1. Diapering and Toilet Training
O’Brien-Chapter 9

2. 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

3. 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)

4. 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

5. 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

6. 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

7. 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

8. 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

9. Analyze a video Watch the video:
Lessons in toilet training!
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?

10. 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
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.

11. 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

12. 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

13. 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