Friday, May 20, 2016

Potty Training Children... In Less Than a Day?

When our oldest daughter was 2-years-old I asked a dear friend how in the world one goes about potty training a child?!  She put a book in to my hands called, Toilet Training In Less Than A Day by Dr. Nathan H. Azrin.  I thought, Praise the Lord and hallelujah!  *laugh!*  Effective, successful, time efficient, ON PURPOSE potty training!  *smile*  I was all over that!  And since then we've used the principles from that book to train our 9 children with great success.  Most of what I will share with you regarding the actual potty strategies we use come strait from this great little book.
  • What are some signs of readiness for potty training?
  • When is a good age?
  • The One Day objective
  • What do I do exactly?
  • Some extra tips

I've been asked many times about how I've gone about potty training our children, and two of our readers recently inquired,
 "What's your secret to potty training success?" ~ Cassandra
 And,
"Potty training tips are much needed.  Because I am a a stay-at-home mom I can't tell you how many people have expected my little one to be trained by age 1.  She just turned 2 in May and has only shown interest a few times but then it quickly fades...I have read pushing her is not a good thing...there are so many sites and books and videos on this...I don't know where to begin."  ~ Brandi

I borrowed the Toilet Training In Less Than A Day book from my friend and then proceeded to take 4 pages of notes on the specific how-to's:  what to do, when to do it, for how long, what to expect, how to determine if children are showing signs of readiness, etc.  And I have reviewed those pages of notes each time I've trained one of our children, adding little additional notes to myself as I've gone along; new ideas, or reminders for next time.  *smile*  
~~~~~
What are some signs of readiness for potty training?

This was a huge question in my own mind when we were looking at potty training.  How in the world do you know if they're ready?  Well here are some signs I watch for.  The child may have all of these signs, but not necessarily all of them.
  • The child starts knowing when he's wet or pooey and asks to be changed.
  • He can recognize when he's either going potty, or has just gone potty, and he'll either tell me, or I can tell by his face (i.e. he stops playing, stands still, looks serious or like he's thinking about something for about 10-15 seconds).
  • His diapers stay dry for longer periods of time, and then he pees in larger quantities when he does go.  He may start seeming to flood his size 6 diapers fairly often where he hadn't done that at all before.
  • He may start waking up from naps or in the morning with a dry diaper.
  • He may start showing signs of interest in using the toilet, and may ask to do so.  To this question I always respond with, "Well not yet, but you may when you're a little older."  Our potty training method is done all in one day, not stretched out over the course of months.  So he needs to wait until we're ready to totally jump in and make the transition out of diapers and in to underpants.
  • If he ever does start peeing when he's on the changing table with his pants off, I can tell him to stop and he's able to do so.
I need to determine if the child is old enough to be held accountable to use the toilet when he knows how, rather than just peeing on the floor.  Is he old enough for me to be able to say, "No, no, you may not pee on the floor."  Or is he too young, and really can't handle that responsibility yet.  This is a big determinant. 


When is a good age?

I personally have trained children pretty early, at age 2, and as late as 4 1/2.  We will not likely train someone at 2-years-old again, though.  And generally, girls are usually physically ready much earlier than boys are.  Here's my varying experiences so far regarding ages:

Child #1 - I trained our first daughter when she was 2-years-old because she had signs of being able to do it; however I did not recon with the fact that she was not emotionally ready, and really wasn't physically mature enough yet in my mind either, for what I was able and willing to deal with.  When she had to go potty it was right now - like I had minutes to get her to the nearest bathroom, and I had to know where every bathroom was in every store so I could get there fast!  This was not at all more convenient than diapers I will tell you.  We also taught her how to go potty at night.  We got her 2-piece pajamas so that she could get them off quickly and easily, and taught her how to let her eyes adjust to the night light.  However when we got up in the morning we discovered that she had been playing all around the house during the night, and for long periods of time, as there was stuff everywhere!  *gasp!* *yikes!*  So, needless to say we had to then take away her privilege of taking herself to the bathroom at night - didn't go over very well, and in fact Bob had to rig up a jingle bell on the girls' bedroom door so that it would make noise if they opened their bedroom door at night.  So, I planned to not train someone again so young.

Child #2 - I trained our next daughter at 2-years and about 8 or 10-months and that worked much better for us.  She was ready physically and emotionally.  I did however monitor her water intake after about 5:00 pm, so that she had no more to drink after that except for 1/2 of a glass of water after dinner.  And I got her a 24 oz. water bottle so that she could drink a lot of water all morning so that she would not be so thirsty in the evening.  These plans helped her to stay dry at night.

Child #3 - I had heard that boys typically train much later than girls as they're just physically ready later than girls are.  So I waited to train our son until he was 3, and attempted it even though he didn't show any signs of being ready.  But after hours of effort to train him I could tell he just wasn't physically able to do it yet.  *sigh*  So I had to quit and wait until he was older.  Well he did not show signs of readiness until about 4 1/2!  *ugh!*  But if they're not ready, they're not ready.  Then at 4 1/2 training was pretty quick and easy and he was off and running.  He did use Pull-Ups at night, however, until about age 7.  He just didn't have the ability to wake up from a deep sleep and know he had to use the bathroom at night yet.  The first two girls never used Pull-UP's at night, they were just dry all night long.  But our next 4 children to train needed night time Pull-Up's for a while, which is fine.  Pull-Up's can be expensive if used during the day time, but they're not very expensive if used only once-a-day at night, and even then they're not always wet so the Pull-Up can be used again the next night.

Child #4 - Our next daughter was longing to use the potty from about age 20 months, having watched her sisters.  But she showed no signs of being physically ready at all.  I was determined not to train so early again, so we waited for signs of physical readiness.  Well she didn't end up having any signs still even at nearly 3-years-old.  I called the friend I borrowed the toilet training book from to ask her opinion about what I should do.  She told me that if we're not careful a child can lose the desire to be potty trained if we wait too long and I could find myself with an apathetic child who didn't care whether she was trained or not.  Since she had been desiring to use the potty for a year-and-a-half, I decided to try her on potty training.


Well she turned out to be the easiest one to train of any of them!  Ha!  And she had a perfect week after that - no accidents even at naps or night!  But then the honeymoon was over and she started having accidents once-in-a-while and waking up wet every morning.  I was so disappointed and confused!  And I was sure she was just being lazy after having a perfect week.  I did not put her in to Pull-Up's for 8...long...months - wet beds pretty much nightly - but eventually I figured that Pull-Ups were worth my sanity, and decided that she really wasn't doing it on purpose.  I don't know why she was totally dry for a week and then not - that's just how she did it.  But bless her heart, she had been waking up so grouchy every morning when she was wet, and when I put her in to Pull-Ups she was her usual sweet self again.  I think her sisters sharing her bedroom had been making her feel bad for wetting every night, and then she was finally able to be dry (with the Pull-Up) and she felt at peace again.  She still wears Pull-Ups at night now at age 6, but she's been getting dryer more often and I'm confident she'll be out of them soon.  And this is not uncommon anyway.

Child #5 - He trained well at age 3, and has been wearing Pull-Ups at night since then.  He's now 5-years-old and is never dry at night, but he'll get there.  *beam*  He's awesome.  *chuckle*


Child #6 - I just trained our little son last weekend, at age 3 1/2, and he took 6 hours to train instead of 4.  Seemed like forever.  *smile*  But he did great in the end, and has had a great week so far over all.  I'll tell you about that with photos in a few minutes.


The One Day objective

The objective from the Toilet Training In Less Than A Day book is for the child to be able toilet themselves completely independently at the end of the training day.  This includes getting their pants down, sitting on the toilet quietly, wiping after peeing (I still do it for them for a while when they poop), getting their pants back up, flushing and putting down the lid of the toilet.  


What do I do exactly?  (from the Toilet Training In Less Than A Day book)

The plan is to train the child completely within a concentrated 4-6 hours, and then complete the training within that same day.  There will likely be accidents for the next couple of days, which is normal as the child learns to think differently than they ever have before, learning to not just "go" when they need to but rather to go to the bathroom instead.  And we generally stay home for one week then while the child learns to firmly establish these new practices of toilet training without the additional distractions of being out of the house, not knowing that there are potty's everywhere they go when they need them, and not risking accidents on car upholstery.  *smile*  But then they're done!  It doesn't drag on for months on end, and I have confidence that the child knows everything they need to do and is physically able to do it.  It's hard work for those 4-6 hours, but I would personally much rather do that and move on, rather than have it take many months.

The training needs to be done in a distraction-free environment.  I know that seems impossible to large families especially, but it really is necessary.  My husband, Bob, takes all of the other children to my parent's house for the day until nap time, or if that is not possible on the day we need to train then he takes them out for about 5-6 hours to varying places.  They may go to a park to play, then for a walk on a trail somewhere else with strollers, then maybe for a long drive, have a picnic lunch, he's gone to a mall play area before if it's raining, maybe to a beach.  But the house where I'm training a child really has to be distraction-free.

I will have purchased some treats to encourage our training experience.  *smile*  A sugary drink that is not only fun to drink, but will encourage a lot of practice if we can get in at least 8 oz. per hour.  I have found that Capri Sun individual drinks work best for us.  This way I don't have to make up a whole pitcher of juice to have in the bathroom, and have a sippy cup to keep filling.  We just open up one package at a time; a convenience I choose to implement to make the experience a little easier and more pleasant. 

I also purchase a salty treat and a sweet treat as rewards for having dry pants.  These will not only be yummy to him, making the hard work more pleasant, but will make him thirsty, enticing him to be drinking a lot of juice.  *wink*  *smile*  I'm telling you, this is a brilliant idea the book recommends.  Here's Tyler, our recently-trained 3-year-old, with his treats before we train on his potty training day.  I've made sure he's had a green smoothie for breakfast, knowing that he'll likely not eat lunch because he'll have no appetite after this training morning.  He has Capri Sun fruit punch drinks, Pringle's potato chips, and frosted animal cookies (all a rarity in our home, so he's thrilled.  *laugh*)


A main principle is rewarding the child for being dry and clean, rather than rewarding for going potty.  If we reward when a child goes on the potty then they don't learn to empty their bladder completely when they go, but rather to go every 5-20 minutes for the reward.  If we reward for them being dry, the child learns to empty their bladder completely every time and to celebrate and enjoy being dry and clean.  (But we actually only offer treats during the actual potty training hours in the one day of training, then they're put away after that). 

Then I turn up the heat in the house to about 75 degrees for a few hours so that he can be comfortable wearing just his under pants, and not have the added distraction of his tee-shirt and shorts.  The thick cotton training under pants are extra thick, so they hold much more urine than regular underpants (can be purchased at Wal Mart, Target, Fre Meyer, and the like).  I also purchase a size on the larger side for the child so that he can get them off and on easily.

Daddy takes all of the other kids out of the house as early in the morning as possible so that we will have the longest amount of time to train possible before nap time.  Right after breakfast, little son and I head to the bathroom.

I gather all of our supplies and the little son and head to the bathroom where we will do our training for the next 4-6 hours.  Yes, it is a long time in the bathroom, but it's necessary.  I get out a dish tub to put the wet under pants and cleaning cloths into as we go along, about 10-12 pairs of training under pants, a pile of cleaning cloths (rags), our treats, a water bottle for me and for little son (the sugar does make him thirsty for water, too), and I put on a quiet audio book for myself to also listen to (from the family room).  The book recommends not having on any TV or radio during this time which are too distracting in visual and audio (louder noises, sudden changes in commercials and programs and music and voices, etc.), but I've found that a quiet, fairly monotone audio book does not distract the child and helps me enjoy our time more. 


I put little son in to a pair of underpants offer him some juice (he downs the first one in about 1 minute *chuckle* *cheer!*) and we do "dry pants checks" every 5 minutes (I use a digital timer) by touching his pants to see if they're dry (other wise he may think they're dry but they're really not), and then he gets to have a sugary or salty treat every time we check and he's dry.  

 

I don't suggest that you let a child eat more than one chip or cookie every five minutes or you may overload his system with fat and sugar and he may throw up.  I have not had that happen to me before last weekend, but it did happen last weekend, and we slowed down after that.  *sigh*  Poor little guy.  And extra mess.  Mistake.  *chuckle*  

The first time he pees it goes on the floor because he's not used to not having a diaper there to catch it.  I don't get mad, but just express disappointment and tell him that his potty needs to go in the potty.  When the child is 3-year-old, I can tell them to stop peeing, and they can usually, and then they can sit up on the potty and finish going there.  (Younger children may not be able to do this yet).   We clean it up and continue doing dry pants checks.  I show the child how to find the edge of his under pants so he can pull them up successfully, and how to put one thumb in the back of his pants so he can get them up over his little bottom.  I also have boys sit when going pee during the first year or two of using the toilet, until he can be trusted to be responsible while standing to go pee, and be tall enough to do so without a stool.  And I require him to sit still when he's on the potty.

After about 15 minutes of working at learning to use the potty, and realizing that he's going to have to work at this, each of our children has decided that they want to quit.  *chuckle*  I have to actively encourage them the entire time, making games, applauding, using enthusiasm in my voice, building them up, telling them, "No, we're going to use the big potty now and have big boy underpants, just like daddy, and Brandon, and Riley..."  Once we start the training it's really important to not go back to diapers, which would be confusing to the child.  We make sure the child is ready, build it up as a great experience and how big they are now, and move forward.  No going back.  

Now I did mention that I had to stop training with Brandon, our 3rd child, because he was not physically able yet to do any of this training, I could see after about 5-6 hours of persevering and hard work.  But there's a difference between being ready and not wanting to do it, verses simply not being able to do it yet.  He was just too immature physically.  We went back to diapers until we re-trained at age 4 1/2-years.  But that's the only time I've come across that problem.

While training we do not have any toys in the bathroom initially, which would divert his attention from the task at hand.  He and I just talk, and interact, and maybe sing songs.  After he's gone in the potty a few times, after maybe 60-90 min., I will introduce one toy like a book or two, or a match box car (something small that won't likely get wet when he pees).  Then the child needs to learn to break his concentration during his play and remember to use the toilet when he needs to.  Sometimes I give him a hand towel to sit on in the bathroom because it's softer and warmer than the cold floor, and I sit on one so that my ankle bones don't hurt on the floor, or I sit on a short stool.  (I don't use large towels, however, simply because when he pees and the large towel gets wet, then I've got way bigger laundry to take care of and clean up, multiple times.)

 
We continue to do dry pants checks and rewards every 5 minutes, gradually spacing them out to 15 minutes if he's starting to stay dry longer; I never spaced the pants checks out this time with Tyler, we continued doing 5 minutes for the first 4 hours because he was peeing fairly frequently.  He would go on the potty when I suggested that he do so, but was not initiating going potty by saying, "Oh, I have to go potty!", which I was waiting for.  He needed to do this before we would expand our environment to the family room, where he would then need to think there, too, when he needed to use the potty.

I also took photos of Tyler this day for the blog, and it turned out to be a great idea because on the digital camera I could show him the pictures!  *smile*  He loved seeing himself sitting on the toilet going potty.  I never realized before the a child really doesn't know what they look like there using the potty; this seemed to really please him and encourage him and I will do it next time I train as well.  Sweetie boy.

After he would pee on the potty, we would call a family member like grandma or grandpa, or daddy or brother, and tell him of his success.  This is very exciting for children, too.  *smile*

 

After hours we were making progress, and accumulating a lot of wet pants, or pooey pants, and cleaning cloths in the dish tub.  Here's our supply counter at that point.  The tub is filling up, almost ready for a first cycle of laundry to be started.


Near lunch time I tried to get Tyler to eat a string cheese - something "real" and healthier for him as he's had only sugar since breakfast...

 

He never ate it.  *chuckle*  *shrug*  I'm not surprised.  Oh well, it's only for one morning.

This whole training process takes patience for me, too, as I need to allow him to be doing everything for himself.  And I need to remember to only give him one direction at a time.  He needs to each time get the stool ready.  Lift the toilet lid.  Stand up on the stool and pull his underpants down.  Sit down.  Sit back far enough so the pee doesn't go out the front or under the seat on to the floor.  Point his little bottom down in front with one finger so that the pee goes strait down.  Then stand up.  Pull up his under pants, one hand in the front and one in the back.  Step down from the stool.  Close the toilet lid.  Flush the toilet.  He loves doing everything by himself, and I need to let him do it.  It is SO tempting for me to reach in and do it with him or for him, but this really takes away from his becoming a big boy, and becoming independent in his toileting.  I still go in to the bathroom with him every time he needs to use the toilet for the first weeks or months until I can trust him to do so himself responsibly (from our experience, boys tend to desire to use the bathroom as a science lab, so they need accountability for a while).  But he does everything all by himself, and he learns quickly, even after just a couple of days, to do so pretty quickly and efficiently.

After he's initiated going on the potty a few times then we put away all of the training supplies - drinks, cookies, chips - and clean up the bathroom.  I leave the tub and under pants in there for a week or so, though, for convenience.  The rest of the family is still gone, but little son is allowed to play in the family room and kitchen areas.  Here he needs to break his concentration on toys and run to the potty when he needs to.  And we do practice running to the bathroom, to encourage him to do so when he needs to go; no doddling, and no losing his way.  *smile*  

When he has an accident on the floor, I clean it up and he changes his under pants.  The book says to have the child clean everything up, but the book was originally written to help mentally disabled children or young adults learn to toilet themselves, who are much larger, grown people.  I really don't want a child's help cleaning up potty from the floor, so I do this part.  But then we need to "do practices" of what he should have done when he had to go potty.

After the child is clean again, we go to the place where the accident occurred and I say enthusiastically, "Okay, what should you do when you need to go potty?"  Then I tell him, "Say, 'I have to go potty!'"  He repeats after me, and then runs to the bathroom where he goes through all of the motions as if he were going to go potty but without actually going.  This is just practice; I want him to actually initiate having to go potty by himself, so I don't encourage him to actually go pee at this time.  We do this practicing 5 times from varying places in the family room and kitchen area.  The book says to do 10 practices, but that seems like a lot for a little child, so we only do 5 (and that still takes a long time, and seems like a lot, but it's important).  After the child has had no accidents for one whole week we discontinue the practices... This is what I strive for anyway.  *wink*  Sometimes it's not quite that long.

I try to, and have always been able to so far, finish before nap time.  If we're not quite done then little son would have a shorter nap than usual, and we'd keep training.  I put him in a Pull-Up for nap time, but I never call it a diaper; we call it a Pull-Up, or "sleeping pants."  *smile*  We've built up being done with diapers forever, and he should never consider the Pull-Up an option to be used willfully as a diaper.  Usually the kids don't need Pull-Ups during nap time, though, because it's such a short amount of sleep (2 hours), and it's not as deep of a sleep as night time is.  Tyler, whom I'm training this time, has used his pull up sometimes, though, and has gone poop in it during nap time, so we'll keep using Pull-Ups for a little while.  Usually he's dry, though.  Children younger than 2 1/2 should use a Pull-Up at night as they're just not physically ready to be dry all night.

It's common for pooping in the toilet to come a little later than peeing does.  Pooping just seems to be scarier.  Sometimes this doesn't happen for a few days or (prayerfully not) a  couple weeks.  When I toilet trained our first daughter and she pooped in the toilet she freaked out, like she had lost s limb into the toilet!  *laugh*  Poor baby!  Being only 2-years-old she had no idea what that thing was in there.  And I had to come up with as graceful of an explanation as I could.  I said something like, "Well...that's...lunch..."  *laugh out loud!*  And then had to explain in a few sentences that she eats food, and goes all through her tummy and then back out again.  Eww - I know - sorry, but I'm trying to help you be prepared.  *laugh*

After the training is complete I continue to prompt the child to go potty 6-7 times each day, or about every 2 hours, for about a week.  And we continue to do dry pants checks and praise for dry pants (and other family members do this, too).  But there are no more treats for dry pants after the bathroom training is done.  I don't require that he go potty every 2 hours, I just ask him if he needs to go.  But I do require that he sit on the potty for 1-3 minutes and really try to go just before going to bed for naps or night time, and before we go in the car.  And he does end up peeing nearly every time during those required times.  

So after this 4-6 hour concentrated training in the bathroom, the child knows everything they should do to go potty and is able to do it by themselves.  I expect accidents for a couple of days after that, sometimes up to a week or so, but then there aren't many accidents.  Training is pretty much done, give or take some variation as all children are unique.  *cheers!*  *laugh*



Some extra tips

The book suggests using a toddler potty chair and teaching children how to use it and then dump the little cup from the toddler chair in to the bit potty and flushing that down.  I've used these little chairs in the past with the first few kids, but I didn't like it at all.  It added at least 2 additional toilets for me to clean (one down stairs, and one upstairs), it made one extra thing for me to keep very little kids hands out of, it was in the way in our small bathrooms, and it then became a necessity at other people's houses or in public which was a problem (because the big potty was scary to use), so we just abandoned using them.  And training children when they're older is another benefit in not having to use those little plastic toilets.  When the child is 2 1/2 or 3, they are usually big enough to not feel like they're going to tall in to the water when they sit down. 

I found a brilliant item I would encourage you to purchase for a newly potty trained child.  It's called a Piddle Pad, sold online through Amazon for $7.53.  It's a little car seat cover a child can sit on that protects the seat from getting wet, or stinky from pooey pants.  We own two for when we've had two children who needed them, but now I'm also grateful to have two so that when I need to wash one and hang it to dry I have another one to use in the mean time.  I was always a little stuck before when the pad was hanging to dry and I didn't have one then to use if we needed to go in the car again within the next day or two.  No more!  *cheer!*  It's worth it to me to buy two!





I also just discovered these nifty little gadgets for toilets, Fold-able, portable potty seat with handles, from Amazon ($8.99).  I don't have one, but it sure seems like it would be useful especially if you have a smaller or younger child who may be afraid of falling into a big toilet.
Here is another great idea I think, especially if you are training a little girl who cannot go pee out in the grass behind the car as easily as a boy can if necessary.  *wink*  The Fisher Price Portable Potty ($18.98 from Amazon).  I don't own one yet since the last child to potty train was a son, this one I just trained is a son, and the next one will be a son; but when our girls train, I think this would be really helpful. 


I also pack a little bag and keep it in the car for the newly-trained muffin, in case of accidents while away from home.  In it I put:
  • An extra pair of under pants.
  • An extra pair of shorts or long pants.
  • An extra shirt (sometimes theirs gets wet as well).
  • An extra pair of socks because sometimes pee runs down in to their shoes if they're standing up somewhere.
  • Some plastic grocery bags to put the wet clothes into to take home.
  • A small package of baby wipes to clean up pooey accidents (rare, but they do happen).  I like to use a 1/2 used-up package of Kirkland Signature (Costco's brand) baby wipes, just to keep the package small in the little bag.  I use this brand exclusively because they are so cheap, nice and thick, and they stay wet forever, not drying out like every other brand I've ever used (and there's nothing worse when you need to clean up pooey messes when out!).  Here's an example, I just cleaned out Tyler's diaper bag that's been in the van and I discovered (judging by the onesies and containers of cheerios still in there) that I haven't used it in about a year-and-a-half...and the opened package of KS baby wipes in there are still wet.  I'm so impressed.  *chuckle*
  • And a mini bottle of Purel hand sanitizer for my hands.



~~~~~
Now I would still so encourage you to pick up a copy of this book, Toilet Training In Less Than A Day and read it for yourself.  You can get a used copy off of Amazon for as little as $2.00.  I have pulled out the strategies that were perfect for our own family's use, but there is more information that may apply to all types of families, regardless of the amount of experience your child has with toilet training.  The book was originally written to enable mentally disabled children to learn to toilet themselves, so there are strategies given for training from basically no knowledge at all of how to use the toilet if necessary.


Blessings on your efforts with your family,

Recommended resources:
Toilet Training in Less Than a Day, by Nathan H. Azrin, Ph.D.

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