Toilet Training with Down Syndrome: Intensive TT

*This is going to be long and detailed for those who actually want to know! 

Based on: Toilet Training for Children with ASD/DD Presented by: The Kelly O’Leary Center for ASD Division of Developmental and Behavioral Pediatrics Cincinnati Children’s Hospital Medical Center with support from Hamilton County Developmental Disabilities Services

Friday morning Hannah woke me up around 6:30am - sleeping in, believe it or not. :: eyeroll :: We came downstairs and I let her have a snack and watch Trolls while I tried to wake up, have my hot lemon water, then coffee... by 7:45am I’d put all my tools and toys in the upstairs bathroom and it was Go Time.

NOTE: even a small dribble in the toilet counts - holler, praise and reward! Keep pushing fluids all day.

Hannah is three years, three months at the time of training.

7:41am: pee & poop / reward of Cheese Puffs & Trolls in our bedroom 5 minute break
7:47am: pee (assume from here out all voids are rewarded) 5 minute break
7:52am: sit for 30 minutes (This was difficult to keep her entertained... she definitely became irritated towards the end which is when I went for the small blanket to ease her bum!) 
8:22am: no void, so only a 2 minute break inside the bathroom
8:30am: small poop 5 minute break
*At this point, because Hannah had 3 voids in the toilet, sit time is decreased to 25 minutes and break time is increased to 10 minutes.
8:35am: pee 10 minute break
8:45am: pee 10 minute break
8:55am: sit for 25 minutes and had no void 2 minute break
9:33am: pee 10 minute break
*Hannah had three 10-minute breaks with no accidents, so we move to 20 minute sits and 15 minute breaks.
9:43am: sit for 20 minutes, no void, 2 minute break
10:21am: pee 15 minute break
10:36am: pee 15 minute break
10:51am: pee 15 minute break
*Hannah had three 15-minute breaks with no accidents, so we move to 15 minute sits and 20 minute breaks.
11:06am: pee 20 minute break
11:26am: pee 20 minute break
11:46am: poop 20 minute break
*At this point in the program, Hannah has been very consistent with no accidents, so now we move to Initiation Training: set a chair next to the toilet and Hannah has to communicate her need to go. The child either gets on the toilet themselves or you can help them. 
12:22pm: poop 25 minute break (we chose to go this long, not called out by the program)
12:47pm: sit for 15 minute on chair, no void, 2 minute break 
1:08pm: pee 25 minute break
*ACCIDENT* on tarp in bedroom, even after peeing in toilet!
1:21pm: Initiates (Hannah SAYS “potty”) pee
*At this point, we try to get Hannah down for a nap - with a diaper - but she’s a smart booger and asks to go potty to get OUT of napping, so she asks to pee both at 1:39pm and 1:44pm
NAP FAIL
2:57pm: sit for 15 minute on chair, no void, 2 minute break 
3:12pm: sit for 15 minute on chair, no void, 2 minute break 
*I decide to remove the chair from the bathroom and just chill inside to see if she’ll initiate
3:42pm: initiates pee 25 minute break
4:11pm: initiates pee 25 minute break
4:37pm: initiates pee

I’d been emailing Dr. K throughout the day and she was very responsive which was great. I told her that Hannah had been consistently asking to go “potty” and if it was okay that we pick her up to rush her to the restroom. She said YES. The goal is for the child to acknowledge the physical urge and address it. She told us “Congratulations, you’ve made it to the other side!”

We made it here by the afternoon of the 1st day!

All day in the small bathroom...