How to potty train a 4yo who won't sit on the toilet?

[Anonymous]

Anonymous wrote:To the person who said put her in underwear and put her on the toilet every 45 minutes - this is not realistic for a child who becomes hysterical when you try to put her on the potty. She has some huge sensory aversion.

You need to start potty exposure early. So, they are used to it. We'd limit the iPad to potty time. At 4, our child could go but not tell us or prompt us non-verbally so for months we did every 45 minutes till it clicked. ABA was a waste of time for PT. So were bribes, sticker charts and all that fun stuff.

[Anonymous]

Anonymous wrote:To the person who said put her in underwear and put her on the toilet every 45 minutes - this is not realistic for a child who becomes hysterical when you try to put her on the potty. She has some huge sensory aversion.

It's not a huge sensory aversion if she sits on the potty fine at PEP. What do they do there that you don't do at home? I'm guessing they put her on it as part of a routine that doesn't change- something like playground, potty, wash hands, have snack

[Anonymous]

Anonymous wrote:

Anonymous wrote:To the person who said put her in underwear and put her on the toilet every 45 minutes - this is not realistic for a child who becomes hysterical when you try to put her on the potty. She has some huge sensory aversion.

It's not a huge sensory aversion if she sits on the potty fine at PEP. What do they do there that you don't do at home? I'm guessing they put her on it as part of a routine that doesn't change- something like playground, potty, wash hands, have snack

+1. The first goal is sitting, then doing something on it. They are probably really consistent and they don't ask, they say its potty time and everyone goes.

[Anonymous]

OP here. Thank you for the replies. She was diagnosed by dev ped who said the stool withholding goes along with diagnosis and sensory issues and advised OT. OT is no help - she is really young and inexperienced but DD loves her so I am sticking with her so far. I didn't even know about ABA so I could not ask dev ped about it. Also, other than PEP, OT and Speech Therapy, there were no other recs. No one including pediatrician really addresses the encopresis/inability or lack of desire to potty train for past 2 years - it's just been chalked up to her diagnosis of ASD. The weird thing is that she does not have anything I can bribe her with to even sit on the potty - I'm not sure she really understands bribes - like you get this if you do this - she can't make that connection? Maybe she is more moderate than mild on the spectrum or just intellectually more behind. Last year at school, they just changed her diapers, but this year I asked them to attempt to potty train so they said they put her on the toilet - which was great news and I thought I could do that at home but to no avail. I guess I have to figure out how to get that into her routine and convince her to go. Right now if she has to use the bathroom, she just hides somewhere but never the bathroom! She also doesn't care if she walks around in a wet or soiled pull-up/diaper; I have to wrestle her down to change her, and we do this in the bathroom and flush the poop down the toilet so she can make the connection - she does like flushing the toilet so that's not the problem... from what I see, it's her desire to hold onto her stool and not fully go (she hides and tries to hold poop in) - which she can do in a diaper/pull-up (or underwear) but not if she is sitting on the toilet. I'm not sure how to break this desire not to poop! It seems so unnatural. Her siblings have tried to help and be good examples, but she is not interested/ignores us/them when we talk about the issue. Sorry for the long post. I would love to hear from anyone who has gone through this and how it eventually was treated.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To the person who said put her in underwear and put her on the toilet every 45 minutes - this is not realistic for a child who becomes hysterical when you try to put her on the potty. She has some huge sensory aversion.

It's not a huge sensory aversion if she sits on the potty fine at PEP. What do they do there that you don't do at home? I'm guessing they put her on it as part of a routine that doesn't change- something like playground, potty, wash hands, have snack

+1. The first goal is sitting, then doing something on it. They are probably really consistent and they don't ask, they say its potty time and everyone goes.

Exactly. You make potty time a routine.

[Anonymous]

My ASD kid was similar. This is what we did:

1. Bribes - there has to be something. I took DS to the store, we bought an awesome toy and said he could open it after he pooped. We put it in the bathroom and he got to look at it as he sat there. Does that sound mean? I guess... but it worked. It cost us a lot of money and time! Maybe psychologists wouldn't agree but our kid learned to poop on the toilet.

2. Exercise -- help the bowel movement along by getting them active. Climbing up and down the slide and all that bending motion really helped!

3. Fruit -- all the time! Citrus really helped get things moving so that he felt the sensation of needing to go.

4. Miralax -- we were up to a full cap at one point! Ugh. I hated those days. There were days I kept him home from pre-k bc I was afraid he'd explode from all the fruit and miralax.

5. Enemas -- this was the real turning point for our DS. We had to give him three enemas over the period when he didn't go regularly. The last time, he said he never wanted to have that happen again. We both cried. He said that he would go on his own... He said he would eat veggies and go everyday...and from that point on, he did!

We all know how frustrating and exhausting this issue is for the entire family. We had so many days where we had to reschedule or work around our child's poop needs. It was such a tough time.

[Anonymous]

You don't sound committed to PT. My kid would not take bribes, could not tell us when he had to go, etc. It was pure consistency and putting him in underwear. Every 45 minutes. It wasn't an option. It took months and it took a year after that of constant reminders before he could go on his own.

[Anonymous]

OP, I had a very stubborn 4 year old who only pooped in a pull up but perhaps what I did will work for you. Step 1: When she asked for a pull up, I told her she was a big girl and she had to go on the potty and I wouldn't give her a pull up. I let her cry for 5-10 minutes and then I "gave in" and said you can have the pull up, but only if you agree to go in the bathroom. I then had her go in the bathroom for 2 weeks to make sure she was comfortable there. Then the harder step was when she asked for the pull up, I said no again, she was a big girl and she needed to use the toilet. I let her cry for a long time again and finally "gave in" and said she can have the pull up but only if she sits on the toilet in the pull up. Then after another 2 weeks of her sitting on the toilet in the pull up I started cutting a hole out of the bottom. But there was no amount of bribes that would have worked on my kid, she just never wanted anything enough.

[Anonymous]

Is your child non-verbal? If so, just be consistent. It can be a long process, but take away the diapers/pull-ups and make it a routine ie: start going every 30 Minutes and build up to every 2 hours. It won't be easy but you absolutely have to be dedicated and very consistent. I thought my DC would never be out of diapers. PEP-C was useless and not working for DC. I was able to get DC into CAPP and they had him toilet trained in 2 weeks. I was blown away. Bribes never worked for my child, but their strict system did. Poop took a lot longer than peeing but eventually got there! GL.

[Anonymous]

Anonymous wrote:

Anonymous wrote:To the person who said put her in underwear and put her on the toilet every 45 minutes - this is not realistic for a child who becomes hysterical when you try to put her on the potty. She has some huge sensory aversion.

You need to start potty exposure early. So, they are used to it. We'd limit the iPad to potty time. At 4, our child could go but not tell us or prompt us non-verbally so for months we did every 45 minutes till it clicked. ABA was a waste of time for PT. So were bribes, sticker charts and all that fun stuff.

There is actually no evidence that supports this. You can even search pub med if you don't believe me. Also, introducing electronics can backfire.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To the person who said put her in underwear and put her on the toilet every 45 minutes - this is not realistic for a child who becomes hysterical when you try to put her on the potty. She has some huge sensory aversion.

You need to start potty exposure early. So, they are used to it. We'd limit the iPad to potty time. At 4, our child could go but not tell us or prompt us non-verbally so for months we did every 45 minutes till it clicked. ABA was a waste of time for PT. So were bribes, sticker charts and all that fun stuff.

There is actually no evidence that supports this. You can even search pub med if you don't believe me. Also, introducing electronics can backfire.

It depends on the child. It worked for us. Our child could go on the potty, but there was far more too it than just actually going. Evidence or not, reality is you have to be very consistent for months. My child PT around 4. We had to force the issue.