going potty on a potty. It didn't go too well, you can see why. I guess some habits are harder to break! What is happening in this video? What “mistakes” are mom making? What would be a better, perhaps more successful, approach?

O’Brien’s Technique giving children an obvious reward (sticker, small cracker) for demonstration of a particular toileting skill appears to help children move through the process can be done at each level of the process more important than tangible rewards, teachers need to give the child lots of encouragement and attention during toilet training times all visits to the toilet area should be pleasant and positive Video: Toddler Parenting Advice : How to Toilet Train Your Toddler http://www.youtube.com/watch?v=WsKCWTAZMZ4&feature=share&list=PL07BCDE1E99CF355A Toilet training a toddler involves finding a toilet that is the right size for the child, watching for signals when the child needs to use the bathroom and reinforcing the good behavior with special treats. Make toilet training a positive experience for a toddler with parenting advice from a clinical psychologist in this free video on child care. Dr. Deborah Wheeler is a clinical psychologist and the vice president of academic affairs at Argosy University in Salt Lake City, Utah.

Diapering & Toilet Training When Children Have Special Needs the gentle procedures previously described make this toilet training technique good for children w/special needs can stay in the familiarization stage as long as they need to in order to understand the expectations all children receive individualized care that is suited for the special needs and levels of development children with motor delays/disabilities also have difficulty with the control of the muscles involved in urinating and defecation some children w/disabilities have reoccurring problems with constipation, particularly if they are inactive or have a limited diet

Diapering & Toilet Training When Children Have Special Needs…cont’d some children are born with conditions that make it impossible to remove waste from their bodies ostomies-a surgical opening in the abdomen that allows waste to be removed without passing through the entire digestive tract or directly from the bladder 3 kinds- colostomy or iliostomy-when the opening is in the large intestine vesicostomy-when the opening is in the bladder stoma-a part of the intestine that is visible at the ostomy site, is covered by the pouch used to collect the stool require special care, cleanliness, a special diet & lots of liquids diarrhea is a special concern b/c it can become life-threatening rather quickly catheter-a thin tube placed into the bladder through the urethra children with spinal cord injuries, spina bifida, or other disabilities inability to control bladder function catheterization is usually done frequently during the day to keep the bladder from getting full careful medical management is crucial

Families and Toilet Training toilet training approaches vary substantially across cultures & family backgrounds teachers must be aware of these preferences & customs a clear description of toilet training procedures should be shared with families at the time of enrollment most teachers would like to have family follow these same procedures at home teachers must accept parents’ rights to practice whatever procedures they wish—even if their choice is to not do any toilet training at home teachers should avoid a power struggle with families a child will learn at his/her own pace! Go over homework: Winning Ways (Toddler) Toilet Learning, pgs 58-65 Summary: Review “Quality Check” lists on pgs. 190 & 191