by Carolyn Joslin

Created on: June 17, 2009   Last Updated: June 21, 2009

As if potty training isn't a daunting enough task, trying to potty train a special needs child adds a whole new set of considerations and challenges. It doesn't have to stress you out, though, if you take a few moments and think about your child's needs.

First, think about your child's physical abilities. Does your child have a physical disability such as underdeveloped bladder or mobility issues that could affect his or her ability to control urination and bowel movements? If this is the case, you may need to allow extra time for your child to develop and/or to physically take your child to the bathroom. As the mother of a child with severe hypotonia (low muscle tone), my husband and I chose to hold off on potty training our 2-year-old son until his physical development has progressed to the point that he can get himself to the bathroom. Because he doesn't show signs of being distressed by wearing diapers or being wet, we decided that we would wait and let him tell us when he is ready for potty training.

Next, think about your child's mental/cognitive issues. Does your child have a developmental delay, autism, or mental retardation? These conditions all affect the way children are able to receive, process, and relay information. While their bodies may be capable and ready for toileting, if a child is not making the connection between the feeling of a full bladder and the need to head for the toilet, potty training just isn't going to work well.

Finally, consider what adaptations you will need to make in order for your child to toilet train as independently as possible. Step stools, potty chairs, and adaptive seats for the top of the toilet are all pretty standard equipment for potty training. However, children with special needs may need additional help. These children may need training seats with a full back (for those, like my son, who have trouble sitting upright), or stools with hand rails or handles to help with maneuvering on and off the toilet and to the sink. There are also a number of visual and auditory cues that can be used, including books, picture schedules, and cue cards that all help a child learn the concept and the steps of potty training.

As with any child, the more fun and encouraging you can make the process, the more likely your child will be to respond. Incorporating a favorite book, song, or game, bubbles, high-fives, stickers, and other rewards can all help to encourage your child and make him or her feel more comfortable during the potty training process. Consider using a schedule or timer to help with consistency and transitions. For autistic children and those with mental retardation, transitions can be a problem and not knowing what is coming next can cause a major meltdown. Using a schedule and preparing your child at the 3-minute and 1-minute marks can help decrease and even avoid stress, frustration, and acting-out behaviors.

The most important part of potty training a special needs child is awareness. Not his or hers, but yours. Watch your child throughout the process of preparing for and initiating toilet training. Monitor things like his or her frustration level, emotional involvement, willingness to go to the toilet, and level of comprehension and ability to follow instructions. Then approach it from a concrete view to try to come up with the best accommodations for your child.

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