Potty Technique

Potty training with Emma is coming along really well.  She understands potty and when I ask her Yes/No if she has to go she is pretty quick to respond.  However, she does not initiate requests to go to the potty so that makes it a bit tricky.  For now we have her on a schedule and she mostly has dry diapers but some days her schedule doesn't mesh with our planned activities so there are days when I let the schedule "slip" a bit.  Not often, but it does happen.  Also, when we are out and about she is getting a bit better about sitting on public toilets about 50% of the time, but the other 50% she still tries to arch her back and not sit on the seat so it's a hit or miss in public.  The only exception is the little potties that are in the restrooms of the Children's Hospitals we visit.  She loves to sit on the little potties and I can't blame here - they are much cuter than the huge ones in the public handicapped restrooms.

We've had various methods and techniques for Operations Potty Train Emma and what I've been doing lately is working well.  Since Emma is very long and getting longer by the day in addition to getting heavier as she ages I want to get her used to being changed without a changing table.  I'm still very friendly with her OT from Early Intervention and she suggested I try having Emma stand for diaper changes and I loved that idea.  Now, instead of moving her to bathroom and back to living room to put on her diaper then back to the bathroom to wash her hands, my current method is all done in the bathroom and it also works for when we are in public.  Plus it saves my back a bit and decreases the time needed for potty breaks.

This is our current method:

1. Place Emma on potty at appropriate time
2. When she is done have her do a word approximating for All Done.  She would love to just cry or fuss but that doesn't get her off and so she is getting pretty good at the word approximation of All Done.
3. Set up our kitchen stool so that it is leaning against the door jamb so it can't move. 
4. Take Emma off potty and lean her over the stool.  If her legs are crossed move them apart a little. Put on diaper while she is in standing position.  It took a few tries to get the hang of putting on the diaper while she is standing up but now it's a piece of cake.  I also stand right behind her so she can't fall backwards since she does hang on the stool and it could fall backwards even though it can't move forwards.  Note:  When we are in public restrooms, I make sure her chair wheels are locked and lean her over the side of her wheelchair so her hands are on the seat and her belly is against the armrest and it works fine.  
5. Turn stool around and stand Emma on the bottom step so we can wash her hands.  She is now trying to get her arms up to turn on the water and she is making progress towards that each day.  Washing hands could be Emma's FAVORITE part of going to the potty.  

And here are some photos showing our method.  If anyone reading this blog has questions or suggestions please leave me a comment.

Potty training update

There are a few people who asked for more information on the potty training, so I wanted to post an update on how it is going now that we have the new supported toileting seat.

The potty training is in full swing!  Emma seems to love her potty seat, loves going in the actual bathroom, loves washing her hands afterwards, loves helping me switch the light on/off, loves the praise she is getting.  She really is ready for this stage of her life and I'm happy that we are able to support her in meeting such a huge milestone!

The biggest issue with our potty training is that she still is not able to tell us when she has to go.  She does have a sort of fuss, but it could be a general you're not paying me any attention fuss or an I have to go to the bathroom fuss or any number of other reasons why she might want to be a bit fussy.  Each time she does fuss, though, I ask her if she has to go potty and give her the Yes/No hand gesture to tell me and each time she does respond.  Truth be told I wasn't so sure in the beginning if she was saying Yes/No with intention when it came to the potty questions.  But, she has totally made a believer our of me!  Emma knows when she has to go - and always picks the correct hand.  There were a couple of times when I thought for sure she didn't have to go but since she said Yes I put her on the potty and sure enough she went!  I shall doubt my Emma no more - it's completely evident to me that she does not want to go in a diaper anymore and would chose the potty if given the opportunity.

The other issue with the potty is that Emma can't sit or stand independently, so it makes potty training harder than wearing a diaper on her caregiver (i.e., usually me).  I had her in diapers but today switched her over to pull-ups.  Our bathroom does not have a changing table in it or anywhere to put Emma to put on her diaper that is pretty much always dry.  So what winds up happening with the diaper is that after she goes potty I take her to another room or lay her on the kitchen floor to put on her diaper.  Then, I take her back to the bathroom to wash and dry her hands and mine and then take her back into another room to continue whatever we are doing.  With the pull up I basically pull down her pants and pull up, put her on, take her off and pull up her pull up and pants, wash our hands and then go about our business.  This is much better on my back so I decided to implement this method sooner rather than later.  I think the switch to pull ups is a good one and hope that it continues to work out for us.  For now, though, when she is not at home we will continue with the diapers.  We are not trying to potty train in public right now (the only exception is school) since Emma is not very cooperative in public restrooms and we don't have all the logistics of it figured out just yet.  One step at a time......

And I'll leave you with a couple photos of Emma working on kneeling while watching Sesame Street.  She loves that show and I let her watch a bit after school while I position her to work on certain skills such as sitting, kneeling, pull to stand, etc.  It's quite sneaky of me since she has school and therapy in the morning before she comes home for lunch and a bit of tv followed by a nap.  This week she was interested in kneeling....that is until she wasn't!

Interested in kneeling and talking to Abby Cadabby

I think she is saying "Mom, give me a break!  Can't I just get a little snuggle while I watch the tv????"

Notice that she was doing so well that I felt OK to move away from her to take a photo?  Way to go my Emma Bean!

Little updates

The other week at school Julia's class was studying the letter L.  They had an activity where the children finished this sentence:  "Love is ...."  and then they illustrated their sentence and it was put on the bulletin board outside their classroom.  Julia wrote:  "Love is making crafts for my sister!" and her illustration is a picture of her and her sister with a heart and the word love.  My heart melts every time I think of this picture and sentence.  Julia is such a special little girl.  How lucky we are to be blessed with such amazing little girls!

In other news, Emma received her new toilet seat today!  I've posted on here before about our goal to potty train Emma this year - or at least get her into pull-ups most of the time.  She is doing really well at home and is mostly dry and using the baby potty instead of her diaper.  She started doing well at school, too, but she now has a new aide and is giving her a bit of a hard time and is refusing to sit on the potty seat at school.  I tried to get her on the seat with her aide at school and Emma refused me, too!  She can be quite stubborn when she wants and her legs are really hard to bend if she doesn't want them bent.  Once Emma gets more comfortable with her aide she should start to cooperate more with the potty training.  In the meantime we are working hard at home to move from diapers to pull-ups.  

I'm thrilled that Emma's Rifton potty seat arrived today!  It's the same one she uses at school so I'm hoping using it at home should make her more comfortable with using the same model at school with her new aide.  Here she is - fully clothed - testing out the seat settings while watching her beloved Sesame Street.  She looks like such a big girl in her potty chair, right?!!!  

The most exciting part of this chair for me is that it can be rolled over the toilet so I don't have to empty the chamber - score one for me!!!!!  Or, it can be used anywhere in the house with the chamber attached.  As of now I think we'll mostly use this in the bathroom because Emma is a big girl and needs to get used to going in the bathroom and having a bit of privacy.  

I think we'll have to take the baby potty we've been using with us when we are on the road because right now we don't know of any fully supported portable potty chair.  Anyway, we'll figure it out as time goes on like we always do.

Potty Talk

Right around Emma's third birthday we started using the potty with her.  She seemed to get the hang of it pretty quickly and was really proud of herself when she went.  We tried to carry over the potty training at school but they weren't really good at putting her on the potty.  They didn't seem to want to do it and only after I asked them every....single....day about the potty did they put her on a couple of times.  Emma never did go on the potty at the school for them and I think it was mostly because the infrequency of it and the lack of a supportive potty and ample amount of time allotted to potty.  Needless to say, that made it pretty hard to potty train our little one.  Plus, it was really hard on my back and so we put the potty training on the back seat for a while.

This summer we took a long trip to Ireland and moved, putting potty training to the very bottom of my list of priorities.  Truthfully, it's much easier to just change Emma's diaper than figuring out all the intricacies of  potty training a non-verbal, non-mobile little girl.  Once we settled down in the house we figured it was time to start potty training again and started up again with our little wooden potty.  We also talked with her OT about ordering an adaptive one for our house.  Potty training was ON!

Emma at fountain in Love park.  Fountain is purple in support of ending domestic abuse.  She looks so grown up!

We set a schedule to sit Emma on the potty and decided to stick to it for a few weeks so Emma could get the rhythm of going on the potty and could start to anticipate the times she would get on the potty.  My idea is that if she knows there are certain times she will get to go, then she will start to hold it in anticipation of her next opportunity.  Right now she doesn't tell us when she has to go, but she does make sounds when she is all done and ready to come off the potty so that's at least a start.

Key to all of this potty training is carryover at school.  Emma really is becoming a big girl and she really wants to do big girl things and going on the potty really makes Emma proud.  I didn't want our second attempt to fail like the first and I was so happy that her school was completely on board.  The day Emma started school they set her up in a potty that gives her amazing support.  It was fitted and cleaned and available for her exclusive use on her second day at school.  The first time she used it, she went on the potty!  Horray for going at school!

We've been working on potty training for a couple of weeks now.  It's going ok.  Some days are better than others, but the last two days have been amazing with lots of dry diapers!  The biggest challenge I have is what to do when we are out in public?  Public restrooms are so not set up for us.  And from what I can tell there aren't any portable potties for kids like Emma.  I've asked around and no one has any great solutions.  Maybe there just isn't any good solution, but if anyone reading this has any ideas please let me know.  In the meantime I'll dig out our traveling fold-up potty seat we used for Julia and hold Emma on the potty.  I can already feel my back hurting thinking about it ;-) but Emma is so worth it.

Here is our current schedule of when we place Emma on the potty:

• After waking up
• When she arrives at school she has her hearing/CIs checked first thing, then off to the potty.  That is about 8:45am.  On days when she doesn't have school, we do ~30 minutes after her morning drink
• Snack is at 10:30am so her next potty time is 11am.  
• School ends at 11:15 and she arrives home around noon and I put her on the potty again once she gets home.  
• After lunch but before nap - she doesn't usually go at this time so I might end up taking it out.  
• After nap - she has been waking up dry and so this is a key time to put her on the potty!
• Before dinner
• Before Bath
• Before Bed

Emma is using the Rifton Blue Wave Small at school and we are ordering the same one for our house.  She looks great in it, has show that she has no problem using it successfully, and it's nice to be consistent.  Plus, it has a couple of features that are nice like going directly over the toilet or using a pan, a tray to set her arms to keep herself upright (might not need to use all the straps), and wheels to move it around easily.  I have no idea how long it will take before we get it approved so we are using our wooden potty seat in the meantime.

My big girl getting on the school bus!

Her school also set-up a checklist that they include in her communication book everyday.  It has four columns on top:  Sat on Potty, Urinated on Potty, Urinated in Pull-up, Notes.  It has two columns on the side:  8:45am, 11am.  Her aid puts a check in the appropriate spots.  This morning she had a check at 8:45am sat on potty, 8:45am urinated on potty, and 11am sat on potty.  I love that I know what is happening with potty training at school.  I love that they are so responsive to my requests - I only asked once if they could let me know if she is "successful" on the potty and the very next day they started to include this checklist.  They also made a checklist for her equipment and time in each so I know what equipment is used during the day and can make decisions for what to use at home.

All smiles when she arrives home from school!

I'm hopeful that this time Emma will be fully potty trained.  I'm even hopeful that she'll have to add princess underwear to her Christmas list.  I know pull-ups will continue in our future - especially when an accessible bathroom isn't viable and for bedtime - but I am so very proud of how Emma is doing and will follow her lead to when the timing is right to take the leap forward to underwear!